脉冲振荡肺功能测定在稳定期慢性阻塞性肺疾病治疗中的应用价值

目的探讨脉冲振荡肺功能测定(IOS)在稳定期慢性阻塞性肺疾病(COPD)临床治疗中的应用价值,及与传统肺功能检测的相关性。方法收集2013年1月至2015年12月我院呼吸科住院的稳定期COPD患者100例作为实验组,根据COPD严重程度分为A、B、C、D四组,A组(轻度)17例,B组(中度)21例,C组(重度)33例,D组(极重度)29例,另选40例健康人作为对照组。所有研究对象入组后进行IOS肺功能测定(Zrs、Fres、R5、R20、X5)和传统肺功能测定(FEV_1、FEV_1/FVC),COPD患者治疗三个月后复诊。结果治疗前后,实验各组与健康组比较,FEV_1、FEV_1/FVC、X5显著降低,Zrs、Fres、R5、R5-R20、R20显著升高;并且COPD越严重Zrs、Fres、R5、R5-R20、R20越高,FEV_1、FEV_1/FVC、X5越低(P0.05);经过治疗后,四个实验组FEV_1、FEV_1/FVC显著升高,Zrs、Fres、R5、R5-R20显著降低(P0.05),X5、R20无明显改变。FEV_1、FEV_1/FVC与Zrs、Fres、R5、R5-R20呈明显负相关(P0.05),与X5呈明显正相关(P0.05),其中FEV_1与Fres的相关性最强(r=-0.765)。结论 IOS肺功能检测指标能客观反映气道阻力,并且与传统肺功能指标有良好的相关性,可以作为一种新的COPD诊断技术在临床上推广使用。

Appling value of impulse oscillometry in patients with chronic obstructive pulmonary disease in stable stage

Objective To research the application value of impulse oscillometry (IOS) in patients with chronic obstructive pulmonary disease (COPD) and its correlation with conventional detecting lung function indexes.Methods 332 cases of COPD in our hospital from January 2013 to December 2015 were selected as experimental group,these patients were divided into mild 17 cases(group A),moderate 21 cases (group B),severe 33 cases (group C),very severe 29 cases (group D).40 health people were selected as control group.The conventional lung function indicators (FEV1/FVC,FEV1) and IOS indexes (ZRS,Fres,R5,X5,R20) were detected before and after treatment and the correlation between them were also analyzed.Results The FEV1,FEV1/FVC and X5 of COPD patients were significantly lower than those of the control group,the indicators such as Zrs,Fres,R5,R5-R20 and R20 in experimenta group were significantly higher than in control group,these indicators worse with the development of disease.FEV/FVC,FEV1,Zrs,Fres,R5 and R5-R20 obviously improved after treatment,and the difference was statistically significant (P＜O.05).FEV1,FEV1/FVC had a negative correlation with Zrs,Fres,R5 and R5-R20 (P＜0.05),but a positive correlation with X5 (P＜0.05),the closest correlation was found in FEV1 and Fres (r =-0.765).Conclusion IOS and reflect the airway resistance and have a good correlation with the traditional lung function indexes.IOS can be used as a new detection technology in COPD patients.