哮喘急性发作时呼吸音的分析研究

Respiratory sounds in patients with the exacerbation of asthma

目的本研究的目的在于利用计算机处理的声音分析技术,对哮喘患者的呼吸音进行评估,并且对哮喘患者和正常个体的声音进行比较。方法对22例哮喘患者分别在发作时和治疗后的整个呼吸循环的呼吸音进行分析。15名正常志愿者作为对照组进行比较分析。分别记录其声音振动模式。对左肺和右肺的呼吸音分别进行分析。结果哮喘发作时左右肺呼吸音的振动能量峰(vibration energy peaks,VEPs)具有不同步性。正常个体的左右肺VEPs几乎同时发生;其呼气VEPs的时间间隔为(0.006±0.012)s。哮喘患者左右肺的呼气VEPs的时间间隔为(0.14±0.09)s,经过治疗改善后的VEPs时间间隔为(0.04±0.04)s。与正常的个体相比,哮喘患者左右肺的不同步性差异有统计学意义(P<0.05)。这种不同步经过治疗改善之后,差异有统计学意义(P<0.05)。结论呼吸音分析结果证明,哮喘发作时左右肺VEPs的不同步性显著增加,哮喘患者经过临床治疗改善之后不同步性显著减少。

Objective The goals of this study were to use a computerized analytic acoustic tool to evaluate respiratory sound patterns in asthmatic patients during acute attacks and after clinical improvement and to compare asthmatic profiles with those of normal individuals.Methods Respiratory sound analysis throughout the respiratory cycle was performed on 22 symptomatic asthma patients at the time of presentation to the emergency department and after clinical improvement. Data of 15 healthy volunteers were analyzed as a control group. Vibrations patterns were plotted. Right and left lungs were analyzed separately. Results Asthmatic attacks were found to be correlated with asynchrony between lungs. In normal subjects, the inspiratory and expiratory vibration energy peaks （VEPs） occurred almost simultaneously in both lungs; the time interval between right and left expiratory VEPs was （0.006±0.012） s. In symptomatic asthmatic patients on admission, the time interval between right and left expiratory VEPs was （0.14±0.09） s and after clinical improvement the interval decreased to （0.04±0.04） s. Compared to healthy volunteers, asynchrony between two lungs was increased in asthmatics （P〈0.05）. The asynchrony was significantly reduced after clinical improvement （P〈0.05）. Conclusion Respiratory sound analysis demonstrated significant asynchrony between right and left lungs in asthma exacerbations. The asynchrony is significantly reduced with clinical improvement following treatment.