脉冲震荡法与常规通气在支气管激发试验中的对比研究

目的：探讨用脉冲震荡法(Impulse Oscilbmetry IOS)测定呼吸阻力在支气管激发试验中的诊断价值。方法：对72例门诊及住院就诊有自觉症状，临床怀疑为支气管哮喘而不能确诊的患者进行支气管激发试验，用IOS测定5～35赫兹震荡频率时的粘性阻力(R5-R35)，5赫兹时的周边弹性阻力(X5)，共振频率(Fres)，阻抗(Zre)，与常规通气一秒量(FEV1)，呼气峰流速值(PEF)，1秒率(FEV1／FVC％)进行对比研究。结果：支气管激发试验阳性组患者FEV1比试验前FEV1基础值降低20％的同时呼吸阻力明显增加，且阻力增加较FEV1下降出现早，部分支气管激发试验通气功能阴性的患者而阻力增加。结论：脉冲震荡法为一种新型肺功能测定方法，用于支气管激发试验可大大减少以往常规通气测定中的不足，对支气管激发试验阴性的患者在鉴别诊断上增加了新的内容。

COMPARATIVE STUDY OF THE USE OF IMPULSE OSCILLOMETRY AND VENTILATION TEST IN BRONCHIAL STIMULATING TEST

Objective:To study the diagnostic value of using impulse oscillation (IOS) to measure the respiratory resistance in bronchial challenge test.Methods:72 patients who were suspicious of asthma were undergone bronchial challenge test, and patients' airway resistance, respiratory impedance, resonant frequency before and after challenge test were compared with that of FEV 1, PEF, FEV 1/FVC.Results:In positive challenge test group, who's FEV 1 decreased more than 20%, patients' respiratory resistance increased significantly and increased earlier than the decreased of FEV 1. In negative challenge test group who's FEV 1 decreased less than 20%, some patients' respiratory resistance also increased.Conclusions:Using of impulse oscillation can reduce the limitation of ventilation test in bronchial challenge test, and it is more sensitive than ventilation test, so it is a new method for testing the pulmonary function.