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目的:探讨脉冲振荡技术(IOS)结合支气管舒张试验(BDT)在老年慢性阻塞性肺疾病(COPD)中的应用价值。方法:选择55例老年稳定期COPD患者进行支气管舒张试验,比较用药前后常规肺功能与IOS测定结果。结果:BDT用药后的用力肺活量占预计值百分比(FVC%pred)、1秒钟用力呼气容积占预计值百分比(FEV1%pred)、呼出肺活量中间50%时的平均用力呼气流量占预计值百分比(FEF25%~75%pred)、呼出肺活量50%时的用力呼气流量占预计值百分比(FEF50%pred)、呼出肺活量75%时的用力呼气流量占预计值百分比(FEF75%pred)结果均明显高于用药前,差异有统计学意义;BDT用药后患者IOS各参数均明显低于对照组,差异有统计学意义;气道总阻力改善率(R5Chg)与1秒钟用力呼气容积改善率(FEV1Chg)呈负相关;低频电抗面积改善率(AXChg)与用力肺活量改善率(FVCChg)、FEV1Chg、呈正相关;周边气道粘性阻力改善率(R5~20Chg)与呼出肺活量50%时的用力呼气流量改善率(FEF50Chg)呈负相关。结论:IOS有可能成为老年COPD患者行BDT时肺通气功能检查的必要补充手段;BDT可用于指导老年COPD患者支气管扩张药的选择及疗效评定。
Objective: To investigate the value of pulse oscillation technique (IOS) combined with bronchodilator test (BDT) in senile chronic obstructive pulmonary disease (COPD). Methods: Fifty-five elderly stable COPD patients were selected for bronchodilation. The pulmonary function and IOS before and after treatment were compared. Results: The forced vital capacity (FVC% pred), the forced expiratory volume in one second (FEV1% pred) and the forced expiratory flow in the middle 50% of exhaled lung volume accounted for the predicted value (FEF25% ~ 75% pred), forced expiratory flow as a percentage of predicted value (FEF50% pred) at 50% expiratory expiratory volume, and forced expiratory flow as a percentage of expected value (FEF75% pred) at expiratory volume of 75% Were significantly higher than before treatment, the difference was statistically significant; BDT after treatment in patients with IOS parameters were significantly lower than the control group, the difference was statistically significant; total airway resistance improvement rate (R5Chg) and forced expiratory volume of 1 second (FVCChg) and FEV1Chg; the improvement rate of peripheral airway viscous resistance (R5 ~ 20Chg) and the expiratory volume of exhaled lungs were 50% Forced expiratory flow rate (FEF50Chg) was negatively correlated. Conclusions: IOS may become necessary complement for elderly patients with COPD when performing BDT. BDT can be used to guide the selection of bronchodilator and evaluation of the curative effect in elderly patients with COPD.