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目的探讨脉冲振荡技术(IOS)用于矽肺患者肺功能评价的临床应用价值。方法对63例矽肺患者和20例健康者依次进行IOS及PFT检测,分析两种肺功能各项指标之间的差异、相关性。结果 (1)随着矽肺期别上升,FVC、FEV1、FEV1/FVC呈下降趋势,叁期矽肺较其他各组均存在显著差异(P<0.05)。(2)矽肺组与健康对照组比较,IOS参数Z5、R5-R20、X5、Fres、AX明显升高,差异有统计学意义(P<0.05);壹期、贰期矽肺组与健康对照组比较,差异有统计学意义(P<0.05);叁期矽肺与其他各组比较均存在显著差异(P<0.05)。(3)按通气功能阻塞程度将矽肺组分为无阻塞和轻度、中度、重度阻塞4组,与对照组比较发现,随阻塞程度上升,各IOS参数结果亦呈上升趋势,且各参数组间比较差异均有统计学意义(P<0.05)。(4)除R20外,其他各IOS参数均与FEV1、FEV1/FVC显著相关(P<0.01),其中X5为正相关,其他为负相关。比较相关性大小,FEV1/FVC与IOS相关性更高。结论 (1)IOS参数如Z5、R5-R20、X5、Fres、AX对发现早期(壹期)矽肺肺功能异常有一定临床价值;(2)IOS和肺通气功能具有良好的相关性,其敏感性似优于PFT,可作为矽肺患者肺功能评价的补充。
Objective To investigate the clinical value of pulsed oscillation technique (IOS) in pulmonary function assessment in patients with silicosis. Methods 63 patients with silicosis and 20 healthy subjects were followed by IOS and PFT testing, analysis of the differences between the two indicators of lung function, correlation. Results (1) FVC, FEV1, FEV1 / FVC showed a decreasing trend with the increase of silicosis stage, and there was significant difference (P <0.05) in the third stage silicosis compared with other groups. (2) Compared with the healthy control group, the IOS parameters Z5, R5-R20, X5, Fres and AX of silicosis group were significantly increased (P <0.05) (P <0.05). There was significant difference between the three stages of silicosis and other groups (P <0.05). (3) The group of silicosis was divided into four groups according to the degree of obstruction of ventilation: non-obstructive and mild, moderate and severe obstruction. Compared with the control group, the results showed that the IOS parameters also showed an upward trend as the obstruction level increased, The differences between the two groups were statistically significant (P <0.05). (4) Except for R20, all other IOS parameters were significantly correlated with FEV1 and FEV1 / FVC (P <0.01), of which X5 was positive and others were negative. Correlation size, FEV1 / FVC and IOS correlation is higher. Conclusions (1) The IOS parameters such as Z5, R5-R20, X5, Fres and AX have certain clinical value in detecting the early (one) silicosis pulmonary function abnormalities. (2) The correlation between IOS and pulmonary ventilation has a good correlation It seems to be superior to PFT, which can be used as a supplement to pulmonary function evaluation in patients with silicosis.