上气道顺应性对气道阻力的影响及其临床意义  

Effect of the Upper Airway Compliance on Airway Resistance and Its Clinical Significance

作　　者：黄桂芳[1] 王爱茹[2] 朱启上[2] 陈芙君[2] 

机构地区：[1]四川大学华西基础医学与法医学院生理学教研室,成都610041 [2]四川大学华西第四医院肺科

出　　处：《华西医科大学学报》2002年第4期515-517,共3页Journal of West China University of Medical Sciences

基　　金：四川大学校基金资助

摘　　要：目的　探讨上气道顺应性对气道阻力测值的影响及其临床意义。方法　按常规测定 110例慢性阻塞性肺疾病 (慢阻肺 COPD)及肺心病患者的 FVC、·V75、·V50 、·V2 5,同时用阻断法测定其气道阻力 Raw。并对其中71例患者进行支撑颊部 (降低上气道顺应性 )和未支撑颊部时 Rawc和 Rawu的比较 ,计算 Rawc/ Rawu的比值。结果　肺通气功能 ·V75、·V50 、·V2 5的实 /预 (% )为慢性支气管炎 (慢支 )组 >肺气肿组 >肺心病组 ;Raw测值则为慢支组 <肺气肿组 <肺心病组。 Rawc/ Rawu的比值 ,在慢支、肺气肿、肺心病分别为 1.0 1～ 1.0 3(平均 1.0 2 )、1.2 2～ 1.2 5 (平均1.2 4 )、1.15～ 1.2 2 (平均 1.19)。结论　对 COPD和肺心病患者 ,用支撑颊部以降低上气道的顺应性 ,可以改善用阻断法所测的 Raw,从而能正确测定 Raw值。Objective To study the effect of the upper airway compliance on the airway resistance (R aw ) and its clinical significance. Methods FVC, ·V 75 , ·V 50 , ·V 25 were measured in 110 patients with chronic obstructive pulmonary disease (COPD) and cor pulmonale by use of routine methods, and their R aw were also measured with interruption technique. The R aw were compared during unsupporting (R awu ) and supporting cheeks (R awc ) (to decrease the upper airway compliance) in 71 from among the 110 patients, and the ratios of R awc /R awu were calculated. Results The change of m.v./p.v. (%) in ·V 75 , ·V 50 , ·V 25 showed: chronic bronchitis > emphysema > cor pulmonale. The measured values of R aw were chronic bronchitis < emphysema < cor pulmonale. The ratios of R awc /R awu were 1.01 1.03 (mean≈1.02), 1.22 1.25 (mean≈1.24), 1.15 1.22 (mean≈1.19) in chronic bronchitis, emphysema, cor pulmonale respectively. Conclusion To decrease the upper airway compliance by supporting cheeks in COPD and cor pulmonale patients can improve R aw measured with interruption technique, therefore, the R aw value can be correctly measured in this way.

关 键 词：气道阻力 阻断性 上气道顺应性 慢性阻塞性肺疾病 肺心病 

分 类 号：R563.9[医药卫生—呼吸系统]