脉冲振荡法在阻塞性通气功能障碍诊断中的应用价值.DOC

脉冲振荡法在阻塞性通气功能障碍中的应用研究 张丽，万毅新，王晓平 兰州大学第二医院呼吸科 兰州 730030 【摘要】目的 使用脉冲振荡法（IOS）测定慢性阻塞性肺疾病（COPD）和支气管哮喘患者的呼吸阻抗，探讨两种疾病的呼吸阻抗与气流阻塞及肺容积之间的关系。方法 用IOS法测定200例COPD和支气管哮喘患者及100例正常成人的R5、R20、Fres、X5、RC和RP的实测值，常规肺功能测定TLC、RV、FEV1、FVC及FEV1／FVC等指标，并对两种指标进行相关分析。结果 与健康组相比COPD、哮喘组R5、R20、R5-R20、Fres、RC和RP均显著升高， X5显著降低，差异有统计学意义（均P＜0.01）；R5、R5-R20、RP、FresFEV1％X5与FEVl％、FEVl／FVC均呈正相关（P＜0.01）；R20与其中任何一项指标均无相关性；其中相关性最强的是FEV1％与X5（r＝0.419），FEV1％与Fres（r＝-0.553）。Fres、X5 和 R5 诊断气流阻塞的阳性率分别为99.9％，94.5％，49.0％。结论 在COPD和支气管哮喘所致的气流阻塞及肺顺应性改变中，IOS电抗测定比阻力测定更具敏感性。IOS的测定指标可用于评估阻塞性通气功能障碍，尤其是X5的诊断价值最大，并且与常规肺通气功能指标之间有良好的相关性。 【关键词】慢性阻塞性肺疾病；支气管哮喘；脉冲振荡法；气道阻塞 中图分类号：R563 文献标志码： The study of impulse oscillometry in obstructive ventilatory dysfunction Zhang Li, Wan Yixin, Wang Xiaoping, Department of Respiratory Disease, the Second Hospital of Lanzhou Univercity, Lanzhou 730030, China 【Abstract】 Objective Impulse oscillometry IOS) assesses pulmonary resistanceand reactance. To investigate which IOS measurements are related to airflow obstruction and lung volumes in chronic obstructive pulmonary disease (COPD) and asthma. Methods The IOS parameters of 200 cases of the two diseases were measured, and compared with those of 100 normal cases. IOS measurements (R5, R20, and their difference R5－R20, X5, Fres, RＣ RP), the conventional pulmonary function (TLC, RV, FEV1, FVC and FEV1/FVC) were performed. Spearman correlation determined the relationships between IOS and other measurements. Results Compared with those of the normal group, the resistance at 5Hz and 20Hz (R5, R20) and their difference (R5－R20), resonance frequency (Fres), central resistance (RＣ) and peripheral resistance (RP) in COPD and asthma group increased significantly, while reactance at 5Hz (X5) decreased obviously (P0.01). In the COPD and asthma group, R5, Fres, RP, R5－R20 were all correlated negatively with FEV1%, TLC and RV, and Fres was correlated negatively with FEVl/FVC, but X5 was correlated positively with FEVl% and FEVl/FVC (P0.01). However, R20