摘要
目的初步探讨脉冲振荡法（ＩＯＳ）的测定指标判断呼吸疾病气道阻力和肺顺应性的临床规律和意义。方法测定、分析４０名健康人、５０例慢性阻塞性肺疾病（ＣＯＰＤ）患者和６０例胸腔积液患者的各项ＩＯＳ指标（在５～３５Ｈｚ时）。同时以传统方法测定一秒钟用力呼气容积占用力肺活量比值（ＦＥＶ１／ＦＶＣ）和最大呼气流量容积曲线（ＭＥＦＶ曲线）。对ＩＯＳ主要结果作ｔ检验。结果与健康组比较，ＣＯＰＤ组周边及部分中心阻力明显增高，共振频率增高，周边电抗下降（Ｐ＜０．０１）；频谱图中Ｒ线呈下凹曲线，呼气末阻力增加和电抗下降。ＦＥＶ１／ＦＶＣ＜５０％，ＭＥＦＶ曲线为严重阻塞形态。胸腔积液组均在低频段出现吸气末阻力增高和电抗下降；ＦＥＶ１／ＦＶＣ接近正常，ＭＥＦＶ曲线仅半数为限制性功能障碍形态。结论ＩＯＳ能够较好反映气道阻力和肺顺应性的变化，可能有一定的应用前景。
Objective To discuss the clinical
significance of impulse oscillometry(IOS) to determine the resistance of large and small
airways and the compliance of lung. MethodsBZThe IOS indices of 40 normal cases, 50 cases
of chronic obstructive pulmonary diseases (COPD) and 60 cases of pleural effusion were
determined at 535 Hz. Their FEV1/FVC and maximal expiratory flowvolume curve (MEFV curve)
were measured in conventional method at the same time. Results Compared with normal
cases, the peripheral resistance of the 50 patients with COPD rose obviously and the central
airway resistance rose in some of them, the resonance frequency increased, but the peripheral
reactance descended at the same time (P<0.01). Resistance curve show markedly nonlinear
decreasing course with increasing frequency. The resistance increased and the reactance
descended in endexpiration. FEV1/FVC<50% , MEFV curve showed severe obstructive shape. 60
patients with pleural effusion were found the resistance increasing and reactance descending to
negative values in endinpiration at low frequencies (inverse values relation at low frequencies).
FEV1/FVC were nearly normal , MEFV curve showed restrictive dysfunction shape only in half of
them. Conclusions IOS can reflect variation of airway resistance and lung compliance. The
future development of IOS could be prosperous.
出处
《中华结核和呼吸杂志》
CAS
CSCD
北大核心
1999年第5期296-298,共3页
Chinese Journal of Tuberculosis and Respiratory Diseases
