脉冲振荡法在支气管舒张试验中的应用价值

Discussion of clinical value of impulse oscillometry in bronchial dilation test

为探讨脉冲振荡法在支气管舒张试验中的应用价值 ,采用脉冲振荡法测定了 2 1例哮喘发作期患者吸入支气管舒张剂前后呼吸阻抗的变化及改善率 ,同时测定肺通气功能变化及改善率 ,并对两种方法所测结果进行对比及相关性分析。结果显示 ,吸入沙丁胺醇后 5 Hz和 2 0 Hz振荡频率时粘性阻力 ( R5、R2 0 )、5 Hz振荡频率时电抗( X5)及共振频率 ( Fres)与用药前比较均明显改善 ( P<0 .0 1) ,其中以 Fres改善最明显 ;一秒钟用力呼气容积( FEV1 )、最大峰流速 ( PEF)、5 0 %和 2 5 %肺活量最大呼气流速 ( V50 、V2 5)均明显改善 ( P<0 .0 1) ;呼吸阻抗改善率显著高于肺通气功能改善率 ( P<0 .0 5 ) ;吸药后 FEV1 增加与 Fres、R5和 X5变化相关密切 ,相关系数分别为0 .69、0 .4 8和 - 0 .4 2。认为 ,脉冲振荡法用于支气管舒张试验是诊断、鉴别诊断支气管哮喘及观察药物疗效的有用工具 。

To explore the clinical value of impluse oscillometry(IOS)in bronchodialtion test,the improvement rates of respiratory impedance was measured before and after inlaling salbutamol and compared with conventional pulmonary function in 21 patients with paroxysmal asthma The relation between these two methods was analysised Result showed that there was a significant chang in resistance at 5Hz and at 20Hz(R 5 R 20 ),reactance at 5Hz(X 5)and resonant frequency(Fres)(P<0 01)after inlaling salbutamol,as well as FEV1,PEF,V 50 and V 25 (P<0 01) In the index of IOS,the change of Fres was the most significant The improvement rates of respiratory impedance were significantly higer than those of the conventional pulmonary function(P<0 05) Close correlation was fund between improvement rates of FEV1 and Fres,FEV 1 and R 5,FEV 1 and X 5 The correlation coefficient values were 0 65,0 48 and -0 42 respectively Therefore,IOS applied in bionchial dilation test is a very useful tool in diagnosis,differential diagnosis and the observation of medication effect It is worthy of wide use in clinic