肺容量和弥散功能在不同级别慢性阻塞性肺疾病患者中的表现

发布时间：2018-01-05 19:06

本文关键词：肺容量和弥散功能在不同级别慢性阻塞性肺疾病患者中的表现　出处：《中国呼吸与危重监护杂志》2015年05期 　论文类型：期刊论文

【摘要】：目的探讨不同级别慢性阻塞性肺疾病(简称慢阻肺)患者肺容量和弥散功能的特点及临床意义。方法收集2014年1月至2015年3月就诊于四川大学华西医院呼吸与危重症医学科门诊的慢阻肺患者,记录其临床资料、肺通气功能指标[第1秒用力呼气容积(FEV1)]以及肺容量指标[肺总量(TLC)、残气容积(RV)及RV/TLC],采用体积描记法和气体稀释法进行测定,并采用单次呼吸法测定肺一氧化碳弥散量(DLCO)。将患者分为轻度、中度、重度和极重度组,对组间资料进行比较,并对肺通气功能指标与肺容量和DLCO%pred的相关性进行分析。结果共计170例慢阻肺患者被纳入研究。随慢阻肺程度的加重,肺容量指标(TLC、RV和RV/TLC)逐渐增加,而且体积描记法和气体稀释法两种方法之间的差值ΔTLC%pred、ΔRV%pred和ΔRV/TLC逐渐增加。随FEV1%pred的降低,DLCO%pred则逐渐降低。相关分析显示,FEV1%pred与ΔTLC%pred、ΔRV%pred和ΔRV/TLC呈显著负相关,与DLCO%pred呈显著正相关。结论与气体稀释法相比,体积描记法能更准确地对慢阻肺患者的肺容量进行测定。随气流受限程度加重,慢阻肺患者弥散功能逐渐下降。
[Abstract]:Objective to explore different grades of chronic obstructive pulmonary disease (COPD). Methods from January 2014 to March 2015, patients with chronic obstructive pulmonary disease (COPD) who were admitted to the Department of Respiratory and critical Care Medicine Department of Respiratory and critical Care, Sichuan University from January 2014 to March 2015 were collected. The clinical data and pulmonary ventilation function were recorded. [1 seconds forced expiratory volume (FEV1) and pulmonary volume index. [Total lung volume (TLC), residual gas volume (RV) and RV/TLC] were measured by means of volumetric method and gas dilution method. The patients were divided into mild, moderate, severe and extremely severe groups, and the data between groups were compared. The correlation between pulmonary ventilation function and lung volume and DLCO%pred was analyzed. Results a total of 170 patients with COPD were included in the study. The RV and RV / TLC increased gradually, and the difference between the two methods was 螖 TLC%pred. 螖 RV%pred and 螖 RV/TLC increased gradually, and with the decrease of FEV1%pred, DLCOpred decreased gradually. FEV1%pred was negatively correlated with 螖 TLC pred, 螖 RV%pred and 螖 RV/TLC. Conclusion compared with the gas dilution method, the volume of lung in COPD patients can be measured more accurately with the increase of airflow limitation. The diffusion function of COPD patients decreased gradually.
【作者单位】：四川大学华西医院呼吸与危重症医学科;
【基金】：四川省科技厅支撑计划(编号:2014SZ0010)
【分类号】：R563.9
【正文快照】： 慢性阻塞性肺疾病(简称慢阻肺)是一种以不完全可逆性气流受限为特征的疾病,气流受限呈进行性加重,与肺对毒性颗粒或气体的异常炎症反应相关。随着疾病进展,可引发肺的过度充气以及换气功能障碍,这些改变可导致患者呼吸困难、活动受限以及生活质量下降[1]。体积描记法和气体稀

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