肺容量与弥散功能在不同严重程度慢性持续性哮喘中的表现  

Lung Capacity and Diffusing Capacity in Patients with Chronic Persistent Asthma with Different Severities

作　　者：杜晶[1] 李林蔚[1] 祖萍[1] 邓燕[1] 何太灵[1] 袁玉茹[1] 梁斌苗[1] 

机构地区：[1]四川大学华西医院呼吸与危重症医学科,四川成都610041

出　　处：《中国呼吸与危重监护杂志》2016年第1期60-63,共4页Chinese Journal of Respiratory and Critical Care Medicine

基　　金：四川省科技厅支撑计划(编号:2014SZ0010)

摘　　要：目的探讨不同严重程度慢性持续性哮喘患者肺容量和弥散功能的特点及临床意义。方法收集2014年1月至2015年4月就诊于四川大学华西医院呼吸与危重症医学科门诊的慢性持续期哮喘患者,记录其临床资料以及肺通气功能指标[第1秒用力呼气容积(FEV_1)],采用体积描记法和气体稀释法测定肺容量指标[肺总量(TLC)、残气容积(RV)及RV/TLC],采用单次呼吸法测定肺一氧化碳弥散量(D_LCO)。根据患者的临床症状和FEV_1占预计值百分比(FEV_1%pred)将这些患者分为轻度、中度和重度,对组间资料进行比较,并对肺通气功能指标与肺容量和D_LCO%pred的关系进行相关分析。结果共纳入93例哮喘患者。随哮喘患者严重程度的加重,肺容量指标(TLC、RV和RV/TLC)逐渐增加,而且体积描记法和气体稀释法两种方法之间的差值△TLC%pred、△RV%pred和△RV/TLC逐渐增加。随FEV_1%pred的降低,D_LCO%pred则稍有下降。相关分析显示,FEV_1%pred与△TLC%pred、ARV%pred和△RV/TLC呈显著负相关,与D_LCO%pred呈显著正相关。结论与气体稀释法相比,体积描记法能更准确地对哮喘患者的肺容量进行测定。随气流受限程度加重,哮喘患者弥散功能逐渐下降,但仍在正常范围。Objective To assess the lung capacity and diffusing capacity in patients with chronic persistent asthma with different severities. Methods Patients diagnosed with chronic persistent asthma in West China Hospital between January 2014 and April 2015 were recruited in the study. The data of clinical characteristics were collected. The forced expiratory volume in the first second （ FEV1 ） was determined by spirometry test. Total lung capacity （ TLC） and residual volume （ RV ） were determined by body plethysmography and helium dilution method. Single breath diffusing capacity for carbon monoxide （ DLCO） was also measured. Lung capacity and the deviations between two methods, and DLCO% pred were compared among different patient groups with mild, moderate and severe asthmas. The correlation between spirometry with lung capacity and DLCO% pred were analyzed. Results A total of 93 patients with chronic persistent asthma were enrolled.With the severity of asthma, TLC% pred, RV% pred, RV/TLC and the deviations of the ones between two methods increased significantly, but DLCO% pred reduced slightly. FEV1% pred were negatively correlative with the deviations of lung capacity between two methods, and positively correlative with DLCO% pred. Conclusions Compared with helium dilution method, the body plethysmography is more accurate for evaluating the lung capacity of chronic persistent asthma.With the severity of airflow limitation, the diffusing capacity of asthma is decreasing gradually, but still within the normal limits.

关 键 词：哮喘 肺容量 一氧化碳弥散量 

分 类 号：R562.25[医药卫生—呼吸系统]