慢性阻塞性肺疾病患者通气功能和弥散功能的特点分析  

Analysis on characteristics of ventilation and diffusion functions in patients with chronic obstructive pulmonary disease

作　　者：栾英[1] 李敬蕊[2] 刘林林 高春燕[3] 张菊香[1] 王晶[1] 崔朝勃[1] Luan Ying;Li Jingrui;Liu Linlin;Gao Chunyan;Zhang Juxiang;Wang Jing;Cui Zhaobo(Department of Respiratory and Critical Care Medicine,Hengshui People's Hospital(Harrison International Peace Hospital),Hengshui 053000,Hebei,China;Department of Prevention and Health Care,Hengshui People's Hospital(Harrison International Peace Hospital),Hengshui 053000,Hebei,China;Department of Geriatric Diseases,Hengshui People's Hospital(Harrison International Peace Hospital),Hengshui 053000,Hebei,China)

机构地区：[1]衡水市人民医院(哈励逊国际和平医院)呼吸与危重症医学科,河北衡水053000 [2]衡水市人民医院(哈励逊国际和平医院)预防保健科,河北衡水053000 [3]衡水市人民医院(哈励逊国际和平医院)老年病一科,河北衡水053000

出　　处：《中国中西医结合急救杂志》2021年第3期284-286,共3页Chinese Journal of Integrated Traditional and Western Medicine in Intensive and Critical Care

基　　金：河北省医学科学研究重点课题(20181596)。

摘　　要：目的分析慢性阻塞性肺疾病(COPD)患者的肺功能容量、流速、弥散功能特点以及衡水市5家医院呼吸科医师应用其诊断COPD的情况.方法选择2015年1月至2017年4月在哈励逊国际和平医院肺功能室进行肺功能检查及支气管舒张试验的300例40岁以上患者作为研究对象.根据肺功能情况将患者分为肺功能正常组(60例)和COPD组(240例),再根据GOLD分级将COPD患者分为COPDⅠ级、Ⅱ级、Ⅲ级和Ⅳ级组,每组各60例.对比分析各级COPD组患者和肺功能正常组的用力肺活量(FVC)、第1秒用力呼气容积(FEV1)、残气量/肺总量比值(RV/TLC)及一氧化碳弥散量占预计值百分比(DLCO)的差异.另外选择衡水市5家医院100名呼吸科医师,分析其应用患者肺功能的容量、流速及弥散功能特点诊析COPD的情况.结果不同GOLD分级COPD患者FVC、FEV1、DLCO均明显低于肺功能正常组,且随着COPD严重程度的增加呈逐渐降低趋势〔COPDⅣ、Ⅲ、Ⅱ、Ⅰ级患者与肺功能正常组比分别为FVC(L):1.63±0.41、2.36±0.45、3.07±0.47、3.85±0.60比4.24±0.54,FEV1(L):0.67±0.13、1.11±0.24、1.87±0.38、2.64±0.44比3.41±0.46,DLCO(%):47.28±11.26、77.95±11.47、88.65±7.97、102.35±5.16比121.72±5.89,均P<0.05〕;但不同GOLD分级COPD患者RV/TLC比值明显高于肺功能正常组,且随着COPD严重程度的增加呈逐渐升高趋势(COPDⅣ、Ⅲ、Ⅱ、Ⅰ级患者与肺功能正常组比分别为0.556±0.536、0.509±0.368、0.414±0.314、0.349±0.219比0.299±0.239,P<0.05).衡水市5家医院100名呼吸科医师中,有60%(60/100)的呼吸科医师应用患者肺功能的容量、流速及弥散功能特点来诊断和分析COPD.结论对于40岁以上COPD患者,其病情越严重,FVC、FEV1、DLCO越低,RV/TLC比值越高.另外,衡水市各医院呼吸科医师对肺功能检查的利用率较低,应加强相关规范化培训,从而真正做到对COPD患者的早发现、早诊断及早治疗.Objective To investigate the characteristics of lung function volume,flow velocity and diffusion function of patients with chronic obstructive pulmonary disease(COPD)and the application of those in the diagnosis of COPD by respiratory doctors in five hospitals in Hengshui City.Methods From January 2015 to April 2017,300 patients over 40 years old who accepted the examination of pulmonary function and the bronchial dilation test in pulmonary function room of Harrison International Peace Hospital were selected as the study objects.According to the pulmonary function results,these patients were divided into a normal pulmonary function group(60 cases)and a COPD group(240 cases),and again the COPD group was subdivided into gradeⅠ,Ⅱ,ⅢandⅣsubgroups based on GOLD gradation criteria,with 60 cases in each subgroup.The differences of forced lung vital capacity(FVC),forced expiratory volume in one second(FEV1),ratio of residual volume/total lung volume(RV/TLC)and the percentage of carbon monoxide diffusion volume in its predicted value(DLCO)were analyzed and compared between each COPD subgroup and normal lung function group.In addition,100 respiratory physicians from five different hospitals in Hengshui were selected to observe their situation of diagnosis of COPD by application of the results of analysis of the patients'characteristics of lung function volume,flow velocity and diffusion function.Results The FVC,FEV1 and DLCO in COPD patients with different GOLD grades were significantly lower than those objects in normal group of lung function,and gradually decreased with the increase of COPD severity[the indexes in COPD patients with gradeⅣ,Ⅲ,Ⅱ,Ⅰand normal pulmonary function group were FVC(L):1.63±0.41,2.36±0.45,3.07±0.47,3.85±0.60 vs.4.24±0.54;FEV1(L):0.67±0.13,1.11±0.24,1.87±0.38,2.64±0.44 vs.3.41±0.46;DLCO(%):47.28±11.26,77.95±11.47,88.65±7.97,102.35±5.16 vs.121.72±5.89,all P<0.05].However,the levels of RV/TLC ratio in COPD patients with different GOLD grades were significantly higher than

关 键 词：第1秒用力呼气容积占预计值百分比 慢性阻塞性肺疾病 流速 容量 弥散功能 

分 类 号：R56[医药卫生—呼吸系统]