弥漫性泛细支气管炎患者肺通气不均指数水平及其应用价值  

The Application of Acinar Ventilation Inhomogeneity Indices in Patients with Diffuse Panbronchiolitis

作　　者：许惠娟[1] 宋梅[1] 方雪映 姚楷涛 XU Hui-juan SONG Mei FANG Xue-ying YAO Kai-tao(Respiratory Medicine, The Second Affiliated Hospital, Shantou University Medical College, Shantou 515041, China Department oF Oncology, The Second Affiliated Hospital, Shantou University Medical College, Shantou 515041, China)

机构地区：[1]汕头大学医学院第二附属医院呼吸内科,广东汕头515041 [2]汕头大学医学院第二附属医院肿瘤科,广东汕头515041

出　　处：《汕头大学医学院学报》2017年第1期22-25,共4页Journal of Shantou University Medical College

基　　金：汕头市医疗卫生科技计划资助项目(20150406)

摘　　要：目的:观察弥漫性泛细支气管炎(DPB)患者肺通气不均指数水平,评估肺通气不均指数对病情程度评估的指导意义。方法:收集长期随访的DPB患者16例,另设同期呼吸内科门诊体检的健康者16名为对照组。检测DPB患者第1秒用力呼气容积(FEV_1),用力肺活量(FVC),第1秒用力呼气容积/用力肺活量(FEV_1/FVC),一氧化碳弥散量(DLCO),残总比(RV/TLC);多次呼吸氮冲洗法(MBWT)检测DPB患者传导区通气不均一性指标(Scond)和腺泡区通气不均一性指标(Sacin)。Pearson直线相关分析观察Scond和Sacin与传统肺功能指标的相关性。结果:DPB组Scond和Sacin较对照组明显升高(P<0.001),且两指标与FVC、FEV_1占预计值%及FEV_1/FVC均负相关(P<0.01),与RV/TLC正相关(P<0.05)。Sacin与DLCO负相关(P<0.01)。结论:DPB患者存在显著的通气不均,与肺通气功能有相关性,且通气不均指数可预测DPB患者气流受限严重程度,对研究DPB小气道损伤部位以及判断肺弥散功能下降均有重要参考价值。Objective：To observe the ventilation indices in patients with diffuse panbronchiolitis（DPB）,and to evaluate the guiding significance of ventilation inhomogeneity indices on severity extent.Methods：Sixteen DPB patients and sixteen healthy subjects were recruited.The forced expiratory volume in one second（FEV1）,forced vital capacity（FVC）,FEV1/FVC,carbon monoxide diffusing capacity（DLCO）,residual volume/total lung capacity（RV/TLC） in patients were detected.Scond（conductivity ventilation heterogeneity index） and Sacin（alveolar ventilation heterogeneity index） in patients were detected by muhiple breath nitrogen washout test（MBWT）.The correlation between ventilation inhomogeneity indices and traditional parameters of lung function was determined by pearson linear correlation.Results：Compared with the healthy control group,Sacin and Scond in the DPB group were significantly increased（P〈0.001）.Sacin and Scond were negatively correlated with predictive FVC%,FEV1%and FEV1/FVC（P〈0.01）,positively with RV/TLC（P〈0.05）.Sacin was negatively correlated with DLCO（P〈0.01）.Conclusion：Sacin and Scondin DPB patients increases significantly,which is significantly correlated with lung function.DPB has ventilation inhomogeneity in conductive and acinar zones and the ventilation inhomogeneity indices can be used to evaluate the severity of DPB.

关 键 词：弥漫性泛细支气管炎 肺通气不均指数 小气道功能 多次呼吸氮冲洗 

分 类 号：R446.1[医药卫生—诊断学]