脉冲震荡法在支气管激发试验中的应用价值

Clinical Value of Impulse Oscillometry in Bronchial Challenge Test

目的:探讨脉冲振荡法在支气管激发试验中的应用价值。方法:采用脉冲振荡法测定96例哮喘稳定期患者(哮喘组)及99例健康者(对照组)在吸入支气管激发剂前后呼吸阻抗的变化及下降率,同时测定肺通气功能变化及下降率,并对2种方法所测结果进行对比及相关性分析。结果:吸入组织胺后哮喘组5 Hz和20 Hz振荡频率时粘性阻力及差值(R5、R20、R5-R20)、20 Hz振荡频率时电抗(X20)、外周阻力(Rperiphery)及共振频率(Fre-quencys)与对照组比较均明显增加(P<0.01),吸药后FEV1下降与R5、R20、Rperiphery、Frequencys变化密切相关,相关系数分别为0.527、0.518、0.365、0.446。结论:脉冲振荡法用于支气管激发试验是诊断、鉴别诊断支气管哮喘及观察药物疗效的有用工具,在临床有一定的应用价值。

Objectives：To investigate the clinical value of impulse oscillometry （IOS） in bronchial challenge test. Methods： Ninety-six patients with stable asthma and 99 healthy controls experienced the respiratory impedance measurement by IOS before and after an inhaling histamine provocation test, the pulmonary function of ventilation was evaluated simultaneously, and related differences and correlations between two methods were also analyzed. Results： Resistance at 5Hz （R5） and 20Hz （R20） as well as the difference between them （R5-R20） was significantly increased after the histamine challenge in the patients group. Similarly, the asthma patients showed marked increases in reactance at 20Hz （X20）, peripheral resistance （Rperi） and resonant frequency（Fres） （P〈0.01） after inhalation of histamine. There were closely negative correlations between FEV1 decrease and R5, R20, X20, Rperi and Fres （r=-0. 545,-0. 521,-0. 376,- 0. 445, -0. 467, respectively）. Conclusion： IOS utilization in bronchial challenge test is clinically useful and significant for the diagnosis and differentiation of bronchial asthma.