脉冲振荡技术在呼吸阻力测试中的诊断价值  

Diagnostic value of pulse oscillation technique in respiratory resistance test

作　　者：李小凤 周怡[1] 解立新[1] 骆永超 LI Xiao-feng;ZHOU Yi;XIE Li-xin;LUO Yong-chao(Pulmonary function room,College of Pulmonary&Critical Care Medicine,Chinese PLA General Hospital/8th Medical Center,Chinese PLA General Hospital,Beijing 100091,China)

机构地区：[1]解放军总医院第八医学中心呼吸与危重症医学部肺功能室,北京100091

出　　处：《临床肺科杂志》2023年第5期649-653,681,共6页Journal of Clinical Pulmonary Medicine

摘　　要：目的本研究旨在了解三种呼吸阻力测试法(IOS法、体描箱法、超声阻断法)评估肺通气功能的差异,了解国人正常预计值(z值)与传统实测值占预计值百分比(实测值%pred)评估肺通气功能的差异,了解脉冲振荡(Impulse oscillometry,IOS)技术在不同呼吸频率及舌置咬嘴的不同位置(舌不同位置)对呼吸阻力的影响。方法纳入受检者277例,以不同观察目的分组:三种方法组、z值组、舌位置组、呼吸频率组,其中78例受检者纳入三种方法组,用3种不同方法测试呼吸阻力计算异常检出率;85例受检者入z值组,受检者使用IOS法测试呼吸阻力,用z值与实测值%pred评估肺通气功能比较差异;44例受检者入舌位置组,观察舌不同位置对呼吸阻抗的影响;70例受检者纳入呼吸频率组,观察不同呼吸频率对呼吸阻抗的影响。结果IOS测定的呼吸阻抗与体描箱法的气道阻力异常检出率比无显著性差异,但这两种方法与超声阻断法气道阻力异常检出率比差异有统计学意义(P<0.05);IOS测试的R_(5)、R_(20)、X_(5)的z值与其实测值%pred的异常检出率比差异有显著统计学意义(P<0.05);测试R_(5)、R_(20)、X_(5)数值于舌不同位置及受检者在不同呼吸频率下测试值无统计学意义。结论IOS法与体描箱法测定的气道阻力有良好的一致性;使用z值评估R_(5)、R_(20)、X_(5)的呼吸阻力比实测值%pred评估的呼吸阻力敏感;IOS测试值受舌不同位置及不同呼吸频率的影响不明显。Objective The purpose of this study is to understand the difference of three respiratory resistance test methods(Impulse oscillometry method,body plethysmograph method,and ultrasonic blocking method)in evaluating pulmonary ventilation function,to understand the difference between Chinese normal predicted value(z score)and traditional methods,and to understand the effects of Impulse oscillometry(IOS)technique on respiratory system resistance at different respiratory frequencies and different positions of the tongue.Methods A total of 277 subjects were included and grouped according to different observation purposes:three methods group,z score group,the different positions of the tongue group,and the respiratory rate group.78 subjects were included in the three methods group,and the abnormal detection rate was calculated by three different methods to test respiratory resistance;85 subjects were included in the z score group,the respiratory resistance was tested by the IOS method,and the difference of pulmonary ventilation function was evaluated by z score and the measured value%pred;44 subjects were enrolled in the different positions of the tongue group to observe the effect of different positions of the tongue on respiratory impedance;70 subjects were enrolled in the respiratory rate group to observe the effect of different respiratory frequencies on respiratory impedance.Results There was no significant difference between the respiratory impedance measured by IOS and the airway resistance ratio measured by the body plethysmograph method,but there was a significant difference between the two methods and the ultrasonic blocking method(P<0.05),and there was a significant difference between the statistical abnormal detection rate of R_(5),R_(20),and X_(5) calculated by the z score used in IOS examination and the measured%pred abnormal detection rate(P<0.05).There was no significant difference in R_(5),R_(20),and X_(5) values in different positions of the tongue.There was no significant difference in the resistance v

关 键 词：脉冲振荡 呼吸频率 舌位置 国人预计值 

分 类 号：R56[医药卫生—呼吸系统] R443.6[医药卫生—内科学]