最大呼气流量-容积曲线和小气道病变对比观察

Comparative observation on the relationship between the MEFV and the visual inspection of small airway

目的比较最大呼气流量-容积曲线(MEFV)和肉眼观察小气道功能病变的关系。方法根据MEFV测定将13例慢性支气管炎(11例)与支气管哮喘(2例)分为MEFV正常组与异常组。用纤维支气管镜(纤支镜)和超细纤维支气管镜观察其大气道和周围小气道病变,气道病变依病变程度计分表示(本文规定的计分及Thompson的气管炎指数-BI)。结果两组大气道总分相近差异无显著性。MEFV异常组总分为7.7±0.8(BI为3.0±0.8);MEFV正常组总分为4.7±1.6(BI为1.5±0.5),P<0.01。MEFV之50%肺活量最大呼气流量(V_(50))与25%肺活量最大呼气流量(V_(25))和小气道病变计分作相关性测定,r值分别为—0.6964(P<0.02)和—0.6271(P<0.05)。结论此测定进一步说明MEFV异常可以反映小气道器质性改变,具有病理基础。由于超细纤维支气管镜观察主要是充血、水肿、分泌物增多等异常,因此实际上MEFV也反映了小气道炎症性病变。

Objective To compare the reiationship between the MEFV and the visual inspection of small airway. Methods According to the result on small airway function test (MEFV), the patients were divided into two group: MEFV abnormal group and MEFV normal group. Their bronchus and peripheral airway were observed with bronchofiberscope and ultra-thin bronchofiberscope. The visual ap- pearance of the airways was scored in the light of the presence or absence of erythema, edema, secre- tions, etc. Resuts The score of visual appearance observed or bronchitis index (BI) in small airway was 7.7±0.8 (BI: 3.0±0.8) and 4.7±1.6 (BI: 1.5±0.5) respectively in MEFV abnormal group and in MEFV normal group, namely the score in MEFV abnormal group was significantly higher than that of normal group (P<0.01). The degree of pathological change in small airway was significantly correlated with the results of V_(25), V_(50), r= -0.6271, (P<0.05) and r=0. 6964, (P<0. 02). Conclusion The abnormal of MEFV may reflect inflamative pathological changes of small airway.