强迫振荡肺功能测定新技术及临床研究

目的探讨强迫振荡肺功能测定在正常人、慢性阻塞性肺疾病、哮喘、肺纤维化等患者中气道阻力和相位角的变化规律以及哮喘患者吸入支气管舒张剂前、后肺功能的变化。方法使用德国Ｃｕｓｔｏｖｉｔｍ强迫振荡设备，测定各患者组气道阻力和相位角，然后分别和正常组进行统计学比较；哮喘患者吸入间羟舒喘宁前、后气道阻力改善率与一秒钟用力呼气容积（ＦＥＶ１）和流速容量（ＦＶ）曲线测定改善率比较。结果慢性阻塞性肺疾患和哮喘组气道阻力值与正常组比较差异有显著性（Ｐ＜０．０５）及显著频率依赖性（Ｐ＜０．０５）；各病种组相位角与正常组比较差异有显著性（Ｐ＜０．０５），且肺纤维化患者仅表现为相位角降低；哮喘患者吸入间羟舒喘宁后气道阻力改善率与ＦＥＶ１和ＦＶ曲线改善率比较差异有显著性（Ｐ＜０．０５）。结论强迫振荡法是一种简便、快速、无创性测定气道阻力与相位角的新方法，适用于重症慢性阻塞性肺疾病患者，且对哮喘的用药观察优于传统肺功能测定。

Clinical study on the forced oscillatory pulmonary function test

Objective To discuss the change of airway resistance and phase angle (phi) in normal subjects, patients with COPD, asthma and pulmonary fibrosis when the new technique of the forced oscillatory pulmonary function test was applied to measure them as well as the change of pulmonary function of patients with asthma after using bronchodilator. Method Use Custo vitm forced oscillation device manufactured in Germany to determine airway resistance and phase angle and to compare their statistical differences between normal subjects and patients with pulmonary disease, and then comparing the improvement rates of their FEV 1, F V curve and airway resistance in patients with asthma after inhaling bricasol. Result The measurements of group COPD and asthma were significantly higher than those of normal group ( P <0.05), and there were obvious frequency dependence in these two groups.The results of phase angle in each group of patients were significantly lower than those of normal group ( P <0.05), and the group of patients with pulmonary fibrosis only demonstrates a decrease in phase angle, and the improvement rate of airway resistance in patients with asthma after inhaling bricasol was significantly higher than FEV 1 and F V curve ( P <0.05). Conclusion Forced oscillation is a convenient, quick, and noninvasive new method when applied to measure airway resistance and phase angle. It is especially suitable for patients with severe COPD and better than conventional pulmonary function test in observing therapeutic effect in asthma.