[摘要] 目的 探討呼吸阻抗對(duì)支氣管哮喘的診斷價(jià)值。 方法 185例健康人和192例支氣管哮喘患者進(jìn)行脈沖振蕩肺功能(IOS)測(cè)定，并與常規(guī)肺通氣功能比較。 結(jié)果 支氣管哮喘患者與健康人相比，Zrs、Rc、Rp、Fres、R均顯著增高，X明顯降低。支氣管哮喘患者Zrs、Rp、Fres、R5、R5~R20與肺通氣功能呈顯著負(fù)相關(guān)，與Fres的相關(guān)性最為密切。結(jié)論 IOS測(cè)定可用于支氣管哮喘的診斷，F(xiàn)res為診斷支氣管哮喘氣流阻塞最敏感的指標(biāo)。
[關(guān)鍵詞] 支氣管哮喘；脈沖振蕩法；呼吸阻抗；肺功能測(cè)定
Respiratory impedance assessed with impulse oscillometry in patients with asthma
FANG Manqi,CHEN Yuying,LIU Ao,et al.Respiratory Department,Kunming General Hospital of Chengdu Military Command,Kunming 650032,China
[Abstract] Objective To assess respiratory impedance in patients with asthma.Methods The respiratory impedance was measured by impulse oscillometry(IOS)and compared with parameters of conventional pulmonary ventilation function on 185 healthy adults and 192 patients with asthma. Results There was a significant increase in respiratory impedance(Zrs),central resistance(Rc),peripheral resistance(Rp),resonant frequency(Fres),respiratory resistance(R) ranging from 5～35 Hz in the asthma group compared to those within the healthy group.Reactance(X) ranging from 5～35 Hz in the asthma group was markedly lower than that in the healthy group.Zrs,Rp,Fres,R5 and R5~R20 were negatively correlated with parameters of pulmonary ventilation.The closest correlation was found between Fres with forced expiratory volume in one second(FEV1).Conclusion We suggest respiratory impedance is suitable for the diagnosis of asthma.Fres is the most sensitive index in the parameters of IOS to confirm the presence of airflow obstructive in patients with asthma.
[Key words] asthma；impulse oscillometry；respiratory impedance；respiratory function tests
支氣管哮喘是由多種細(xì)胞和細(xì)胞組分參與的氣道慢性炎癥性疾患[1]。這種慢性炎癥導(dǎo)致氣道高反應(yīng)性的增加，通常出現(xiàn)廣泛多變的可逆性氣流受限，并引起反復(fù)發(fā)作性的喘息、氣急、胸悶或咳嗽等癥狀，反映在肺功能上的改變就是阻塞性通氣功能障礙。因此，肺功能檢查在支氣管哮喘病人的診斷、分級(jí)和治療評(píng)價(jià)具有重要地位。近年研究表明，呼吸阻抗是判斷氣流阻塞的敏感指標(biāo)[2]。我們應(yīng)用脈沖振蕩法(impulse oscillometry，IOS)測(cè)定了192例支氣管哮喘患者急性發(fā)作期的呼吸阻抗，并與常規(guī)肺功能進(jìn)行比較，探討其臨床意義。
[關(guān)鍵詞] 支氣管哮喘；脈沖振蕩法；呼吸阻抗；肺功能測(cè)定
Respiratory impedance assessed with impulse oscillometry in patients with asthma
FANG Manqi,CHEN Yuying,LIU Ao,et al.Respiratory Department,Kunming General Hospital of Chengdu Military Command,Kunming 650032,China
[Abstract] Objective To assess respiratory impedance in patients with asthma.Methods The respiratory impedance was measured by impulse oscillometry(IOS)and compared with parameters of conventional pulmonary ventilation function on 185 healthy adults and 192 patients with asthma. Results There was a significant increase in respiratory impedance(Zrs),central resistance(Rc),peripheral resistance(Rp),resonant frequency(Fres),respiratory resistance(R) ranging from 5～35 Hz in the asthma group compared to those within the healthy group.Reactance(X) ranging from 5～35 Hz in the asthma group was markedly lower than that in the healthy group.Zrs,Rp,Fres,R5 and R5~R20 were negatively correlated with parameters of pulmonary ventilation.The closest correlation was found between Fres with forced expiratory volume in one second(FEV1).Conclusion We suggest respiratory impedance is suitable for the diagnosis of asthma.Fres is the most sensitive index in the parameters of IOS to confirm the presence of airflow obstructive in patients with asthma.
[Key words] asthma；impulse oscillometry；respiratory impedance；respiratory function tests
支氣管哮喘是由多種細(xì)胞和細(xì)胞組分參與的氣道慢性炎癥性疾患[1]。這種慢性炎癥導(dǎo)致氣道高反應(yīng)性的增加，通常出現(xiàn)廣泛多變的可逆性氣流受限，并引起反復(fù)發(fā)作性的喘息、氣急、胸悶或咳嗽等癥狀，反映在肺功能上的改變就是阻塞性通氣功能障礙。因此，肺功能檢查在支氣管哮喘病人的診斷、分級(jí)和治療評(píng)價(jià)具有重要地位。近年研究表明，呼吸阻抗是判斷氣流阻塞的敏感指標(biāo)[2]。我們應(yīng)用脈沖振蕩法(impulse oscillometry，IOS)測(cè)定了192例支氣管哮喘患者急性發(fā)作期的呼吸阻抗，并與常規(guī)肺功能進(jìn)行比較，探討其臨床意義。