慢阻肺患者PI_(max)和PE_(max)及P_(0.1)测定与影响因素的研究

Detection of PI_(max) ,PE_(max) and P_(0.1) in patients with chronic obstructive pulmonary disease and its influential factors

目的研究慢性阻塞性肺疾病(COPD)患者PImax、PEmax及P0.1随着病情恶化的变化趋势,分析COPD患者PImax、PEmax及P0.1与各影响因素的相关性。方法肺功能诊断系统测定71例COPD患者与健康对照60例的通气、呼吸阻抗及呼吸阻力指标,比较两组间PImax、PEmax及P0.1结果,分析COPD组PImax、PEmax及P0.1与性别、年龄、身高、体重、呼吸阻抗各指标及通气功能各指标的相关性。结果与健康对照组比较,COPD组PImax及PEmax下降,P0.1上升。轻、中、重度COPD患者与健康对照比较,PImax及PEmax差异无统计学意义,而极重度患者差异有统计学意义;P0.1在中度以上患者均有统计学差异。相关性分析显示,COPD组PImax大小与X5、FEV1、MVV、MMEF、V25及V50呈正相关性,与年龄、Zrs、Fres及R5-R20呈负相关性,与性别、身高、体重、R5、R20及FEV1/FVC无线性相关关系;PEmax大小与性别、身高、体重、PImax、X5、FEV1、MVV、MMEF、V25及V50呈正相关性,与Zrs、Fres、R5、R20及R5-R20呈负相关性,与年龄及FEV1/FVC无线性相关关系;P0.1大小与年龄、Zrs、Fres、R5、R5-R20及V25呈正相关性,与PImax、PEmax及X5呈负相关性,与性别、身高、体重、R20、FEV1、FEV1/FVC、MVV、MMEF及V50无线性相关关系。结论 COPD患者PImax及PEmax较同年龄健康人下降,P0.1上升,并随病情加重差距明显;COPD患者PImax、PEmax及P0.1与性别、年龄、身高、体重、通气功能及呼吸阻抗各指标密切相关。

Objective To investigate the changes of PI max,PE max and P 0.1 in chronic obstructive pulmonary disease（COPD） patients,and to explore their correlations with the influential factors.Methods Lung function diagnosis system was used to detect the indices of the ventilatory function,total respiratory impedance and the respiratory muscle function in 71 COPD patients and 60 healthy controls.The values of PI max,PE max and P 0.1 were compared between two groups.The relationship of PI max,PE max,P 0.1 with gender,age,height,weight,respiratory impedance indices（Z rs,F res,R 5,R 20,R 5-R 20 and X 5） and ventilation function indices（FEV1,FEV1/FVC,MVV,MMEF,V 25 and V 50） were analyzed.Results Compared with healthy group,the values of PI max and PE max were declined in COPD group,while P 0.1 was raised.The decreases of PI max and PE max was not statistically different between patients with gradeⅠ,Ⅱ,Ⅲ and healthy controls,but threre was statistical difference between patients with grade Ⅳ and healthy controls.The values of P 0.1 had significant difference between gradeⅡ,ⅢandⅣpatients and the controls.In COPD group,PI max was positively correlated to X 5,FEV1,MVV,MMEF,V 25 and V 50,and negatively correlated to age,Z rs,F res and R 5-R 20,but not linearly correlated with sex,height,weight,R 5,R 20 or FEV1 /FVC.PE max was positively correlated to sex,height,weight,PI max,X 5,FEV1,MVV,MMEF,V 25 and V 50,and negatively correlated to Z rs,F res,R 5,R 20 and R 5-R 20,but not linearly correlated with age or FEV1/FVC.P 0.1 was positively correlated to age,Z rs,F res,R 5,R 5-R 20 and V 25,and negatively correlated to PI max,PE max and X 5,but not correlated with sex,height,weight,R 20,FEV1,FEV1/FVC,MVV,MMEF or V 50.Conclusion Compared with the healthy controls,PI max and PE max are declined,while P 0.1 is raised in COPD patients.The changes become larger as the disease exacerbating.There are close relationships between PI max,PE max,P 0.1 and sex,age,height,weight,ventilatory function,total respiratory impedance.