脉冲震荡法在不同严重程度哮喘患者小气道功能中的研究  

Study on the function of small airway in asthma patients with different severity by impulse oscillometry

作　　者：贺瑞珍 许建英 成孟瑜 HE Ruizhen;XU Jianying;CHENG Mengyu(Department of Respiratory and Critical Care,Shanxi Dayi Hospital Affiliated to Shanxi Medical University,Taiyuan 030032,China;Department of Respiratory and Critical Care,Shanxi Dayi Hospital;Department of Respiratory and Critical Care,Shanxi Dayi Hospital)

机构地区：[1]山西医科大学附属大医院呼吸与危重症医学科,太原030032 [2]山西大医院呼吸与危重症医学科 [3]山西大医院呼吸与危重症医学科

出　　处：《山西医科大学学报》2019年第6期793-797,共5页Journal of Shanxi Medical University

基　　金：山西省青年科技研究基金资助项目(201701D221261)

摘　　要：目的通过对慢性持续期哮喘患者进行脉冲震荡法及常规肺功能测定,探讨脉冲震荡法在不同严重程度哮喘患者小气道功能中的应用价值。方法收集2016-07~2017-06于山西大医院呼吸与危重症医学科确诊为慢性持续期的哮喘患者154例,并将其按第1秒用力呼气容积占预计值的百分比(FEV1%Pre)分为轻度(FEV1≥80%Pre)75例、中度(60%Pre≤FEV1<80%Pre)43例、重度(FEV1<60%Pre)36例三组。选择同期体检人员40例作为健康对照组。分别进行脉冲震荡法及常规肺功能检测,记录脉冲震荡法(R5、R20、R5-20、R5-20%、Rp、X5)及常规肺功能(FEV1、FEV1%Pre、FEV1/FVC、FEF50%、FEF25%-75%、PEF)指标。结果①哮喘患者与健康对照者两组间性别及平均年龄差异无统计学意义(P>0.05)。②与健康对照组比较,除轻度哮喘组FEV1/FVC无明显降低外,其余哮喘各组FEV1/FVC、FEF25%-75%、FEF50%和PEF均明显降低(均P<0.01)。哮喘各组间比较,上述指标差异均有统计学意义(均P<0.01)。③与健康对照组比较,哮喘各组R5、R20、R5-20、R5-20%、Rp和X5均明显增加(均P<0.01)。哮喘各组间比较,上述指标差异均有统计学意义(均P<0.01)。④哮喘患者脉冲震荡法各参数R5、R5-20、R5-20%、Rp和X5与FEF25%-75%相关系数r分别为-0.611、-0.587、-0.506、-0.624和0.560。其中,R5、R5-20、R5-20%和Rp与FEF25%-75%均呈负相关(均P<0.01)。X5与FEF25%-75%呈正相关(P<0.01)。结论慢性持续期哮喘患者脉冲震荡法反映小气道功能的各项指标均明显增高,并且与常规肺功能FEF25%-75%及哮喘严重程度具有良好的相关性。Objective To explore the application value of impulse oscillometry in small airway function in chronic persistent asthma patients with different severity using impulse oscillometry and spirometry.Methods The 154 patients with chronic persistent asthma were collected from July 2016 to June 2017 in the Department of Respiratory and Critical Care,Shanxi Dayi Hospital Affiliated to Shanxi Medical University,and divided into three groups according to the percentage of forced expiratory volume in one second as predicted(FEV 1%Pre):mild group(FEV 1%Pre≥80%,n=75),moderate group(60%≤FEV 1%Pre<80%,n=43)and severe group(FEV 1%Pre<60%,n=36).The 40 healthy adults in the same period were selected as healthy control group.Spirometry and impulse oscillometry parameters were obtained from every subject.Impulse oscillometry parameters were recorded,such as respiratory resistance at 5 Hz(R5),respiratory resistance at 20 Hz(R20),absolute difference in resistance between 5 Hz and 20 Hz(R5-20),relative difference in resistance between 5 Hz and 20 Hz(R5-20%),peripheral resistance(Rp),reactance at 5 Hz(X5).Pulmonary function indicators were also recorded,including forced expiratory volume in one second(FEV 1),FEV 1%Pre,ratio of forced expiratory volume in one second to forced vital capacity(FEV 1/FVC),forced expiratory flow(FEF),FEF 50%,FEF 25%-75%,peak expiratory flow(PEF)were recorded.Results①There was no significant difference in gender and mean age between asthma patients and healthy controls(P>0.05).②Compared with healthy control group,FEV 1/FVC was significantly reduced in moderate group and severe group,and the FEF 25%-75%,FEF 50%and PEF were significantly decreased in all the asthma groups(P<0.01).③Compared with healthy control group,the R5,R20,R5-20,R5-20%,Rp and X5 were significantly increased in mild group,moderate group and severe group(P<0.01).There were statistically significant differences in the above indicators among three asthma groups(P<0.01).④The correlation coefficient of R5,R5-20,R5-20%,Rp and X5 with F

关 键 词：支气管哮喘 脉冲震荡法 小气道功能 

分 类 号：R562.25[医药卫生—呼吸系统]