最大用力呼气中段流量时间测定及临床价值

Measurement of maximal forced midexpiratory time and its clinical value

目的：探讨最大用力呼气中段流量时间（ＦＥＴ２５％～７５％）的正常值及临床应用价值。方法：应用美国６２００ＡｕｔｏｂｏｘＤＬ型体积描记仪，测定了２０１例健康成人，３２例限制性通气障碍患者和１６８例ＣＯＰＤ患者ＦＥＴ２５％～７５％。结果：ＦＥＴ２５％～７５％与年龄显著相关（Ｐ＜０．０１），求出其预计回归方程式。对各组依实测值占预计值百分比均值进行了比较。慢支组、轻、中、重度肺气肿组ＦＥＧ２５％～７５％明显延长（Ｐ＜０．０１），ＭＭＦ、ＦＥＶ１．０／ＦＶＣ％、ＦＶＣ明显减低（Ｐ＜０．０１）；限制性疾患组ＦＥＴ２５％～７５％缩短（Ｐ＜０．０１），ＭＭＦ及ＦＶＣ明显减低（Ｐ＜０．０１），ＦＥＶ１．０／ＦＶＣ％增高。结论：ＦＥＴ２５％～７５％不仅是判断阻塞性通气障碍的一项十分有用的指标，而且其缩短也可作为限制性通气障碍的参考指标之一。

Objective: To determine the normal value of maximal forced midexpiratory time and explore its clinical value. Methods: Forced expiratory time for 25%～75% FVC (FET 25%～75%) was measure in 201 healthy adults, 32 patients with limitative ventilational pulmonary disease (LVPD) and 168 patients with chronic obstructive pulmonary disease (COPD) with a 6200 Autobox DL Automated body plethysmoghraph. Results: FET 25%～75% was significantly correlated to age (P<0.01). Prediction formula was calculated and prediction value percentage was compared with that of measured value among different groups. It was found that: ①In patients with LVPD, there were significant shortening in FET 25%～75% (P<0.01), significant reduction in MMF and FVC and marked rise in FEV1.0/FVC%. ②In patients with COPD complicated with chronic bronchitis, there were significant lengthening in FET 25%～75% (P<0.01) and remarkable reduction in MMF, FEV1.0/FVC% and FVC (P<0.01). ③In patients exhibited light, medium or severe symptoms of COPD, there were significant lengthening in MMF, FEV1.0/FVC% and FVC (P<0.01). Conclusion: FET 25%～75% is an important index for judging COPD and its shortening might be an implication that patients suffer from LVPD.