脑卒中患者肺通气功能的变化

Changes of the pulmonary ventilation function in stroke patients Zhang Jian jie

目的:研究脑卒中患者肺通气功能变化,探讨其临床意义。方法:用Pal型肺通气功能测定仪检测了深圳铁路医院1997-01/2002-12收治的47例脑卒中患者肺通气功能情况,包括用力肺活量(FV)C,第1秒用力呼气量FEV1),第1秒用力呼气量占用力肺活量百(分比(FEV1/FVC),峰值流速(PEF),平均呼气中期流速(MMEF),50%呼气最大流速V50)及25%呼气最大流速(V25)。(结果:患者肺通气功能实测值FVC,FEV1,FEV1/FVC分别为(2.80±0.17),(2.02±0.28)L,(68.79±10.23)%,其正常预计值分别为(3.62±0.42),(2.84±0.35)L,(81.61±7.55)%,两组比较差异有显著性意义。肌力0或1级患者组FVC,FEV1,FEV1/FVC分别为(2.25±0.51),(1.65±0.23)L,(65.19±7.25)%,肌力2或3级患者组FVC,FEV1,FEV1/FVC分别为(2.87±0.36),(2.11±0.73)L,(70.06±5.52)%,肌力4级患者组FVC,FEV1,FEV1/FVC分别为(3.05±0.85),(2.45±0.38)L,(85.67±9.43)%,组间比较差异有显著性意义(P均<0.05)。随访18例患者,肌力恢复前FVC,FEV1,FEV1/FVC分别为(2.46±0.21),(1.85±0.23)L,(67.52±12.09)%,肌力恢复后FVC,FEV1,FEV1/FVC分别为(3.62±0.42),(2.23±0.26)L,(78.56±3.42)%两组比较差异有显著性意义。,结论:脑卒中可造成患者肺通气功能损害,肌力下降可能是其主要因素之一。

AIM: To study the changes of pulmonary ventilation function in stroke patients , so as to investigate its clinical significance. METHODS: The pulmonary ventilation function of 47 stroke patients, selected fr om Shenzhen Railway Hospital from January 1997 to December 2002, was assayed wit h Pal function testing machine, included fast vital capacity (FVC), forced expir atory volume in first second(FEV1), the rate of FEV1/FVC, peak expiratory flow r ate (PEF), mean maximum expiratory flow(MMEF), 50%maximal volume (V50), and 25 %maximal volume (V25). RESULTS: The pulmonary ventilation function in practical measurement group was as follows: FVC (2.80±0.17)L, FEV1 (2.02±0.28)L, and FEV1/FVC (68.79±10.23) %, but that in normal estimated measurement group was (3.62±0.42)L,(2.84±0.35 ) L and (81.61±7.55)%respectively, which was remarkable difference between two groups. The FVC, FEV1, FEV1/FVC were respectively (2.25±0.51) L, (1.65±0.23)L and (65.19±7.25)%in 0-1 grade muscle strength group;(2.87±0.36) L, (2.11±0 .73) L and (70.06±5.52)%in 2-3 grade muscle strength group; (3.05±0.85) L, ( 2.45±0.38)L and (85.67±9.43)%in 4 grade muscle strength group, which was sign ificant difference among three groups (all P< 0.05).The FVC, FEV1 and FEV1/FVC o f 18 patients with follow up were respectively(2.46±0.21) L,(1.85±0.23)L and( 67.52 ±12.09)%before recovered muscle strength, and(3.62±0.42) L, (2.23±0.26 ) L and (78.56±3.42)%after recovered muscle strength, which was remarkable dif ference between two groups. CONCLUSION: Stroke can cause the lesion in pulmonary ventilation function of t he patients, and the decreased muscle strength is one of the main factors of tha t. It is helpful for the recovery of pulmonary ventilation function with the phy sical training of respiratory muscle breathing and injured limb muscle strength.