脉冲振荡技术在支气管哮喘诊断中的临床应用

The clinical application of impulse oscillation technique in the diagnosis of bronchial asthma

目的探讨脉冲振荡技术(IOS)测定呼吸阻抗诊断支气管哮喘的价值。方法对86例支气管哮喘患者(哮喘组)和70例健康者(对照组)进行IOS及常规肺通气功能测定,比较两组患者的呼吸阻抗指标,并与常规肺通气功能指标进行相关性分析。结果哮喘组IOS指标共振频率(Fres)、呼吸总抗阻(Zrs)、5Hz黏性阻力(R5)、20Hz黏性阻力(R20)、5Hz和20Hz黏性阻力差(R5-R20)、中心阻力(Rc)、周边阻力(Rp)均明显高于对照组,X5明显低于对照组。哮喘组Fres、Zrs、R5、R5-R20、Rp与常规肺通气指标第1秒用力呼气量/1秒用力呼气量预计值的百分比(FEV1%)、1秒用力呼气量/用力肺活量(FEV1/FVC)、用力呼气50%肺活量瞬间流量(FEF50%)、用力呼气75%肺活量瞬间流量(FEF75%)呈显著负相关,其中Fres与FEV1%和FEV1/FVC相关性最密切(r=-0.642、-0.590,P<0.01);X5与FEV1%、FEV1/FVC%呈显著正相关,R20、Rc与常规肺功能指标无相关性。结论 IOS可用于支气管哮喘的病情判断,是一种无创、简便、实用的方法,值得临床推广应用。Fres是IOS参数中诊断哮喘气流阻塞最敏感的指标。

Objective To investigate the impulse oscillation technique（IOS） measured respiratory impedance in the diagnosis of bronchial asthma.Methods The routine pulmonary function and IOS were measured in 86 cases of bronchial asthma and 70 healthy persons,compared the indicates of IOS in the two groups and the correlation with the indicates of routine pulmonary function test.Results The Zrs,Fres,R5,R20,R5-R20,Rc,Rp in the asthma group were significantly higher than the normal control group,X5 was significantly lower than the normal control group,the indicates of routine pulmonary function test had a significantly negative correlation with Zrs,Fres,R5,R5-R20 and a positive correlation with X5 and had no correlation with R20,Rc.Fres was most closely correlated with FEV1%and FEV1/FVC（r=-0.642,-0.590,P〈0.01）.Conclusion IOS can be used in the condition judgment of bronchial asthma and is a non-invasive,simple and practical method worthy of clinical application.Fres is the most sensitive indicators of IOS parameter in the airflow obstruction diagnosis of asthma.