脉冲震荡法在诊断特发性肺纤维化（IPF）的价值

发布时间：2018-05-05 15:49

本文选题：特发性肺纤维化 + 脉冲震荡　；参考：《吉林大学》2012年硕士论文

【摘要】：目的：初步探讨脉冲震荡法(IOS)在测定特发性肺纤维化疾病（IPF）患者呼吸阻抗中的诊断价值。方法：回顾性分析在我院进行常规肺功能及IOS肺功能测定的，且已明确诊断为特发性肺纤维化疾病的45例受试者，其中男20例，女25例；年龄41-65岁，平均（54.21±12.43）岁。选择健康人27例为对照组，男12例，女15例；年龄38-62岁，平均（58.64±11.8）岁。应用德国耶格公司生产的常规肺功能仪(MasterScreenPFT)及脉冲震荡肺功能仪（MasterIOS）进行肺功能测定，此仪器的技术参数满足美国胸科协会和欧洲呼吸协会制定的标准要求。计算气道阻力时取三次呼吸曲线平均值为X5。结果包括参数数值，结构参数图，频谱图，频谱微分均值图和阻抗容积图。主要观察反映总气道阻力的低频（5Hz）时的R5，反映中央气道阻力的高频（20Hz）时的R20，反映周边弹性阻力的X5。计算气道阻力时取三次呼吸曲线平均值为X5。结果包括参数数值，结构参数图，频谱图，频谱微分均值图和阻抗容积图。主要观察反映总气道阻力的低频（5Hz）时的R5，反映中央气道阻力的高频（20Hz）时的R20，反映周边弹性阻力的X5。同时患者进行常规肺功能测定，包括肺活量（VC）、单次呼吸法弥散功能（一氧化碳弥散量TLCOSB%），此外还有血气分析中的P_(A-a)O_2等数据的测定。采用SPSS17.0版软件包进行统计学分析，统计结果以x±s表示，两组间比较采用配对样本t检验。结果：在肺残气位作深吸气，IPF组与健康组之间肺弹性阻力（X5）有非常显著性诧异（P0.01），弥散功能测定（TLCOSB，TLCOSB%）两组之间亦存在非常显著差异（P0.01）。IOS阳性率明显高于常规肺功能及P_(A-a)O_2阳性率。选取IOS检测指标中的X5与TLCOSB%做变量相关性分析，结果表明X5与TLCOSB%显著性相关，，r为0.5762，P0.01。这表明X5能够反映IPF的呼吸力学状况，与肺弥散功能之间表现出良好的相关性。结论：脉冲震荡法可以为特发性肺纤维化患者的早期诊断提供帮助。
[Abstract]:Objective: to evaluate the diagnostic value of pulse oscillations (IOSs) in the determination of respiratory impedance in patients with idiopathic pulmonary fibrosis (IPF). Methods: 45 patients with idiopathic pulmonary fibrosis were analyzed retrospectively, including 20 males and 25 females, aged 41-65 years, with an average age of 54.21 卤12.43 years. 27 healthy persons were selected as control group, 12 males and 15 females, aged from 38 to 62 years, with an average age of 58.64 卤11.8years. The lung function was measured by using MasterScreen PFTs and MasterIOS, which were produced by Jager Company in Germany. The technical parameters of the instrument met the requirements of the American chest Association and the European Respiratory Association. When calculating airway resistance, the mean value of cubic respiration curve is X 5. The results include parameter value, structure parameter diagram, spectrum diagram, spectrum differential mean value diagram and impedance volume diagram. The R5 was observed when the total airway resistance was low frequency (5Hz), the central airway resistance (R20) and the peripheral elastic resistance (X5). When calculating airway resistance, the mean value of cubic respiration curve is X 5. The results include parameter value, structure parameter diagram, spectrum diagram, spectrum differential mean value diagram and impedance volume diagram. The R5 was observed when the total airway resistance was low frequency (5Hz), the central airway resistance (R20) and the peripheral elastic resistance (X5). At the same time, the patients underwent routine pulmonary function measurements, including vital capacity (VCC), single breath diffusion (CO) diffusion capacity (CO), and P_(A-a)O_2 data in blood gas analysis. SPSS17.0 software package was used for statistical analysis. The statistical results were expressed as x 卤s, and the paired sample t-test was used for the comparison between the two groups. Results: there was a very significant difference between the lung residual gas level and the lung elastic resistance X5 between the two groups. There was also a very significant difference between the two groups. The positive rate of P0.01 + iOS was significantly higher than that of routine lung function and P_(A-a)O_2. The correlation between X5 and TLCOSB% in IOS was analyzed. The results showed that the significant correlation between X5 and TLCOSB% was 0.5762% (P 0.01). This indicates that X5 can reflect the respiratory mechanics of IPF and show a good correlation with pulmonary diffusion function. Conclusion: pulse oscillation may be helpful for the early diagnosis of idiopathic pulmonary fibrosis.
【学位授予单位】：吉林大学
【学位级别】：硕士
【学位授予年份】：2012
【分类号】：R563.9

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