老年哮喘和慢性阻塞性肺疾病患者的呼吸阻抗被引量：15

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摘要目的探讨呼吸阻抗在老年哮喘和慢性阻塞性肺疾病(COPD)患者中的应用价值。方法选取老年哮喘患者88例(哮喘组)、COPD患者276例(COPD组)和健康体检者45名(对照组),采用肺量计法检测常规通气功能、脉冲震荡法(IOS)进行呼吸阻抗测定,并分析通气功能FEV1/FVC和FEV1占预计值百分比与呼吸阻抗的相关性。结果与对照组比较,哮喘组20 Hz时气道阻力(R20)增高(P<0.05),COPD组呼吸总阻抗(Zrs)、5 Hz时气道阻力(R5)明显增加(P<0.01,P<0.05);哮喘组和COPD组5 Hz与20 Hz时气道阻力差值(R5-R20)、中心阻力(Rc)、周边阻力(Rp)及共振频率(Fres)均明显增高,5 Hz时电抗(X5)明显下降(P<0.05或P<0.01);与哮喘组比较,COPD组R5-R20、Rp、Fres增加,X5下降(P<0.05或P<0.01);随COPD严重程度加重,Zrs、R5、R5-R20、Rc、Rp、Fres逐渐增加,X5逐渐下降(P<0.05或P<0.01)。哮喘组与COPD组FEV1/FVC和FEV1占预计值百分比与气道阻力Zrs、R5、R5-R20均呈负相关(P<0.05或P<0.01),而与X5呈正相关(P<0.01);哮喘组FEV1/FVC和FEV1占预计值百分比与R20均呈负相关(P<0.01),而COPD组FEV1/FVC和FEV1占预计值百分比与R20无相关性(均P<0.05);哮喘组FEV1占预计值百分比与Fres呈负相关(P<0.01),FEV1/FVC与Fres无相关性(P<0.05),COPD组FEV1/FVC和FEV1占预计值百分比与Fres均呈负相关(P<0.01)。结论哮喘和COPD两组患者的气道阻力均增加,但增加的部位不同,哮喘患者以中心气道阻力增加为主。COPD患者以外周气道阻力增加为主;COPD患者呼吸总阻抗明显增加,且与COPD患者病情严重程度有关,中重度COPD明显增加。呼吸阻抗与通气功能具有良好的相关性,提示简单易行的呼吸阻抗测定具有较好的临床应用前景。

作者刘晓菊包海荣方应根张艺程勇董理

机构地区兰州大学第一医院老年呼吸科

出处《中国老年学杂志》 CAS CSCD 北大核心 2011年第22期4305-4308,共4页 Chinese Journal of Gerontology

基金甘肃省卫生行业计划项目(GSWST2010-05) 中华医学会临床医学慢性呼吸道疾病科研专项资金(07010240032)

关键词哮喘慢性阻塞性肺疾病脉冲震荡法呼吸阻抗

分类号 R562.2 [医药卫生—呼吸系统]

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