电子式和机械式两种吸气峰流速测量方法比较
发布时间：2018-08-10 20:38
【摘要】：目的吸入疗法在呼吸疾病的诊疗中广泛应用,其中干粉吸入器(DPI)是最常用的吸入装置,因吸气驱动,须达到足够的吸气流量。本课题旨在利用In-Check DIAL吸气峰流量仪模拟各种DPI的内部阻力,比较电子式和机械式两种测量吸气峰流量(PIF)的方法,观察不同气道阻塞程度患者的吸气流量特征,为临床选择PIF测量方法提供客观依据。方法采用自身对照试验的方法,以不同严重程度的气道阻塞患者作为研究对象,均采用电子式和机械式两种方法同步测量PIF。以串联的形式将电子式测量仪(PowerLab ML870的1000L流量头)和机械式测量仪(In-Check DIAL吸气峰流量仪)相连接,指导受试者先呼气至残气位,然后口含咬口器,再从连接好的测定装置中进行用力快速吸气,并吸气至肺总量位,记录电子式测量仪和机械式测量仪的同步测量值。一共测量3种不同阻力状态下的PIF:无阻力状态(Free)、模拟准纳器阻力状态(Accuhaler)和模拟都保阻力状态(Turbuhaler)。每一种阻力状态下至少测定3次,重复性要求≤10%,分别取电子式和机械式测量的最佳值用于计算。结果共纳入30例气道阻塞患者,依肺功能障碍的程度,分为轻度、中度和重度阻塞3个组,年龄(67.7±7.6)岁。在Free和Accuhaler的阻力状态下,分别有12例(40%)和1例(3.3%)因超过机械式流量仪的量程,不能获得测量值,其余均可获得测量值用于统计。(1)轻度阻塞组,机械式和电子式测量法在Free、Accuhaler和Turbuhaler阻力下的PIF(PIF-F、PIF-A、PIF-T)分别为(80.00±34.52)L/min、(76.86±32.85)L/min(P=0.051);(73.00±31.29)L/min、(71.63±31.53)L/min(P=0.126);(61.50±23.10)L/min、(59.10±22.42)L/min(P=0.075),3种阻力下两种方法间均无统计学差异。(2)中度阻塞组,机械式和电子式测量法的PIF-F、PIF-A、PIF-T分别为(86.00±26.32)L/min、(82.96±29.66)L/min(P=0.027);(79.50±24.66)L/min、(76.26±24.65)L/min(P=0.028);(67.00±18.59)L/min、(62.89±17.92)L/min(P=0.008),3种阻力下两种方法间均有统计学差异。(3)重度阻塞组,机械式和电子式测量法的PIF-F、PIF-A、PIF-T分别为(85.00±20.25)L/min、(84.22±22.11)L/min(P=0.599);(75.56±24.81)L/min、(74.53±25.67)L/min(P=0.374);(68.50±21.09)L/min、(65.40±19.97)L/min(P=0.016),PIF-F和PIF-A两种方法间无统计学差异,PIF-T两种方法间有统计学差异。结论尽管两种测量方法存在一定的差异,但差异小于患者的自身变异,因此两种测量方法的结果均可用于指导临床。通过比较,电子式测量方法量程大,精度高,可反复校正调零,准确度更佳,并可记录下呼吸波形,可计算吸气时间以及吸气容积等,适于深入开展科研。但电子式测量仪价格昂贵,结构复杂,体积较大,而机械式吸气峰流量仪价格便宜、轻便易带,操作简单。如需外出调查或仅为患者在家自测PIF,则建议选择机械式测量方法。
[Abstract]:Objective inhalation therapy is widely used in the diagnosis and treatment of respiratory diseases, in which dry powder inhaler (DPI) is the most commonly used inhaling device. The purpose of this study was to simulate the internal resistance of various DPI by In-Check DIAL peak inspiratory flow meter, compare the two methods of measuring the inspiratory peak flow (PIF) with electronic and mechanical methods, and observe the inspiratory flow characteristics of patients with different degree of airway obstruction. To provide objective basis for clinical selection of PIF measurement methods. Methods the PIFs of patients with different severity of airway obstruction were measured by both electronic and mechanical methods. The electronic meter (1000L flow head of PowerLab ML870) and the mechanical meter (In-Check DIAL peak inspiratory flow meter) were connected in series to guide the subjects to exhale to the residual air level first, and then to have the mouthbite device in their mouth. Then inhale quickly and forcefully from the connected measuring device and inhale to the total lung position and record the synchronous measurements of electronic and mechanical measuring instruments. A total of 3 PIFs were measured under different resistance states: no drag state (Free), simulation quasi-sensor resistance state (Accuhaler) and simulation both resistive state (Turbuhaler). At least 3 times in each resistance state, the repeatability requirement is less than 10. The optimum values of electronic and mechanical measurements are taken for calculation respectively. Results A total of 30 patients with airway obstruction were divided into 3 groups according to the degree of pulmonary dysfunction: mild, moderate and severe obstruction, aged (67.7 卤7.6) years. Under the resistance state of Free and Accuhaler, 12 cases (40%) and 1 case (3.3%) could not obtain the measured value because they exceeded the measuring range of the mechanical flow meter. The PIF (PIF-FU) PIF-An PIF-T of mechanical and electronic methods were (80.00 卤34.52) L / min, (76.86 卤32.85) L/min (P0.051); (73.00 卤31.29) L / min, (71.63 卤31.53) L/min (P0.126); (61.50 卤23.10) L / min, (59.10 卤22.42) L/min (P0.075) and (59.10 卤22.42) L/min (P0.075) L / min, respectively. The PIF-FU PIF-An PIF-T of mechanical and electronic methods were (86.00 卤26.32) L / min, (82.96 卤29.66) L/min (P0.027); (79.50 卤24.66) L / min, (76.26 卤24.65) L/min (P0.028); (67.00 卤18.59) L / min, (62.89 卤17.92) L/min (P0. 008), respectively. The PIF-FU PIF-An PIF-T of mechanical and electronic measurement methods were (85.00 卤20.25) L / min, (84.22 卤22.11) L/min (P0. 599); (75.56 卤24.81) L / min, (74.53 卤25.67) L/min (P0.374); (68.50 卤21.09) L / min, (65.40 卤19.97) L/min (P0.016) PIF-F and PIF-A respectively. Conclusion although there is a certain difference between the two methods, the difference is less than that of the patient's own variation, so the results of the two methods can be used to guide the clinical practice. By comparison, the electronic measurement method has the advantages of large measuring range, high precision, repeatable correction and zero adjustment, better accuracy, and the recording of respiratory waveform, calculation of inspiratory time and volume, etc., which is suitable for further scientific research. However, the electronic measuring instrument is expensive, complex in structure and large in volume, while the mechanical inspiratory peak flow meter is cheap, light and easy to take, and easy to operate. If you need to go out to investigate or only test PIFs at home, it is recommended to choose mechanical measurement methods.
【作者单位】： 广州医科大学;广州医科大学附属第一医院广州呼吸疾病研究所(呼吸疾病国家重点实验室呼吸疾病国家临床研究中心);
【分类号】：R56
本文编号：2176137
[Abstract]:Objective inhalation therapy is widely used in the diagnosis and treatment of respiratory diseases, in which dry powder inhaler (DPI) is the most commonly used inhaling device. The purpose of this study was to simulate the internal resistance of various DPI by In-Check DIAL peak inspiratory flow meter, compare the two methods of measuring the inspiratory peak flow (PIF) with electronic and mechanical methods, and observe the inspiratory flow characteristics of patients with different degree of airway obstruction. To provide objective basis for clinical selection of PIF measurement methods. Methods the PIFs of patients with different severity of airway obstruction were measured by both electronic and mechanical methods. The electronic meter (1000L flow head of PowerLab ML870) and the mechanical meter (In-Check DIAL peak inspiratory flow meter) were connected in series to guide the subjects to exhale to the residual air level first, and then to have the mouthbite device in their mouth. Then inhale quickly and forcefully from the connected measuring device and inhale to the total lung position and record the synchronous measurements of electronic and mechanical measuring instruments. A total of 3 PIFs were measured under different resistance states: no drag state (Free), simulation quasi-sensor resistance state (Accuhaler) and simulation both resistive state (Turbuhaler). At least 3 times in each resistance state, the repeatability requirement is less than 10. The optimum values of electronic and mechanical measurements are taken for calculation respectively. Results A total of 30 patients with airway obstruction were divided into 3 groups according to the degree of pulmonary dysfunction: mild, moderate and severe obstruction, aged (67.7 卤7.6) years. Under the resistance state of Free and Accuhaler, 12 cases (40%) and 1 case (3.3%) could not obtain the measured value because they exceeded the measuring range of the mechanical flow meter. The PIF (PIF-FU) PIF-An PIF-T of mechanical and electronic methods were (80.00 卤34.52) L / min, (76.86 卤32.85) L/min (P0.051); (73.00 卤31.29) L / min, (71.63 卤31.53) L/min (P0.126); (61.50 卤23.10) L / min, (59.10 卤22.42) L/min (P0.075) and (59.10 卤22.42) L/min (P0.075) L / min, respectively. The PIF-FU PIF-An PIF-T of mechanical and electronic methods were (86.00 卤26.32) L / min, (82.96 卤29.66) L/min (P0.027); (79.50 卤24.66) L / min, (76.26 卤24.65) L/min (P0.028); (67.00 卤18.59) L / min, (62.89 卤17.92) L/min (P0. 008), respectively. The PIF-FU PIF-An PIF-T of mechanical and electronic measurement methods were (85.00 卤20.25) L / min, (84.22 卤22.11) L/min (P0. 599); (75.56 卤24.81) L / min, (74.53 卤25.67) L/min (P0.374); (68.50 卤21.09) L / min, (65.40 卤19.97) L/min (P0.016) PIF-F and PIF-A respectively. Conclusion although there is a certain difference between the two methods, the difference is less than that of the patient's own variation, so the results of the two methods can be used to guide the clinical practice. By comparison, the electronic measurement method has the advantages of large measuring range, high precision, repeatable correction and zero adjustment, better accuracy, and the recording of respiratory waveform, calculation of inspiratory time and volume, etc., which is suitable for further scientific research. However, the electronic measuring instrument is expensive, complex in structure and large in volume, while the mechanical inspiratory peak flow meter is cheap, light and easy to take, and easy to operate. If you need to go out to investigate or only test PIFs at home, it is recommended to choose mechanical measurement methods.
【作者单位】： 广州医科大学;广州医科大学附属第一医院广州呼吸疾病研究所(呼吸疾病国家重点实验室呼吸疾病国家临床研究中心);
【分类号】：R56
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