慢性肺心病患者最大用力吸气流量－容积曲线测定的意义

Significance of the measurement of the maximal force inspiratory flow volume curve in patients with cor pulmonale

对７５例慢性肺心病患者和３１例健康成年人测定了各项肺容积和最大用力呼气流量－容积曲线（ＭＥＦＶ）及最大用力吸气流量－容积曲线（ＭＩＦＶ）。结果显示：慢性肺心病患者组肺活量（ＶＣ）、补呼气容积（ＥＲＶ）、一秒率（ＦＥＶ１．０％）和最大呼气中段流量（ＭＭＥＦ）非常显著降低（Ｐ＜０．０１），功能残气量（ＦＲＣ）、残气容积（ＲＶ）、ＲＶ／ＴＬＣ％均非常显著增高（Ｐ＜０．００１）；而最大用力吸气流量－容积曲线（ＭＩＦＶ）１５％、２５％、５０％、７５％、８５％和ＭＭＩＦ各段平均流量亦有非常显著降低（Ｐ＜０．００１）和用力吸气时间（ＦＩｔ）明显延长（Ｐ＜０．００１）。表明慢性肺心病患者不仅在最大用力呼时大小气道有严重的通气功能障碍。

The lung volume, the maximal force expiratory flow volume curve (MEFV) and the maximal force inspiratory flow volume (MIFV) curve were determined in 75 patients with cor pulmonale (CCP) and 31 healthy adults (HAs). It was found that: (1) vital capacity (VC), expiratory reserve volume (ERV), forced expiratory volume in one second to forced vital capacity ratio (FEV1.0%) and maximal mid expiratory flow (MMEF) were significantly decreased ( P <0.01) and functional residual capacity (FRC), residual volume (RV) and RV/TLC% were significantly increased in patients with CCP; (2) Significant decrease in 15, 25, 50, 75 and 85% of MIFV and the mean volume in each segment of MMEF ( P <0.01) and prolongation of inspiratory time ( P <0.01) were found. Our findings suggest that there are not only severe barrier in ventilational volume during the maximal force expiration but also significant decrease of mean volume in each segment of MMEF and prolongation of inspiratory time in patients with CCP.