支气管舒张试验对慢性阻塞性肺疾病患者脉冲振荡参数的影响

Influence of bronchial dilation test on the parameters of impulse oscillometry system in COPD patients

目的探讨支气管舒张试验对不同程度慢性阻塞性肺疾病患者脉冲振荡参数的影响。方法选取2012年11月至2014年5月于首都医科大学宣武医院就诊的慢性阻塞性肺疾病稳定期患者163例,其中男性85例,女性78例,按2011版GOLD策略将患者分为A、B、C、D组,所有患者均行支气管舒张试验。在支气管舒张试验前、后行脉冲振荡法检查,主要测量呼吸总阻抗(Zrs)、总气道阻力(R5)、周围气道阻力(R5-R20)、共振频率(Fres)、周边弹性阻力(X5)、中心阻力(RC)、周边阻力(RP)。结果 A组患者,Fres、Zrs、R5、R5-R20指标在支气管舒张试验前后相比,均有所下降(P均<0.05),而支气管舒张试验后Rc、Rp等较试验前相比,均有所下降(P均<0.05),而X5试验前后比较,则无统计学意义(P均>0.05)。B组患者支气管舒张试验后各项指标均有所改善(P均<0.05)。C组患者支气管舒张试验前后RP、RC无统计学差异(P均>0.05)。D组患者支气管舒张试验前后R5-R20、Rc无统计学差异(P均>0.05),Rp有所下降,P均<0.05。结论脉冲振荡检查技术可以监测肺功能的变化,指导临床用药。

Objective To investigate the influence of bronchial dilation test on the parameters of impulse oscillometry system in COPD patients.Methods 163 stable COPD patients were selected from November 2012 to May 2014 in Xuanwu hospital,including 85 male cases and 78 female cases.According to the 2011 version of the GOLD strategy,they were divided into the A,B,C and D groups,and all patients underwent bronchial dilation test.Pulse oscillation method was performed before and after bronchodilation test.Their main indexes were measured including respiratory impedance(Zrs),total airway resistance(R5),peripheral airway resistance(R5-R20),resonance frequency(Fres),surrounding elastic resistance(X5),center resistance(CR),and peripheral resistance(PR).Results The value of Fres,Zrs,R5,R5-R20,Rc and Rp indicators decreased after bronchodilation test(P 0.05),but X5 showed no significant difference in the group A(P 0.05).All the indexes were improved in the group B after bronchodilation test(P<0.05).There was no significant difference in RP and RC in the group C and R5-R20 and Rc in the group D(P<0.05).The value of Rp decreased in the group D(P<0.05).Conclusion Pulse oscillation inspection technology can monitor the change of lung function,and guide the use of clinical drug.