脉冲振荡肺功能在慢性阻塞性肺疾病中的应用价值

发布时间：2018-10-25 08:58

【摘要】：目的:探讨脉冲振荡肺功能在慢性阻塞性肺疾病中的应用价值。方法:对98例稳定期COPD患者和42例健康成人进行常规肺功能(PFT)和脉冲振荡肺功能(IOS)检查,并用改良版英国医学研究委员会呼吸问卷(m MRC)评估COPD患者呼吸困难程度,询问患者过去一年急性加重次数。按照2013年《慢性阻塞性肺疾病诊治指南》(修订版)将COPD患者分为A、B、C、D四组。结果1.COPD组与健康对照组相比,IOS参数和PFT参数差异均有统计学意义(P0.05)。在IOS参数与PFT参数相关性分析中,共振频率(Fres)、振荡频率为5Hz时的呼吸阻抗(R5)、振荡频率为5Hz与振荡频率为20Hz时的呼吸阻抗之差(R5-R20)与用力肺活量占预计值的百分比(FVC%pred)、第一秒用力呼气容积占预计值的百分比(FEV1%pred)、第一秒用力呼气容积与用力肺活量之比(FEV1/FVC)呈显著负相关(P0.05),振荡频率为5Hz时的电抗(X5)与FVC%pred、FEV1%pred、FEV1/FVC呈显著正相关(p0.05),其中Fres与FEV1/FVC相关性最强,X5与FEV1%pred的相关性最强。振荡频率为20Hz时的电抗(R20)与FVC%pred、FEV1%pred、FEV1/FVC之间的均无相关性。(P0.05)。2.Fres、R5、R5-R20及X5的ROC曲线下面积分别为0.898、0.823、0.762、0.870,FresX5R5R5-R20。3.在COPD综合评估分组中Fres及X5除B组与C组外,其余各组间差异均有统计学意义。R5及R5-R20:D组明显大于A组、B组、C组,差异有统计学意义,P0.05,其余各组间差异无统计学意义,P0.05。R20:各组间差异均无统计学意义,P0.05。4.Fres、R5、R20、R5-R20与COPD综合评估分组呈正相关(r分别为0.455、0.497、0401),X5与COPD综合评估分组呈负相关(r=-0.558)。。结论1.Fres、X5、R5及R5-R20与PFT参数具有很好的相关性,对COPD的分级诊断具有较好的临床价值,其中Fres价值最高。2.Fres、R5、R5-R20与X5提示的病情的严重程度与指南中综合评估所提示的病情严重程度相一致性,可反应COPD患者疾病的严重程度。
[Abstract]:Objective: to investigate the application value of pulse oscillating pulmonary function in chronic obstructive pulmonary disease. Methods: 98 patients with stable COPD and 42 healthy adults were examined with routine pulmonary function (PFT) and pulsed oscillatory pulmonary function (IOS). The degree of dyspnea in COPD patients was evaluated by modified British Medical Research Council Respiratory questionnaire (m MRC). Ask the patient about the number of acute exacerbations in the past year. Patients with COPD were divided into four groups according to the guidelines for the diagnosis and treatment of chronic obstructive Pulmonary Disease (2013). Results there were significant differences in IOS and PFT parameters between 1.COPD group and healthy control group (P0.05). In the correlation analysis of IOS parameters and PFT parameters, Respiratory impedance (R5) at resonance frequency (Fres), oscillation frequency of 5Hz, difference between respiratory impedance (R5-R20) and forced vital capacity (FVC%pred) and forced expiratory volume of first second (100) of predicted value at 5Hz and 20Hz oscillation frequency. The score ratio (FEV1%pred), forced expiratory volume in the first second (FEV1/FVC) and forced vital capacity (FEV1/FVC) were negatively correlated (P0.05), and the reactance (X5) was positively correlated with FVC%pred,FEV1%pred,FEV1/FVC when the oscillation frequency was 5Hz (p0.05). The correlation between Fres and FEV1/FVC was the strongest, and that between X5 and FEV1%pred was the strongest (p0.05). There was no correlation between the reactance (R20) and FVC%pred,FEV1%pred,FEV1/FVC when the oscillation frequency was 20Hz (P0.05). 2. The area under the ROC curve of Freschon R5N R5-R20 and X5 was 0.898N0.823 / 0.762n 0.870 FresX5R5R5-R20.3respectively. There were significant differences in Fres and X5 between the two groups except group B and group C. R5 and R5-R20:D were significantly higher than those in group A, B and C. The difference was statistically significant (P0.05, the other groups had no statistical significance, P0.05.R20: there was no significant difference among the groups, P0.05.4.Fres5.4.Fres5R5R20R20R5-R20 was positively correlated with the COPD comprehensive evaluation subgroup (r = 0.4550.497n0401, respectively), and X5 was negatively correlated with the COPD comprehensive evaluation subgroup (r-0.558). Conclusion: 1. Fressilon X5G R5 and R5-R20 have good correlation with the parameters of PFT, and have good clinical value in the grading diagnosis of COPD. 2. The value of Fres was the highest. 2. The severity of the disease suggested by Freso R5, R5-R20 and X5 was consistent with that suggested by the comprehensive evaluation in the guidelines, which could reflect the severity of the disease in patients with COPD.
【学位授予单位】：宁夏医科大学
【学位级别】：硕士
【学位授予年份】：2015
【分类号】：R563.9

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