不同阻力状态下吸气峰流速分析

Analysis of peak inspiratory flow in different resistances

目的分析在不同阻力状态下的吸气流量能力，并探讨其与吸气流量曲线及通气功能的相关性。方法对120例中老年气道阻塞患者（包括非急性发作期哮喘和COPD患者）及41名中老年健康志愿者测试其用力肺活量、吸气流量曲线及模拟吸入器阻力下的吸气峰流速（PIF）。结果PIF-T最低，PIF-D与PIF-A相似，均高于PIF-T，PIF-E最高，但均低于无阻力状态下的PIF；随着气道阻塞程度的严重度增加，各阻力模拟状态下的吸气流量均随之降低，这种情况在Turbuhaler阻力状态下更加明显；用快速、用力的吸气方式，在使用Autohaler和Surehaler时大部分的受试者都会超过合适的吸气流速范围。结论各吸入器内部阻力在不同程度上影响了吸气流量的大小，且各吸入器阻力状态下的吸气流量均随着气道阻塞程度的严重而降低，因此，评估患者的PIF时应以吸入器阻力状态下的PIF为准。

Objective To understand the inspiratory flow（IF） in elderly subjects when using commonly used inhalers and the correlations between IF and ,inspiratory profile as well as spirometry. Methods One hundred and twenty subjects with airway obstruction and 41 healthy subjects were designed to measure their inspiration curves, pulmonary function and peak inspiratory flow （PIF） without and with resistances, which mimic the internal resistances of several inhalers, accuhaler, turbuhatar,autohaler,and surehaler by PIF meter （In-check DIAL）. Results The PIF in resistance of turbuhaler was the lowest,PIF in resistance of accuhaler and autohaler was similar,and PIF in resistance of surehaler was the highest. The more severe the airway obstruction was, the lower PIF was, especially in the resistance of turbuhaler. The PIF with resistances of autohaler and surehaler in almost subjects was exceeded the required range when inspired forced and fast. Conclusions The PIF in different inhalers is various because of different inner resistances, so PIF with resistance in inhaler is considered the best when physicians evaluate the patients＇ PIF.