慢性阻塞性肺病患者弥散功能的测定分析

Detection of diffusing capacity and correlative study in patients with chronic obstructive pulmonary disease

目的探讨慢性阻塞性肺病(COPD)患者的弥散功能改变及与其它肺功能参数的相关性。方法通过对123例COPD患者的肺弥散功能进行检测,并与84例健康人进行对照。结果COPD患者的弥散功能指标低于正常范围,与对照组相比差异有显著性。DLCO%与VC%、FEV1%、FVC%、FEV1/FVC%、MVV%等指标呈正相关,FEV1/FVC%、MVV%与DLCO/VA%呈正相关;RV/TLC与DLCO%、DLCO/VA%呈负相关。弥散功能随阻塞程度加重而下降。无肺气肿组、轻度肺气肿组的弥散功能指标在正常范围内,两组相比无差异。中度、重度肺气肿组弥散功能指标低于正常,与无肺气肿组及轻度肺气肿组相比差异有显著性。结论COPD患者存在弥散功能的减退,肺通气阻塞程度及肺气肿的程度对之均有影响,弥散功能指标与通气功能指标、肺气肿指标明显相关。COPD患者弥散功能检测对病情发展及肺气肿的诊断有一定价值。

[Objective] To investigate the change of diffusing capacity and correlation with other lung fimction marks in patients with chronic obstructive pulmonary disease. [Methods] Diffusing capacity was tested on 123 cases of chronic obstructive pulmonary disease and 84 normal controls. [Results] There was significant difference in DLCO% and DLCO/VA% between COPD group and control group. The DLCO% was positively correlated with VC%, FEV1%, FVC%, FEV1/FVC%, MVV%. The DLCO/VA% was positively correlated with FEV1/FVC%, MVV%. The DLCO% and DLCO/VA% were negativly correlated with RV/TLC. DLCO% and DLCO/VA% decreased in the groups with different degree obstructive ventilation dysfanction, DLCO% and DLCO/VA% decreased in the groups with different degree of pulmonary emphysema. [ Conclusions] The diffusing capacity decreases in the patients with COPD, The different degree obstructive ventilation dysfunction and the degree of pulmonary emphysema may influence the diffusing capacity. The diffusing capacity was correlated with ventilation function marks. The detection of diffusing capacity of the patients with COPD may play a role in the diagnosis of pulmonary emphysema arid the estimation of disease development.