The Diagnosis Value and Its Implication of Impulse Oscillometry in Obstructive Sleep Apnea Syndrome Patients

The change of measurements of impulse oscillometry (105) in obstructive sleep apnea syn- drome (OSAS) patients and its mechanism were observed. The respiratory impedance was measured by using IOS technique and polysomnography (PSG) was monitored synchronously in 36 OSAS pa- tients,14 patients with chronic obstructive pulmonary disease (COPD) and 12 normal controls. Re- sults showed that R20 in OSAS group was significantly higher than in COPD group and control group (P<0.01). R5-R20 in OSAS group was lower than that in COPD group, but significantly higher than that in control group(P<0. 01). The levels of R20 and R5-R20 were positively correlated with severity degree of the disease. In addition, apnea-hyponea index (AHI) was positively correlated with R5 and R20 with the correlation index (r)being 0. 66 and 0. 86 respectively. The lowest SO2 was negatively correlated with R5 and R5-R20, with r being-0. 66 and- 0. 79 respectively. The mean SO2 was negatively correlated with R5 and R5-R20 with r being-0. 81 and-0. 69 respectively. IOS technique could be used as a valuable tool for assessing the degree of upper airway obstruction in the patients with OSAS, and could help to explore its pathological mechanism.

Association of Superior Vena Cava Syndrome with Sleep Apnea: Investigation Using an Impulse Oscillometry System

Superior vena cava syndrome (SVCS) patients sometimes show signs of obstructive sleep apnea (OSA). However, the mechanism causing hypoxia during sleep in SVCS patients is still uncertain. The aim of this study was to elucidate 1) the changes in central and peripheral respiratory resistance with SVCS, and 2) interpret the mechanism underlying the development of hypoxia during sleep in patients with SVCS related to OSA. Ten SVCS patients related to a neoplasm were recruited for this study. The degree of apnea hypopnea index (AHI) for OSA was evaluated by portable diagnosing device before and after SVCS treatment. We also analyzed the airway resistance and reactance quantitatively in the supine position by Master Screen impulse oscillometry system (MS-IOS?). After SVCS treatment, mean values of AHI were significantly decreased from 30.9 to 16.9 (/hour) (p = 0.001). Central respiratory resistance (R20) also decreased significantly from 0.40 to 0.33 kPa/L/s (p = 0.025) in the supine position. In contrast, peripheral respiratory resistance (R5-R20) and distal capacitive reactance (X5) did not change significantly. It is thought that the exacerbation of OSA due to SVCS is caused by increasing upper airway resistance related to reversible edema of the upper airway mucous or tissue. In contrast, SVCS may not cause peripheral respiratory tract and lung parenchyma edema.

Analysis on relationship of parameters such as R5 and MEFV with severity of chronic cough in 3 to 5 years old children by impulse oscillometry detection

Objective:The article aims to investigate the relationship of parameters such as airway vicosity resistance (R5) and maximal expiratory flow-volume curve (MEFV) with severity of chronic cough in 3 to 5 years old children by impulse oscillometry (IOS) detection when the oscillation frequency is 5Hz.Method: The article chooses eighty children with chronic cough who were diagnosed or treated in our hospital from March 2017 to March 2018 as the research group, and chooses 50 healthy children who had physical examination in our hospital as the control group. Children's asthma control test (C-ACT) is used to assess the disease severity of children. MEFV detection is carried out to the two groups of children to obtain the ratio of forced expiratory volume in one second and forced vital capacity (FEV1/FVC) and the peak expiratory flow (PEF). LsS inductance (X5) is detected by IOS when R5, the resonant frequency (Fres), and the oscillation frequency is 5Hz. The relationship of ACT score with MEFV and IOS indicators is analyzed by Pearson correlation. The receiver operating characteristic (ROC) curve is used to evaluate the diagnostic value of MEFV and IOS indicators to chronic cough. Results: The C-ACT score of the severe group is significantly lower than that of the control group (P<0.05). FEV1/FVC and PEF of the mild and severe groups are both lower than those of the control group, and FEV1/FVC and PEF of the severe group is lower than those of the mild group (P<0.05). Fres, R5 and X5 of the mild and severe groups are significantly higher than those of the control group, and Fres, R5 and X5 of the severe group are higher than the mild group (P<0.05). FEV1/FVC and PEF are positively correlated with C-ACT score (P<0.05), while Fres, R5 and X5 are negatively correlated with C-ACT score (P<0.05). FEV1/FVC and PEF respectively shows significant negative correlations with Fres, R5 and X5 (P<0.05). R5 has a self-high ROC value of 0.938, followed by Fres, which is 0.917. And the value of IOS diagnostic indicators is higher than MEFV indicators.Conclusion: FEV1 / FVC and PEF of children with chronic cough will decrease while Fres, R5 and X5 will increase, of which Fres, R5 and X5 have a higher correlation with the severity of cough symptoms, and ROC analysis results also show that R5 has the highest diagnostic value to 3~5 years old children with chronic cough.

血清TIgE、SPT和IOS测定在儿童咳嗽变异型哮喘中的临床意义

目的探讨皮肤点刺、血清总IgE和脉冲振荡肺功能测定在学龄前儿童咳嗽变异型哮喘中的作用。方法分别测定并比较100例咳嗽变异型哮喘患儿,102例支气管哮喘患儿及同期本院体检的105例健康儿童血清总IgE水平、皮肤点刺结果和脉冲振荡肺功能结果。结果 (1)CVA组、哮喘组患儿吸入性变应原、摄入性变应原、尘螨阳性率、总变应原阳性率和总IgE比较显著高于健康组(P<0.01),CVA组与哮喘组比较差异无统计学意义。(2)脉冲振荡肺功能检测显示CVA组和哮喘组的呼吸总阻抗(Zrs)、总呼吸黏性阻力(R5)、中心气道黏性阻力(R20)、周边气道黏性阻力(R5-R20)及共振频率(Fres)均高于对照组(P<0.05);CVA组的Zrs、R5、R20、R5-R20、Fres均低于哮喘组(P<0.05)。结论检测皮肤点刺、血清总IgE水平和脉冲振荡肺功能有助于了解学龄前儿童咳嗽变异性哮喘气道炎症变化及气道阻塞情况。

阻断阻力肺功能检查在学龄前儿童哮喘诊断中应用的单中心研究

目的探讨阻断阻力(interrupter resistance,Rint)肺功能检查对学龄前儿童哮喘的诊断价值,同时对比Rint肺功能检查和脉冲振荡(impulse oscillometry,IOS)对哮喘的诊断意义。方法前瞻性收集2022年7月—2023年11月收治的4~<6岁反复喘息儿童108例为研究对象,根据结局分为哮喘组(n=61)和非哮喘组(n=47)。对2组患儿的Rint、IOS肺功能参数等进行分析,并比较两者的可行性及价值。结果哮喘组中Rint实测值/预计值百分比、Rint实测值改善率、Rint预计值改善率高于非哮喘组(P<0.05)。受试者操作特征曲线结果显示,Rint预计值改善率诊断学龄前儿童哮喘的最佳截断值为32.0%,曲线下面积为0.705,灵敏度为41.0%,特异度为91.5%(P<0.05)。在完成度方面,有18例(16.7%)患儿未能完成IOS检查,但是可以顺利完成Rint肺功能检查,且质控良好。Rint肺功能检查及IOS各参数对学龄前儿童哮喘诊断的曲线下面积比较差异均无统计学意义(P>0.05)。结论Rint肺功能检查可用于辅助诊断学龄前儿童哮喘,其诊断价值与IOS相当,且具有较高的可行性。支气管舒张试验提示Rint预计值改善率≥32%可作为哮喘诊断的截断值。

脉冲振荡肺功能检测在慢性阻塞性肺疾病患者恶化风险评估中的应用

目的探讨脉冲振荡肺功能检测(IOS)在慢性阻塞性肺疾病(COPD)恶化风险评估中的应用价值。方法选取184例COPD患者,用1年内发生COPD急性加重期(AECOPD)的次数评估COPD患者恶化风险,将COPD患者分为非频繁发作组(AECOPD发作≤1次/年)81例、频繁发作组(AECOPD≥2次/年)103例。患者稳定期均行常规肺功能测试(PFT)、IOS,PFT参数包括第1秒用力呼气末容积(FEV1)、用力肺活量(FVC)、FVC实际值与预计值比值(FVC%pred)、第1秒用力呼气末容积占其预计值的百分比(FEV1%pred)、用力呼出50%肺活量时的瞬时呼气流量(FEF50%)、用力呼出75%肺活量时的瞬时呼气流量(FEF75%)、呼气峰流速(PEF)、用力呼气时中段呼气流速(MMEF),根据FEV1%pred对气道阻塞严重程度进行分级(GOLD分级);IOS参数包括振荡频率为5 Hz时呼吸总阻抗(Z5)、振荡频率为5 Hz时电抗(X5)、振荡频率为5 Hz时电抗占其预计值的百分比(X5%pred)、振荡频率为5 Hz时气道总阻力(R5)、振荡频率为5 Hz时气道总阻力占其预计值的百分比(R5%pred)、振荡频率为20 Hz时的气道阻力(R20)、振荡频率为5和20 Hz时气道阻力差值(R5-R20)、ΔR5-R20[100×(R5-R20)/R20]、响应频率(Fres),用X5和R5对气道阻塞严重程度进行分级。用改良版英国医学研究委员会呼吸问卷(mMRC)评估患者的呼吸困难程度,用COPD评估测试(CAT)问卷评估患者的生活质量。用Pearson相关法分析各指标间的相关性。结果频繁发作组FEV1、FVC、FVC%pred、FEV1/FVC、FEV1%pred、FEF50%、FEF75%、PEF、MMEF等PFT参数均较非频繁发作组低(P均<0.05),非频繁发作组和频繁发作组GOLD分级差异有统计学意义(P<0.05)。频繁发作组Z5、X5、X5%pred、R5、R5%pred、R20、R5-R20、ΔR5-R20、Fres等IOS参数均较非频繁发作组高(P均<0.05),非频繁发作组和频繁发作组IOS分级差异有统计学意义(P<0.05)。频繁发作组mMRC、CAT评分均较非频繁发作组高(P均<0.05)。COPD患者Z5、X5%pred、R5、R5%pred、R20、R5-R20、ΔR5-R20、Fres与FEV1、FVC、FVC%pred、FEV1/FVC、FEV1%pred、FEF50%、FEF75%、PEF、MMEF、mMRC评分、CAT评分均呈负相关(P均<0.05),X5与FEV1、FVC、FVC%pred、FEV1/FVC、FEV1%pred、FEF50%、FEF75%、PEF、MMEF、mMRC评分、CAT评分均呈正相关(P均<0.05)。结论IOS可用于评价COPD患者的恶化风险。

呼出气一氧化氮、脉冲振荡检查在儿童哮喘中的诊断价值分析

目的:分析呼出气一氧化氮(FeNO)、脉冲振荡(IOS)检查在儿童哮喘中的诊断价值。方法:选取2019年1月—2022年1月成都市成华区妇幼保健院呼吸科收治的48例非哮喘患儿作为对照组,选取同期48例哮喘患儿作为研究组。两组患儿均进行FeNO检测、IOS检查,分析检查结果。结果:研究组FeNO水平及中心气道阻力(R20)、呼吸总阻抗(R5)、呼吸系统总阻抗(Z5)、响应频率(Fres)高于对照组,差异有统计学意义(P<0.001)。急性期FeNO水平及R20、R5、Z5、Fres高于缓解期,差异有统计学意义(P<0.001)。结论:哮喘患儿FeNO检测、IOS检查结果呈高表达水平,且急性期表达水平更高,可为儿童哮喘的诊断与病情评估提供参考。

学龄前慢性咳嗽患儿IOS检查中R35的临床意义

目的：探讨学龄前慢性咳嗽患儿强迫脉冲振荡（ IOS）检查中R35的临床意义及健康指导。方法：选择我院肺功能室2013年6~12月240例诊断为慢性咳嗽患儿，有鼻塞、鼻痒等变应性鼻炎或哮喘合并鼻炎和或有早期咳嗽或体位改变咳嗽加重等上气道咳嗽综合征表现的120例患儿纳入观察组，其余没有上述综合征表现的咳嗽患儿120例纳入对照组。两组患儿均进行IOS检查，对两组5岁以上的患儿同时进行通气功能检测，观察其指标及图形变化。结果：观察组IOS各项参数与对照组比较有统计学意义（P〈0.05）。两组5岁以上患儿同时兼做通气功能检查，结果比较无统计学意义（P〉0.05）。结论：IOS检查能很好地反应呼吸系统各部位疾病的改变，特别是临床症状不典型患儿，对其进行早期辅助检查，能为临床治疗和护理健康指导提供早期客观依据，提高生活质量。

脉冲振荡肺功能检测在儿童支气管舒张试验中诊断阈值探讨

目的探讨脉冲振荡(impulse oscillometry,IOS)肺功能检测在儿童支气管舒张试验中的诊断价值,确定脉冲振荡肺功能各指标舒张试验的阳性标准。方法本研究选取2021年1月—2022年8月在四川大学华西第二医院就诊的86例儿童为研究对象,年龄在4~14岁。其中,哮喘门诊就诊患儿为哮喘组(51例),健康体检儿童为对照组(35例)。两组患者均在吸入沙丁胺醇前后进行常规肺通气功能测定和IOS肺功能检测,以第一秒用力呼气容积(forced expiratory volume in one second,FEV1)≥12%作为标准,比较两组受试者在支气管舒张试验前后IOS各参数的差异,确定IOS舒张试验的阳性标准。结果舒张试验前,哮喘组肺通气功能测定指标FEV1/FVC、FEV1为(82.64±7.53)和(78.64±16.49),对照组为(99.27±6.16)和(98.19±9.02),吸入沙丁胺醇后哮喘组FEV1改善率≥12%,而对照组<12%。支气管舒张试验后,哮喘组和对照组IOS肺功能各参数均有不同程度改善。ROC结果显示,IOS各指标中,振荡频率为5Hz时的呼吸总阻抗(Z5)、周边弹性阻力(X5)、气道黏性阻力(R5)等指标对于支气管舒张试验阳性有较好的诊断价值。以Z5下降≥13.91%、X5下降≥14.78%、R5下降≥14.96%为脉冲振荡肺功能支气管舒张试验阳性的分界点,敏感性和特异性较高。结论支气管舒张试验后,Z5下降≥13.91%、X5下降≥14.78%、R5下降≥14.96%可以判断支气管舒张试验阳性。

支气管哮喘儿童IOS指标与PFT指标的变化及相关性分析

目的探讨支气管哮喘儿童脉冲振荡肺功能检查(IOS)指标与常规肺功能检查(PFT)指标的变化及其相关性。方法回顾性分析2020年1月至2021年3月东莞市人民医院收治的100例支气管哮喘患儿的临床资料,根据患儿病情不同分为急性发作期21例、慢性持续期54例和临床缓解期25例。比较三组患儿的IOS指标[呼吸总阻抗(Zrs)、呼吸道总阻力(R_(5))、中心呼吸道阻力(R_(20))、周边呼吸道阻力(R_(5)~R_(20))、周边弹性阻力(X_(5))、响应频率(Fres)]以及PFT指标[第一秒用力呼气容积(FEV1)、FEV1/用力肺活量(FVC)、呼气峰值流量(PEF)、用力呼出25%、50%、75%肺活量时的瞬间呼气流量(PEF_(25)、PEF_(50)、PEF_(75))及最大呼气中期流量(MMEF)],并采用Pearson相关性分析法分析IOS指标和PFT指标的相关性。结果急性发作期患儿Zrs、R_(5)、R_(20)、R_(5)~R_(20)、X_(5)、Fres分别为(1.33±0.19)kPa/(L·s)、(126.82±20.51)%pred、(98.67±9.10)%pred、(198.75±25.17)%pred、(143.03±17.86)%pred、(18.76±2.10)Hz,明显高于慢性持续期患儿的(1.17±0.16)kPa/(L·s)、(84.19±15.66)%pred、(83.32±7.69)%pred、(109.24±16.53)%pred、(79.23±10.14)%pred、(12.05±1.73)Hz和临床缓解期患儿的(0.92±0.14)kPa/(L·s)、(72.53±10.74)%pred、(73.00±7.15)%pred、(85.81±10.62)%pred、(45.96±6.92)%pred、(8.42±1.61)Hz,且慢性持续期患儿上述指标均明显高于临床缓解期,差异均有统计学意义(P<0.05);急性发作期患儿FEV1、FEV1/FVC、PEF、PEF_(25)、PEF_(50)、PEF_(75)、MMEF分别为(1.28±0.13)L、(76.50±4.86)%、(2.40±0.36)L/s、(1.98±0.16)L/s、(1.05±0.14)L/s、(0.50±0.06)L/s、(0.96±0.08)L/s,明显低于慢性持续期患儿的(1.43±0.15)L、(85.61±6.77)%、(3.51±0.44)L/s、(2.57±0.26)L/s、(1.63±0.17)L/s、(0.78±0.10)L/s、(1.28±0.13)L/s和临床缓解期患儿的(1.57±0.16)L、(93.15±5.48)%、(4.60±0.53)L/s、(3.69±0.40)L/s、(2.50±0.23)L/s、(1.06±0.12)L/s、(1.52±0.18)L/s,且慢性持续期患儿上述指标均明显低于临床缓解期患儿,差异均有统计学意义(P<0.05);经Pearson相关性分析结果显示,IOS与PFT各项指标均呈负相关(P<0.05)。结论支气管哮喘患儿IOS指标与PFT指标之间具有明显的负相关,IOS对临床诊断更有意义,临床应用价值高。

应用脉冲振荡法(IOS)测定大学生肺功能的研究

目的：为能全面反映呼吸生理和呼吸动力学特征，提供较通气功能更多的有用信息。方法：应用脉冲振荡法（im-pulseoscillometry，IOS），测定100名健康大学生5～35Hz频率下的呼吸阻抗值后，测定常规通气肺功能，其中23名男性大学生进行IOS重复试验。结果：呼吸阻抗（Zrs）＜0．5kPa／L·s-1，响应频率（Fre）10Hz左右，除R35外，5～25Hz频率下呼吸道粘性阻力R值均小于预计值的150％，预计R值与实测值间差异无显著性（P＞0．05），预计X值与实测X值间差异显著（P＜0．01）。以频率F为自变量，R与X分别为因变量作相关分析显示，R值不随振荡频率而变化，X值随振荡频率而轻度增高。阻抗微分均值图显示阻力和电抗均无流速依赖性和容积依赖性，但Resistance图显示频谱对阻力的流速有一定影响。结论：健康大学生IOS呼吸道粘性阻力参数基本正常，IOS技术重复性良好，反映弹性阻力和惯性阻力的X变化及频谱对阻力流速的影响，而常规肺功能正常。可认为IOS较适合于大学生健康普查。比传统肺功能可以较早地发现与吸烟有关的COPD潜在病变─—轻度周边阻塞。

Is there a correlation between the changes in airway inflammation and the changes in respiratory mechanics after vaping in patients with asthma?

BACKGROUND Electronic cigarettes(ECs)have been promoted as alternatives to traditional cigarettes.To investigate ECs’effects on respiratory system,especially in patients with respiratory diseases.METHODS We randomly selected 25 smokers with stable moderate asthma and matched them with 25 healthy smokers.All were subjucted to pulmonary function tests(PFTs),impulse oscillometry(IOS),fraction exhaled Nitric Oxide(FeNO),exhaled breathe condensate(EBC)and biomarker measurements before and after vaping one nicotinecontaining EC.RESULTS The increase in FeNO 30 minutes after EC,reflecting airway inflammation,significantly correlated with increase of residual volume(RV),total lung capacity,respiratory impedance at 5 Hz(Z5Hz)and respiratory resistance at 5 and 20 Hz(R5Hz and R20Hz).No significant correlations were found between EBC biomarkers'changes and respiratory mechanics.CONCLUSION This is the first study demonstrating that the changes in airway inflammation caused by EC have direct effects in respiratory mechanics of asthmatic patients.

脉冲振荡肺功能检查在学龄前儿童哮喘诊断中的价值

目的 探讨脉冲振荡(IOS)肺功能检查在学龄前儿童哮喘诊断中的价值。方法 将96例学龄前哮喘患儿作为研究组,96例健康儿童作为对照组,比较2组IOS肺功能检查参数[总呼吸黏性阻力(R5)、周边气道黏性阻力(R5-R20)、中心气道黏性阻力(R20)、共振频率(Fres)]、常规肺功能指标[用力肺活量(FVC)、呼气峰流速(PEF)、第1秒用力呼气容积(FEV1)]。将研究组患儿按哮喘急性发作程度分为轻度组、中度组、重度组,比较不同病情程度患儿IOS肺功能检查参数、哮喘控制测试(ACT)评分、常规肺功能指标,分析IOS肺功能检查参数与ACT评分、常规肺功能指标的关系。结果 研究组R5、R5-R20、Fres、R20值均显著高于对照组(P<0.001),FVC、PEF、FEV1值均显著低于对照组(P<0.001)。研究组患儿R5、R5-R20、Fres、R20值随着病情的加重而增加,FVC、PEF、FEV1值及ACT评分随着病情的加重而降低,上述指标不同病情患儿之间比较差异均有统计学意义(P<0.001)。IOS肺功能检查参数与ACT评分、常规肺功能指标均呈显著负相关(P<0.05)。结论 IOS肺功能检查参数随学龄前儿童哮喘发生发展而变化,在学龄前儿童哮喘临床诊断及疗效监测中有较高的应用价值。

IOS、PFT与外周血EOS检测在糖皮质激素雾化吸入治疗儿童支气管哮喘效果评估中的应用价值

目的 探讨分析脉冲振荡肺功能(IOS)、肺功能测试(PFT)与外周血嗜酸性粒细胞(EOS)检测在糖皮质激素雾化吸入治疗儿童支气管哮喘效果评估中的应用价值。方法 选择我院2018年10月至2020年8月收治的88例支气管哮喘患儿作为哮喘组,另选取同期于我院行健康体检的80例儿童作为对照组。对比两组的IOS、 PFT及外周血EOS检查情况。结果 哮喘组治疗前后IOS各指标及外周血EOS水平均高于对照组,PFT指标水平均低于对照组(P <0.05)。哮喘组治疗前后IOS、 PFT及外周血EOS水平比较,差异有统计学意义(P <0.05)。结论 IOS、 PFT与外周血EOS检测在糖皮质激素雾化吸入治疗儿童支气管哮喘效果评估中的应用价值较高,对评估患儿病情及指导治疗意义重大。

Assessment of Respiratory lmpedance During Deep Slow Breathing with lmpulse Oscillometry in Patients with Chronic Obstructive Pulmonary Disease

Objective: To observe the relationship of deep slow respiratory pattern and respiratory impedance(RI) in patients with chronic obstructive pulmonary disease (COPD). Methods: RI under normal respiration and during deep slow respira tion was measured one after the other with impulse oscillometry for 8 patients with COPD and for 9 healthy volunteers as control. Results: When r espiration was changed from normal pattern to the deep slow pattern, the tida l volume increased and respiratory frequency significantly decreased in both gro ups , the total respiratory impedance (Z respir) showed a decreasing trend in COPD group, but with no obvious change in the control group. No chang e in the resonant frequency (fres) was found in both groups, and the respiratory viscous resistance obviously decreased in the COPD group(R5: P =0.0168 ; R20: P =0.0498; R5—R20: P =0.0388),though in the control group it was unchanged. Conclusion: IOS detection could reflect the response he terogeneity of different compartments of respiratory system during tidal breathi ng. During deep slow respiration, the viscous resistance in both central airw ay and peripheral airway was decreased in patients with COPD. RI measurement by impulse oscillometry may be a convenient pathophysiological method for studying the application of breathing exercise in patients with COPD.

脉冲振荡技术在呼吸阻力测试中的诊断价值

目的本研究旨在了解三种呼吸阻力测试法(IOS法、体描箱法、超声阻断法)评估肺通气功能的差异,了解国人正常预计值(z值)与传统实测值占预计值百分比(实测值%pred)评估肺通气功能的差异,了解脉冲振荡(Impulse oscillometry,IOS)技术在不同呼吸频率及舌置咬嘴的不同位置(舌不同位置)对呼吸阻力的影响。方法纳入受检者277例,以不同观察目的分组:三种方法组、z值组、舌位置组、呼吸频率组,其中78例受检者纳入三种方法组,用3种不同方法测试呼吸阻力计算异常检出率;85例受检者入z值组,受检者使用IOS法测试呼吸阻力,用z值与实测值%pred评估肺通气功能比较差异;44例受检者入舌位置组,观察舌不同位置对呼吸阻抗的影响;70例受检者纳入呼吸频率组,观察不同呼吸频率对呼吸阻抗的影响。结果IOS测定的呼吸阻抗与体描箱法的气道阻力异常检出率比无显著性差异,但这两种方法与超声阻断法气道阻力异常检出率比差异有统计学意义(P<0.05);IOS测试的R_(5)、R_(20)、X_(5)的z值与其实测值%pred的异常检出率比差异有显著统计学意义(P<0.05);测试R_(5)、R_(20)、X_(5)数值于舌不同位置及受检者在不同呼吸频率下测试值无统计学意义。结论IOS法与体描箱法测定的气道阻力有良好的一致性;使用z值评估R_(5)、R_(20)、X_(5)的呼吸阻力比实测值%pred评估的呼吸阻力敏感;IOS测试值受舌不同位置及不同呼吸频率的影响不明显。

脉冲振荡肺功能在儿童小气道功能障碍疾病中的临床应用

小气道功能障碍已被证实广泛存在于哮喘、慢性阻塞性肺病等疾病中,其临床表现不典型,不易被早期发现。及时明确小气道功能障碍,有利于疾病的早期治疗、准确判断及改善预后。脉冲振荡肺功能是一种新型的肺功能检测方式,目前被广泛认为是评估小气道功能最敏感的技术之一,其可以测量被检查者在平静呼吸时呼吸系统的阻抗(R)和电抗(X),了解中央和外周气道阻塞情况,同时具有无创、操作简单、重复性好等优点。

昆明地区健康成人脉冲振荡肺功能测定

目的确定昆明地区健康成人脉冲振荡肺功能的正常参考值及预计值.方法185例昆明地区的的健康成人,常规肺功能正常,测定脉冲振荡肺功能,指标包括R(5～35)Hz粘性阻力,X(5～35)Hz弹性阻力及惯性阻力,Fres(共振频率),Zrs(呼吸总阻抗),Rc(中心阻力),Rp(周边阻力),顺应性Cl、Cb及Cm等.结果X5～X35、Cl、Cb、Cm、Rp不呈正态分布.建立了阻抗R的多元回归方程式.结论建议临床使用本地区正常预计值,实测值/预计值%保持不变.

脉冲振荡技术在支气管哮喘诊断中的临床应用

目的探讨脉冲振荡技术(IOS)测定呼吸阻抗诊断支气管哮喘的价值。方法对86例支气管哮喘患者(哮喘组)和70例健康者(对照组)进行IOS及常规肺通气功能测定,比较两组患者的呼吸阻抗指标,并与常规肺通气功能指标进行相关性分析。结果哮喘组IOS指标共振频率(Fres)、呼吸总抗阻(Zrs)、5Hz黏性阻力(R5)、20Hz黏性阻力(R20)、5Hz和20Hz黏性阻力差(R5-R20)、中心阻力(Rc)、周边阻力(Rp)均明显高于对照组,X5明显低于对照组。哮喘组Fres、Zrs、R5、R5-R20、Rp与常规肺通气指标第1秒用力呼气量/1秒用力呼气量预计值的百分比(FEV1%)、1秒用力呼气量/用力肺活量(FEV1/FVC)、用力呼气50%肺活量瞬间流量(FEF50%)、用力呼气75%肺活量瞬间流量(FEF75%)呈显著负相关,其中Fres与FEV1%和FEV1/FVC相关性最密切(r=-0.642、-0.590,P<0.01);X5与FEV1%、FEV1/FVC%呈显著正相关,R20、Rc与常规肺功能指标无相关性。结论 IOS可用于支气管哮喘的病情判断,是一种无创、简便、实用的方法,值得临床推广应用。Fres是IOS参数中诊断哮喘气流阻塞最敏感的指标。

脉冲振荡肺功能在阻塞性睡眠呼吸暂停低通气综合征中的应用

目的:观察脉冲振荡(IOS)呼吸阻抗值在阻塞性睡眠呼吸暂停低通气综合征(OSAHS)患者中的变化,并探讨其在OSAHS诊断中的应用价值。方法:对38例OSAHS患者(OSAHS组)、22例单纯打鼾而无睡眠呼吸暂停患者(单纯鼾症组)和20名健康人(对照组)进行IOS肺功能检测,比较3组的呼吸阻抗指标,并将OSAHS患者睡眠监测有关指标与呼吸阻抗指标进行相关性分析。结果:OSAHS患者上气道阻力(R35)、中心气道阻力(R20)、呼吸总阻抗(Zrs)、总气道阻力(R5)明显高于单纯鼾症组和对照组,差异有非常显著性(P<0.01),单纯鼾症组又高于对照组,差异亦有显著性(P<0.05)。OSAHS组呼吸暂停低通气指数(AHI)与R35和R20呈正相关,相关系数(r)分别为0.623和0.617(P<0.01);最低SO2与R35、R20、Zrs呈负相关,r分别为-0.607、-0.591和-0.462(P<0.01)。结论:IOS肺功能可作为检测OSAHS患者上气道阻力的一种方法,为非睡眠状态下OSAHS诊断及病情程度判断提供帮助。