脉冲振荡法在阻塞性通气功能障碍评定中的价值

目的 探讨脉冲振荡法评定阻塞性通气功能障碍的应用价值及其与常规肺通气功能测定的关系.方法 2007年11月至2008年5月,采用德国耶格公司的肺功能仪及产品说明书给出的预计值公式,测定100例(男72例,女28例)门诊和住院患者的FEV1、FVC、5 Hz时气道阻力(R5)、20 Hz时气道阻力(R20)、结构参数图中的中心阻力(Rc)和周边阻力(Rp)的实测值,FEV1、R5和R20占预计值%,以及FEV1/FVC等指标.并对常规和脉冲振荡法测定肺通气功能的指标进行相关分析.结果 所有受试者均获得满意的脉冲振荡测定结果.当FEV1/FVC低于正常时(＜70%),R5和Rp明显升高至(5.3±2.1)和(6.2±2.9)cm H2O·L-1·S-1(1 cm H2O=0.098 kPa),FEV1与R5、Rp呈显著负相关(r值分别为-0.38和-0.47,均P＜0.01),FVC与R5、Rp也呈显著负相关(r值分别为-0.28和-0.37,均P＜0.01).FEV1占预计值%、FVC占预计值%、FEV1/FVC与R5占预计值%均呈显著负相关(r值分别为-0.49、-0.39和-0.43,均P＜0.01).结论 脉冲振荡法的测定指标可用于评估阻塞性通气功能障碍,尤其是R5的诊断价值最大,并且与常规肺通气功能指标之间有良好的相关性.

Impulse oscillometry for estimation of airway obstruction

Objective To explore the application of impulse oscillometry (IOS) in the estimation of airway obstruction and to evaluate the correlation between spirometry indices and IOS parameters.Methods From Nov.2007 to May 2008,spirometry and IOS measurements were performed in 100 participants ( male 72,female 28).FEV1,FVC,FEV1/FVC,airway resistance at 5 Hz (R5),airway resistance at 20 Hz (R20),central resistance (Rc) and peripheral resistance (Rp) of structural parameters interpretation graph,FEV1% pred,R5%pred,P20% pred,and FEV1/FVC were analyzed.Correlations between spirometry and IOS parameters were studied.ResultsAll participants had satisfactory impulse oscillometry results.R5 and Rp were significantly increased in FEV1/FVC ＜70% group[(5.3 +2.1 ) and (6.2 +2.9) cm H2O· L-1· s-1 (1 cm H2O = 0.098 kPa)],respectively.There was significant negative correlation between FEV1 and R5 and Rp ( correlation coefficient was-0.38 and-0.47 respectively,all P ＜ 0.01 ).There was also negative correlation between FVC and R5 and Rp (correlation coefficient was-0.28 and -0.37,respectively,all P ＜0.01 ).A significant negative correlation between FEV1% pred,FVC% pred,FEV1/FVC% pred and R5% pred was also observed (correlation coefficient-0.49,-0.39 and -0.43,respectively).Conclusions IOS parameters can be used to evaluate airway obstruction.Among lOS parameters,R5 was the most sensitive,which was also significantly correlated with spirometric parameters.