老年哮喘患者呼吸驱动和气道阻力的研究

Research of central respiratory drive and respiratory resistance in the old patients with asthma

目的探讨老年哮喘患者和老年正常对照者两组人群的最大口腔吸气压（PIMAX）、最大口腔呼气压（PEMAX）、中枢呼吸驱动（P0.1）、最大通气时的中枢呼吸驱动（P0.1MAX）、中枢呼吸驱动储备（P0.1／P0.1MAX）、每分通气量（MV）校正中枢呼吸驱动（P0.1/MV）、PIMAX校正中枢呼吸驱动（P0.1／PIMAx）、有效吸气阻抗（P0.1／MIF）、吸气时间／总呼吸时间（TIN／TTOT）（也称吸气时间分数）、MV、呼吸频率（BF）、平均吸气流速（MIF）、潮气量（VT）以及4Hz振荡频率下呼吸阻力（Rfo 4Hz）的水平；并同时探讨上述呼吸驱动诸项指标与4Hz振荡频率下呼吸阻力的关系。方法本研究纳入哮喘组118例、正常对照组120例，均为男性，年龄60480岁，使用SPSS10．0 for Windows对各项参数加以分析。两组之问各指标比较采用t检验，两因素之间的相关性分析采用直线相关分析。结果哮喘患者的PIMAX和PEMAx均明显低于正常人，P0.1、P0.1／MV、P0.1／PIMAX、P0.1／MIF、P0.1／P0.1MAX均明显高于正常人；Rfo4HZ与PIMAX、P0.1及其校正指标、P0.1／P0.1MAX和P0.1／MIF均明显相关。结论中枢呼吸驱动与气道阻力的测量对于老年哮喘患者的病情与预后有较确切的评价效果，可以有效地应用于临床。常规使用具有支气管扩张功能的药物可改善气道阻力，从而改善中枢呼吸驱动诸项指标，最终改善哮喘患者的病情与预后。

Objective To evaluate maximum inspiratory pressure （PIMAX）, maximum expiratory pressure（PEMAX）, central respiratory drive（P0.1 ）, central respiratory drive in MVV （maximal voluntary ventilation） （ P0. 1 MAX）, reservation of central respiratory drive （ measured by P0.1/P0. 1 MAX）, central respiratory drive rectified by MV （minute ventilation） （P0.1/MV）, central respiratory drive rectified by PIMAX（ P0. 1/PIMAX）, effective inspiratory resistance（ P0.1/MIF）, inspiratory duration/respiratory duration （ TIN/TTOT）, MV, respiratory frequency（ BF）, mean inspiratory flow （ MIF）, tidal volume （ VT ）, resistance of airway （RAW） （measured by forced oscillation technology-FOT with 4Hz air waves （Rfo） and the relationship between parameters of respiratory drive and parameters of resistande of airway in the old patients with asthma. Methods Add up to 118 patients with asthma and 120 normal people as control group whose age between 60 and 80 were admitted to our research and SPSS 10. 0 for Windows is used for analysis. The comparison between two groups is measured with t-test and the relationship between parameters of respiratory drive and RAW is measured with linear correlation analysis. Results In asthma group,the levels of PIMAX and PEMAX are lower than control group and the levels of P0.1, P0.1/MV, P0.1/ PIMAX, P0. 1/MIF and P0.1/P0.1 MAX are higher. PIMAX, P0.1 , P0.1/MV, P0.1/PIMAX, P0.1/P0.1 MAX and P0.1/MIF are related with RAW significantly. Conclusions The measurements of central respiratory drive and RAW can be used effectively in patients with asthma. Therapy with medicine which can ameliorate RAW would improve parameters of central respiratory drive and then improve patients＂ clinical condition and prognosis.