论文部分内容阅读
目的探讨脉冲振荡法在哮喘患者中的诊断价值。方法收集天津市第一中心医院呼吸科门诊及病房2010年3—9月就诊的不吸烟的急性发作期支气管哮喘患者45例,其中,肺功能正常的哮喘患者25例(A组),肺功能异常哮喘患者20例(B组),另外收集40例不吸烟正常人作为健康对照(C组)。使用德国耶格公司生产的Master Screen肺功能仪测定常规肺功能指标和脉冲振荡系统(IOS)测定仪测定气道阻力。结果哮喘组(A、B组)IOS指标共振频率(Fres)、呼吸总抗阻(Zrs)、5Hz黏性阻力(R5)、20Hz黏性阻力(R20)、5Hz和20Hz黏性阻力差(R5-R20)均明显高于对照组,X5明显低于对照组。B组Fres、Zrs、R5、R20、R5-R20与常规肺通气指标1秒钟用力呼气量/1秒用力呼气量预计值的百分比(FEV1%)、1秒钟用力呼气量/用力肺活量(FEV1/F-VC)呈显著负相关,其中Fres与FEV1%和FEV1/F-VC相关性最密切(r=-0.59、-0.56,P<0.01),而在A组则无显著相关性。此外,Fres与呼出气一氧化氮(FENO)呈显著正相关(r=0.63、0.66,P<0.01)。结论 IOS测定可协助支气管哮喘的诊断,与常规肺通气功能检查、支气管舒张试验、FENO具有良好的相关性。IOS系统可用于肺功能正常的哮喘患者的早期诊断,Fres是IOS参数中诊断哮喘气流阻塞最敏感的指标。
Objective To investigate the diagnostic value of pulse oscillation in patients with asthma. Methods A total of 45 patients with acute asthma exacerbation were enrolled in Department of Respiratory Clinic and Ward of the First Central Hospital of Tianjin from March to September in 2010. Among them, 25 patients with asthma (group A), pulmonary function 20 patients with abnormal asthma (group B), and another 40 non-smokers were collected as healthy controls (group C). Airway resistance was measured using the Master Screen Pulmonary Function Meter manufactured by a German company, Jaeger-Borbeck, using conventional pulmonary function tests and pulsed-oscillatory system (IOS) analyzer. Results Respiratory resonance (Fres), total respiration (Zrs), 5Hz viscous resistance (R5), 20Hz viscous resistance (R20), 5Hz and 20Hz viscous resistance difference (R5 -R20) were significantly higher than the control group, X5 was significantly lower than the control group. Group B Fres, Zrs, R5, R20, R5-R20 and conventional lung ventilation indicators 1 second forced expiratory volume / 1 sec forced expiratory volume predicted value (FEV1%), forced expiratory volume per second There was a significant negative correlation between vital capacity (FEV1 / F-VC) and Fres with FEV1% and FEV1 / F-VC (r = -0.59, -0.56, P <0.01) Sex. In addition, there was a significant positive correlation between Fres and exhaled nitric oxide (FENO) (r = 0.63,0.66, P <0.01). Conclusions The IOS test can help the diagnosis of bronchial asthma and has good correlation with routine pulmonary ventilation test, bronchial dilation test and FENO. The IOS system can be used for the early diagnosis of asthmatic patients with normal lung function. Fres is the most sensitive index for diagnosing airflow obstruction in asthma in IOS parameters.