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...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.展开更多
Objective:To evaluate the applicable value of respiratory impedance for the stage 0 of chronic obstructive pulmonary disease （COPD）. Methods:Respiratory impedance was measured by impulse oscillometry （IOS） in 41 c...Objective:To evaluate the applicable value of respiratory impedance for the stage 0 of chronic obstructive pulmonary disease （COPD）. Methods:Respiratory impedance was measured by impulse oscillometry （IOS） in 41 cases at stage 0 of COPD （NHLBI/WHO, 2001 Standard） and their conventional pulmonary function values were compared with 42 healthy subjects. Both groups had no significant deviation in age, stature and avoirdupois, etc. Master-Screen pulmonary function test system （Jaeger Co, Germany） were used to determine IOS parameters including viscous resistance of 5Hz, 20 Hz and 35Hz （R5, R 20, R 35）, reactance of 5Hz, 35 Hz （X5, X 35 ）, resonant frequency （Fres） ,total respiratory impedance （Zrs） and routine pulmonary function values including forced expiratory volume in one second to predicted value （FEV1%）, forced expiratory volume in one second to forced vital capacity ratio（ FEV1/FVC%）, maximal mid-expiratory flow （MMEF%）,V 25% and V 50%. Results:Both groups had no significant deviation in FEV1%, FEV1/FVC% and X 35 （P>0.05）. It was increased significantly in viscous resistance of 5Hz, 20 Hz and 35Hz （R5, R 20, R 35） in COPD group than that in healthy group （P<0.01）. So were Fres and Zrs （P<0.01）. MMEF%,V 25%,V 50% and reactance of 5Hz （X5） in COPD group were marked lower than that in healthy group （P<0.01）. The sensitivity of MMEF%, V 25%,V 50% was higher than others, but its specificity was lower. In parameters of IOS, Fres was the most sensitive index for diagnosis of the small airway function and its specificity was higher than that of MMEF%, V 25%,V 50%. Conclusion:In the risk case at the stage 0 of COPD, MMEF%, V 25% and V 50% could be decreased, but Fres, R5,R 5-20 could be increased in spite of FEV1% and FEV1/FVC% in normal range.展开更多
目的研究常规肺功能测试(pulmonary function test, PFT)与脉冲振荡肺功能(impulse oscillometry system, IOS)评价慢性阻塞性肺疾病(chronic obstructive pulmonary disease, COPD)气道阻塞严重程度的一致性。方法对2016年4月-2017年4...目的研究常规肺功能测试(pulmonary function test, PFT)与脉冲振荡肺功能(impulse oscillometry system, IOS)评价慢性阻塞性肺疾病(chronic obstructive pulmonary disease, COPD)气道阻塞严重程度的一致性。方法对2016年4月-2017年4月随访的116例稳定期COPD患者(男性103例、女性13例)依次进行IOS检测和PFT检测,应用统计学分析软件对IOS和PFT参数行一致性与相关性分析。结果 116例受试者中,仅38例(32.8%)受试者气道阻塞严重程度分级结果一致,分级一致性存在较大差异(P<0.05);在78例严重程度不同的受试者中,52例IOS分级重于PFT分级。将52例IOS分级较重的患者与其余患者对比分析发现,这部分患者的PFT参数中,用力肺活量占预计值百分比(forced vital capacity, FVC%pred)、第1秒用力呼气容积占预计值百分比(forced vital capacity in one second, FEV1%pred)、第1秒用力呼气容积与用力肺活量之比(ratio of forced expiratory volume in one second to forced vital capacity, FEV1/FVC)较对照组均有升高(P<0.05);而IOS参数中振荡频率为5Hz时的黏性阻力(respiratory resistance at 5Hz, R5)、振荡频率为20Hz时的黏性阻力(respiratory resistance at 20Hz, R20)、振荡频率为5Hz和20Hz时的黏性阻力差值(difference between respiratory resistance at 5Hz and 20Hz, R5-R20)、共振频率(resonant frequency, Fres)较对照组均升高(P<0.05);IOS与PFT各参数相关性分析中,IOS参数:低频电抗面积(reactance area, AX)、R5-R20、ΔR5-R20、Fres、R5与PFT参数:FEV1%pred、FVC%pred、FEV1/FVC、第3秒用力呼气容积与用力肺活量之比(ratio of forced expiratory volume in three second to forced vital capacity, FEV3/FVC)、50%肺活量时最大呼吸流速(maximal expiratory flow rate at 50%of vital capacity, FEF50)、75%肺活量时最大呼吸流速(maximal expiratory flow rate at 75%of vital capacity, FEF75)呈负相关(P<0.01),与残气与肺总量之比(ratio of residual volume to total lung volume, RV/TLC)呈正相关(P<0.01)。结论 IOS与PFT对COPD气道阻塞严重程度评价存在差异,在早中期气道阻塞患者中,IOS损害程度级别显著高于PFT,IOS在评价小气道功能障碍时敏感性可能高于PFT,在临床应用中将二者相互结合可能可以更好地评价气道功能障碍。展开更多
文摘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.
文摘Objective:To evaluate the applicable value of respiratory impedance for the stage 0 of chronic obstructive pulmonary disease （COPD）. Methods:Respiratory impedance was measured by impulse oscillometry （IOS） in 41 cases at stage 0 of COPD （NHLBI/WHO, 2001 Standard） and their conventional pulmonary function values were compared with 42 healthy subjects. Both groups had no significant deviation in age, stature and avoirdupois, etc. Master-Screen pulmonary function test system （Jaeger Co, Germany） were used to determine IOS parameters including viscous resistance of 5Hz, 20 Hz and 35Hz （R5, R 20, R 35）, reactance of 5Hz, 35 Hz （X5, X 35 ）, resonant frequency （Fres） ,total respiratory impedance （Zrs） and routine pulmonary function values including forced expiratory volume in one second to predicted value （FEV1%）, forced expiratory volume in one second to forced vital capacity ratio（ FEV1/FVC%）, maximal mid-expiratory flow （MMEF%）,V 25% and V 50%. Results:Both groups had no significant deviation in FEV1%, FEV1/FVC% and X 35 （P>0.05）. It was increased significantly in viscous resistance of 5Hz, 20 Hz and 35Hz （R5, R 20, R 35） in COPD group than that in healthy group （P<0.01）. So were Fres and Zrs （P<0.01）. MMEF%,V 25%,V 50% and reactance of 5Hz （X5） in COPD group were marked lower than that in healthy group （P<0.01）. The sensitivity of MMEF%, V 25%,V 50% was higher than others, but its specificity was lower. In parameters of IOS, Fres was the most sensitive index for diagnosis of the small airway function and its specificity was higher than that of MMEF%, V 25%,V 50%. Conclusion:In the risk case at the stage 0 of COPD, MMEF%, V 25% and V 50% could be decreased, but Fres, R5,R 5-20 could be increased in spite of FEV1% and FEV1/FVC% in normal range.
文摘目的研究常规肺功能测试(pulmonary function test, PFT)与脉冲振荡肺功能(impulse oscillometry system, IOS)评价慢性阻塞性肺疾病(chronic obstructive pulmonary disease, COPD)气道阻塞严重程度的一致性。方法对2016年4月-2017年4月随访的116例稳定期COPD患者(男性103例、女性13例)依次进行IOS检测和PFT检测,应用统计学分析软件对IOS和PFT参数行一致性与相关性分析。结果 116例受试者中,仅38例(32.8%)受试者气道阻塞严重程度分级结果一致,分级一致性存在较大差异(P<0.05);在78例严重程度不同的受试者中,52例IOS分级重于PFT分级。将52例IOS分级较重的患者与其余患者对比分析发现,这部分患者的PFT参数中,用力肺活量占预计值百分比(forced vital capacity, FVC%pred)、第1秒用力呼气容积占预计值百分比(forced vital capacity in one second, FEV1%pred)、第1秒用力呼气容积与用力肺活量之比(ratio of forced expiratory volume in one second to forced vital capacity, FEV1/FVC)较对照组均有升高(P<0.05);而IOS参数中振荡频率为5Hz时的黏性阻力(respiratory resistance at 5Hz, R5)、振荡频率为20Hz时的黏性阻力(respiratory resistance at 20Hz, R20)、振荡频率为5Hz和20Hz时的黏性阻力差值(difference between respiratory resistance at 5Hz and 20Hz, R5-R20)、共振频率(resonant frequency, Fres)较对照组均升高(P<0.05);IOS与PFT各参数相关性分析中,IOS参数:低频电抗面积(reactance area, AX)、R5-R20、ΔR5-R20、Fres、R5与PFT参数:FEV1%pred、FVC%pred、FEV1/FVC、第3秒用力呼气容积与用力肺活量之比(ratio of forced expiratory volume in three second to forced vital capacity, FEV3/FVC)、50%肺活量时最大呼吸流速(maximal expiratory flow rate at 50%of vital capacity, FEF50)、75%肺活量时最大呼吸流速(maximal expiratory flow rate at 75%of vital capacity, FEF75)呈负相关(P<0.01),与残气与肺总量之比(ratio of residual volume to total lung volume, RV/TLC)呈正相关(P<0.01)。结论 IOS与PFT对COPD气道阻塞严重程度评价存在差异,在早中期气道阻塞患者中,IOS损害程度级别显著高于PFT,IOS在评价小气道功能障碍时敏感性可能高于PFT,在临床应用中将二者相互结合可能可以更好地评价气道功能障碍。
