利用脉冲振荡技术评价慢性阻塞性肺病患者肺功能

Diagnostic value of impulse oscillometry to pumonary function of patients with chronic obstructive pulmonary disease

目的 评价脉冲振荡法 (IOS)在慢性阻塞性肺病 (COPD)肺功能诊断中的价值。 方法 随机对 2 96例COPD缓解期患者和 171例健康者进行包括IOS及常规肺通气在内的肺功能测定 ,比较两组IOS测试结果 ,评价IOS与常规肺通气检测的一致性。 结果 与健康组比较 ,COPD组IOS测试值差异有显著性 (P <0 .0 5 ) ,且差异呈频率依赖性。共振频率 (Fres)、不同脉冲频率下黏性阻力 (R5 R2 0 )、R5、周边弹性阻力 (X5 )等IOS值与呼气容积百分比 (FEV1% )、1秒种用力呼气容积 (FEV1) /用力肺活量(FVC)、最大流速 (PEEF)、5 0 %肺活量呼气流量 (FEF5 0 % )等有显著相关性 (P <0 .0 5 )。 结论 脉冲振荡法与常规通气试验具有较好的一致性 ,可以反映早期气道阻塞情况。

Objective To evaluate the diagnostic value of i mp ulse oscillometry (IOS) to pulmonary function of patients with chronic obstructi ve pulmonary disese (COPD). Methods The pulomany function of 296 COPD patients and 171 health people was detected by IOS and routine pulmonar y ventilation.The results of two groups were compared.The correlation between IO S indices and parameter values of routine pulmonary ventilation was studied in the COPD group. Results The viscous resistance (R5、R5-R20 ), resonant frequency (Fres)and peripheral elastic resistance (X5) detected b y IOS in the COPD group were higher than those of the healthy group (P <0.05). There were significantly frequency dependence of viscous resistanc e and reactance in the COPD patients. IOS indices including Fres,R5-R20,R5,X5 we re negatively correlated with parameters of pulmonary ventilation indices includ ing FEV1%,FEV1/FVC,PEF and FEF50, etc (P<0.05). Conclu sion With a good coherence to parameter indices of routine pulmonary v entilation,IOS is a sensitive method to reflect the change of viscous resistance and reactance in COPD.