脉冲振荡肺功能测试研究支气管哮喘患者的呼吸阻抗

Respiratory impedance measured by impulse oscillometry in patients with bronchial asthma

目的应用脉冲振荡法(IOS)测定支气管哮喘患者在支气管激发试验前后的呼吸阻抗及肺通气功能参数的变化规律和临床意义,探讨IOS测定在哮喘诊断中的价值。方法选择33例健康人及44例哮喘患者,在支气管激发试验前后分别测定肺通气功能及呼吸阻抗值,并作相关性分析。结果哮喘患者激发试验后,IOS测试参数中的共振频率(Fres)、呼吸总阻抗(Z5)、气道总阻力(R5)、中心气道阻力(R20)、周围气道阻力(R5-R20)和周围弹性阻力(X5的负值)等参数明显增大,与对照组激发试验前后及哮喘组激发试验前各参数均有显著性差异。IOS各参数与肺通气功能参数有显著相关性。结论IOS测试参数能全面地反映患者呼吸生理的动力学特征,是判断哮喘患者气道阻塞部位及阻塞程度的敏感指标。

Aim To measure the variation and significance of respiratory impedance and pulmonary ventilation function in patients with bronchial asthma by impulse oscillometry（IOS） before or after the bronchial provocation test. Method First of all,the basic level in 33 control cases and 44 asthmatic cases was measured, then the bronchial provocation test was performed. After the bronchial provocation test, pulmonary ventilation function and respiratory impedance were monitored. Results After the bronchial provocation test, various parameters in cluding the resonance frequency （ Fres ）, the impedance of the respiratory system （ Zrs ）, the resistance of central airways （Rc） and peripheral airways （Rp） ,the resistance （R） and the reactance （X） calculated in the frequency ranging from 5 to 35 Hz, and parameters such as forced expiratory volume in 1 second （FEV1 ） ,the ratio of forced expiratory volume in 1 second to forced vital capacity （FEV1/FVC）, et al, got much higher than healthy control group and asthmatic group before test. Conclusions The parameters in lOS test may reflect the patient＇ s physical characteristics of his respiratory system. It is a useful tool in testing the site and extent of airway block sensitively.