脉冲振荡肺功能在间质性肺疾病诊断中的意义

Significance of impulse oscillation technique in the diagnosis of interstitial pulmonary disease

目的 :评价脉冲振荡肺功能 (impulseoscillation ,IOS)在肺间质纤维化诊断中的意义。 方法 :分析 3组不同病因所致肺间质纤维化的病人常规和脉冲振荡肺功能诸指标间的关系以及两种肺功能检测方法对肺间质纤维化诊断的敏感性。结果 :常规肺功能检查指标FVC、FEV1、TLC、RV/TLC、DLco结节病组与结缔组织病和间质性肺炎组间差异有显著性 ,IOS检查 3组间各项指标无明显差异 ,常规肺功能FVC、TLC、DLco与IOS中的X5呈正相关 (r =0 .5 6 ,P <0 .0 0 1;r =0 .6 2 ,P <0 .0 0 1;r =0 .4 6 ,P <0 .0 5 )。FVC、DLco与响应频率呈负相关 (r=- 0 .4 3,P <0 .0 1,r=- 0 .4 7,P <0 .0 5 )。两种肺功能检测方法对间质纤维化的诊断的敏感性无显著性差异 (P >0 .0 5 )。结论 :间质性肺疾病的肺功能改变与其肺受累的程度有关 ,而与导致纤维化的病因无关 ,常规肺功能指标FVC、DLCO,脉冲振荡肺功能指标X5以及响应频率对肺间质纤维化的诊断有一定的意义 ;

Objective: To evaluate the significance of impulse oscillation technique in the diagnosis of interstitial lung disease. Methods: The relationships between the items of general pulmonary function testing and that of impulse oscillation technique in three groups of interstitial lung disease induced by different etiology were analyzed and the sensitivity of the two methods in the diagnosis of interstitial lung disease evaluated. Results: There was significance in the items of FVC, FEV 1 , TLC, RV/TLC and DLco of general pulmonary function among the three groups, but no significance in any item of IOS. A significant positive independent correlation between X 5 in IOS and FVC, TLC, DL co in general pulmonary function( r =0.56, P <0.001; r =0.62, P <0.001; r =0.46, P <0.05 respectively) and a significant negative independent correlation between Resonance frequency and FVC , DL co ( r =-0.43, P <0.01, r =-0.47, P <0.05 respectively)were observed. There was no significance in sensitivity between the two methods in detecting interstitial lung disease. Conclusion: The present study suggested that the change of lung function depended on the degree of involved lung; X 5 and Resonance frequency in IOS and FVC, TLC, DL co in general pulmonary function were the physiological variables and thus might provide significant information for the assessment of interstitial lung disease and there was no significance in the sensitivity between the two methods in detecting interstitial lung disease.