容积二氧化碳图及其指标诊断慢性阻塞性肺疾病患者换气功能的评价

目的 评价容积二氧化碳图(VCap)及其指标诊断慢性阻塞性肺疾病(COPD)患者换气功能障碍的临床应用价值.方法 比较分析COPD组92例与对照组48例VCap及其11项指标Bohr测定法死腔(VD-B)、呼气末最大CO2浓度(CO2max)、呼出气CO2浓度为25%～50%时的容量(Vm25-50)、呼出气CO2浓度为50%～75%时的容量(Vm50 75)、潮气量(VT)、VD-B/VT、Vm25-50/VT、Vm50-75/VT、Ⅱ期斜率(dC/dV2)、Ⅲ期斜率(dC/dV3)和Ⅲ期斜率/Ⅱ期斜率× 100(SR23)]的差别.结果 COPD组与对照组CO2 max、Vm50-75、VT、VD-B/VT、Vm25 50/VT、Vm50-75/VT、dC/dV2、dC/dV3和SR23等9项指标差异有统计学意义(P＜0.05).在COPD组中,Ⅱ级与Ⅲ级的VD-B/VT、Vm25-50/VT、dC/dV3和SR23等4项指标差异有统计学意义(P＜0.05);Ⅱ级与Ⅳ级的dC/dV2、dC/dV3和SR23等3项指标差异有统计学意义(P＜0.05);Ⅲ级与Ⅳ级dC/dV3和SR23等2项指标差异有统计学意义(P＜0.05).结论 COPD组VCap曲线形态有异常改变,dC/dV3和SR23可作为最佳诊断指标.VCap检测技术具有无创性和价廉等优点,是诊断COPD换气功能状况的好方法.

Abstract：

Objective To evaluate on volumetric capnography ( VCap) change of patients with chronic obstructive pulmonary diseases (COPD), diagnosing their dysfunction of ventilation. Methods Compard the differences between the 92 patients of COPD group and 48 healthly people of control group on VCap and its indices ( VD-B, CO2max, Vm25-50, Vm50-57 , VT, VD-B/VT, Vm25-50/VT, Vm50-57/VT,dC/dV2 ,dC/dV3 and SR23). Results There were significant differences ( P ＜0. 05) between COPD group and control group on VCap and its indices (CO2max, Vm50 75 ,VT,VD-B/VT,Vm25-50/VT, Vm50-57/VT,dC/dV2 ,dC/dV3 and SR23), between COPDⅡ and COPD Ⅲ on VCap indices (VD-B/VT, Vm25 50/VT,dC/dV3 and SR23), between COPD Ⅱ and COPDIV on VCap indices (dC/dV2 ,dC/dV3 and SR23),between COPDⅢ and COPDIV on dC/dV3 and SR23. Conclusions The shape of VCap curve of the COPD group were significant different from the control group. For diagnosing dysfunction of ventilation COPD patient, the dC/dV3 and SR23 were the best indices, and the VD-B/VT, Vm25-50/VT and Vm50-75/VT were more significant than the VD-B,CO2 max, Vm25-50 and Vm50-75.

Evaluation on volumetric capnography diagnosing dysfunction of ventilation in patients with chronic obstruction pulmonary disease

Objective To evaluate on volumetric capnography ( VCap) change of patients with chronic obstructive pulmonary diseases (COPD), diagnosing their dysfunction of ventilation. Methods Compard the differences between the 92 patients of COPD group and 48 healthly people of control group on VCap and its indices ( VD-B, CO2max, Vm25-50, Vm50-57 , VT, VD-B/VT, Vm25-50/VT, Vm50-57/VT,dC/dV2 ,dC/dV3 and SR23). Results There were significant differences ( P ＜0. 05) between COPD group and control group on VCap and its indices (CO2max, Vm50 75 ,VT,VD-B/VT,Vm25-50/VT, Vm50-57/VT,dC/dV2 ,dC/dV3 and SR23), between COPDⅡ and COPD Ⅲ on VCap indices (VD-B/VT, Vm25 50/VT,dC/dV3 and SR23), between COPD Ⅱ and COPDIV on VCap indices (dC/dV2 ,dC/dV3 and SR23),between COPDⅢ and COPDIV on dC/dV3 and SR23. Conclusions The shape of VCap curve of the COPD group were significant different from the control group. For diagnosing dysfunction of ventilation COPD patient, the dC/dV3 and SR23 were the best indices, and the VD-B/VT, Vm25-50/VT and Vm50-75/VT were more significant than the VD-B,CO2 max, Vm25-50 and Vm50-75.