脉冲震荡法对慢性阻塞性肺疾病严重程度评估的临床意义

发布时间：2018-03-28 23:17

本文选题：慢性阻塞性肺疾病　切入点：脉冲震荡法　出处：《山西医科大学》2017年硕士论文

【摘要】：目的:通过对慢性阻塞性肺疾病(COPD)稳定期患者进行脉冲震荡法(IOS)及常规肺功能FEV1%pre和FEV1/FVC测定,探讨脉冲震荡法对慢性阻塞性肺疾病严重程度评估的临床意义。方法:收集2014年7月至2015年6月于山西大医院确诊为慢阻肺稳定期的患者214例,根据GOLD指南(2011版)联合评估的方法将其分为A、B、C和D四组。选同期体检人员41例作为健康对照组,分别进行IOS(Z5、R5、R20、R5㧟R20、X5、Fres)及常规肺功能(FEV1%pre、FEV1/FVC)检测。结果:1.慢阻肺组男性164例,女性50例,平均年龄63.6±9.5岁;其中A组48例、B组68例、C组55例、D组43例。健康对照组男性26例,女性15例,平均年龄54.6±10.4岁。两组性别及平均年龄差异无统计学意义。2.慢阻肺组IOS中Z5、R5、R20、R5㧟R20和X5分别为(0.70±0.30)、(0.62±0.25)、(0.36±0.12)、(0.26±0.18)和(-0.31±0.19)k Pa/L/s,Fres为(28.71±9.07)Hz;常规肺功能中FEV1%pre和FEV1/FVC分别为(50.83±21.91)%和(51.57±11.29)%。其中,Z5、R5、R20、R5㧟R20及Fres均较健康对照组显著增高(P均0.05),X5、FEV1%pre和FEV1/FVC均较健康对照组显著减低(P均0.05)。3.慢阻肺患者A、B、C和D四组IOS中Z5、R5、R5㧟R20和Fres呈上升趋势,X5呈下降趋势。A、B、C三组间比较差异均有显著性(P均0.05)。4.慢阻肺患者IOS中Z5、R5、R5㧟R20和Fres与FEV1%pre均呈显著负相关(P均0.05),其中Fres与FEV1%pre相关性最大(r=㧟0.599);X5与FEV1%pre呈显著正相关(P0.05)。慢阻肺患者A、B、C和D四组IOS中各指标与FEV1%pre相关性逐渐降低。A、B、C三组间比较差异均有显著性(P均0.05)。结论:IOS测定能较好地反映不同组别慢性阻塞性肺疾病患者气道阻力的变化,可更好地评估慢性阻塞性肺疾病患者疾病严重程度,尤其适用于老年患者。
[Abstract]:Objective : To investigate the clinical significance of pulse oscillation in patients with chronic obstructive pulmonary disease ( COPD ) by pulse oscillation ( IOS ) and conventional lung function FEV1 % pre and FEV1 / FVC . Results : In group A , there were 164 cases of chronic obstructive pulmonary disease , including 68 in group B , 55 in group C and 43 in group D . Results : In normal lung function , the mean age was ( 0 . 70 卤 0 . 30 ) , ( 0 . 62 卤 0.25 ) , ( 0.36 卤 0.12 ) , ( 0 . 26 卤 0 . 18 ) and ( - 0.31 卤 0.19 ) k Pa / L / s , and that of X5 , FEV1 % pre and FEV1 / FVC were significantly lower than those in healthy control group ( P 0 . 05 ) . There was a significant negative correlation between groups A , B , C and Fres ( P < 0.05 ) . The correlation between the indexes of A , B , C , and D in patients with chronic obstructive pulmonary disease was significantly correlated with FEV1 % pre ( P < 0.05 ) . Conclusion : The IOS assay can better reflect the change of airway resistance in patients with chronic obstructive pulmonary disease ( COPD ) , and can better evaluate the severity of disease in patients with COPD .

【学位授予单位】：山西医科大学
【学位级别】：硕士
【学位授予年份】：2017
【分类号】：R563.9

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