脉冲振荡肺功能与慢性阻塞性肺疾病病情严重程度的关系分析
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摘要
目的:探究脉冲振荡肺功能与慢性阻塞性肺疾病(慢阻肺)病情严重程度的关系。方法:选取2017年8月—2018年7月本院呼吸科收治的127例慢阻肺患者设置为观察组,根据患者临床症状、呼吸困难指数、综合慢阻肺肺功能分级等评定依据可分为Ⅰ级患者40例、Ⅱ级患者45例以及Ⅲ级患者42例,另择取同期在本院进行体检的健康者共43例设置为对照组,两组均行常规肺功能检测和脉冲振荡法检测。对两组的两种检测方式检测结果进行比较,同时分析常规肺功能和脉冲振荡检测肺功能指标相关性,以及脉冲振荡肺功能与慢性阻塞性肺疾病病情严重程度的关系。结果:观察组患者用力肺活量(FVC)、第一秒用力呼气容积(FEV_1)、FEV_1在预计值中的占比(FEV_1%pred)、FEV_1在用力肺活量中的占比(FEV_1/FVC%)、峰流速(PEF)以及最大呼气中期流速(MMEF)均低于对照组,差异均有统计学意义(P<0.05);且观察组内Ⅰ、Ⅱ、Ⅲ级患者肺功能指标比较,差异均有统计学意义(P<0.05),其中分级越高患者肺功能指标数据越低。观察组患者5 Hz以及20 Hz振荡频率检测时呼吸道总黏性阻力(R5)、中心气道黏性阻力(R20)、阻抗(Z5)、外周气道黏性阻力(R5-20)、共振频率(Fres)均高于对照组,周边惯性阻力(X5)则显著低于对照组,差异均有统计学意义(P<0.05);观察组内Ⅰ、Ⅱ、Ⅲ级患者检测指标比较,差异均有统计学意义(P<0.05),其中分级越高患者X5越低,而剩余脉冲振荡检测指标则越高。脉冲振荡检测指标中X5与常规肺功能指标均呈正相关(P<0.05),脉冲振荡检测指标中R5、R20、Z5、R5-20、Fres与常规肺功能指标均呈负相关(P<0.05)。结论:脉冲振荡法对慢阻肺患者病情评估具有良好的效果,其检测结果与常规肺功能检测结果之间存在显著相关性,因此可用于慢阻肺患者病情评估工作中,提升患者病情诊断准确率,为其临床治疗奠定基础。
Objective:To explore the relationship between pulsed oscillatory lung function and the severity of chronic obstructive pulmonary disease(COPD).Method:A total of 127 patients with chronic obstructive pulmonary disease admitted to our hospital from August 2017 to July 2018 were enrolled in the observation group,according to the clinical symptoms,dyspnea index and pulmonary function grading of comprehensive COPD,the patients were divided into 40 patients with Ⅰ grade,45 patients with Ⅱ grade and 42 patients with Ⅲ grade.In addition,a total of 43 healthy patients who underwent physical examination in our hospital during the same period were selected as the control group,routine lung function test and pulse oscillation test were performed in both groups.The results of the two methods were compared between the two groups were compared,and the correlation between the pulmonary function indexes of the two groups were analyzed,and the relationship between pulsed oscillatory lung function and the severity of chronic obstructive pulmonary disease.Result:In the observation group,the patient's forced vital capacity(FVC),forced expiratory volume in the first second(FEV_1),the proportion of FEV_1 in the predicted value(FEV_1%pred),and the proportion of FEV_1 in the forced vital capacity(FEV_1/FVC%),the routine pulmonary function test indexes such as peak flow rate(PEF)and maximum expiratory flow rate(MMEF)were lower than those in control group,the differences were statistically significant(P<0.05).The differences in lung function indexes among the grade Ⅰ,Ⅱ and Ⅲ patients in the observation group were statistically significant(P<0.05),wherein the higher the grade,the lower the lung function index data of the patient.The total viscous resistance of the respiratory tract(R5),the central airway viscosity resistance(R20),and the impedance(Z5)of the 5 Hz and 20 Hz oscillation frequency of the observation group,the peripheral airway viscosity resistance(R5-20)and resonance frequency(Fres)were higher than those in control group,and the peripheral inertial resistance(X5)was significantly lower than that of the control group,the differences were statistically significant(P<0.05).Observation group Ⅰ,Ⅱ,Ⅲ grade patients detection index comparison,the differences were statistically significant(P<0.05),the higher the grade,the lower the X5,and the higher the residual pulse oscillation detection index.There were a positive correlation between X5 and routine lung function indicators in pulse oscillation test indexes(P<0.05).Among the pulsed oscillation test indexes,R5,R20,Z5,R5-20 and Fres were negatively correlated with the conventional lung function indexes(P<0.05). Conclusion:Pulsed oscillation method has a good effect on the condition evaluation of patients with COPD,and there is a significant correlation between the test results and the results of conventional lung function test.Therefore,it can be used in the condition evaluation of patients with COPD to improve the diagnostic accuracy of patients' conditions and lay a foundation for clinical treatment.
Objective:To explore the relationship between pulsed oscillatory lung function and the severity of chronic obstructive pulmonary disease(COPD).Method:A total of 127 patients with chronic obstructive pulmonary disease admitted to our hospital from August 2017 to July 2018 were enrolled in the observation group,according to the clinical symptoms,dyspnea index and pulmonary function grading of comprehensive COPD,the patients were divided into 40 patients with Ⅰ grade,45 patients with Ⅱ grade and 42 patients with Ⅲ grade.In addition,a total of 43 healthy patients who underwent physical examination in our hospital during the same period were selected as the control group,routine lung function test and pulse oscillation test were performed in both groups.The results of the two methods were compared between the two groups were compared,and the correlation between the pulmonary function indexes of the two groups were analyzed,and the relationship between pulsed oscillatory lung function and the severity of chronic obstructive pulmonary disease.Result:In the observation group,the patient's forced vital capacity(FVC),forced expiratory volume in the first second(FEV_1),the proportion of FEV_1 in the predicted value(FEV_1%pred),and the proportion of FEV_1 in the forced vital capacity(FEV_1/FVC%),the routine pulmonary function test indexes such as peak flow rate(PEF)and maximum expiratory flow rate(MMEF)were lower than those in control group,the differences were statistically significant(P<0.05).The differences in lung function indexes among the grade Ⅰ,Ⅱ and Ⅲ patients in the observation group were statistically significant(P<0.05),wherein the higher the grade,the lower the lung function index data of the patient.The total viscous resistance of the respiratory tract(R5),the central airway viscosity resistance(R20),and the impedance(Z5)of the 5 Hz and 20 Hz oscillation frequency of the observation group,the peripheral airway viscosity resistance(R5-20)and resonance frequency(Fres)were higher than those in control group,and the peripheral inertial resistance(X5)was significantly lower than that of the control group,the differences were statistically significant(P<0.05).Observation group Ⅰ,Ⅱ,Ⅲ grade patients detection index comparison,the differences were statistically significant(P<0.05),the higher the grade,the lower the X5,and the higher the residual pulse oscillation detection index.There were a positive correlation between X5 and routine lung function indicators in pulse oscillation test indexes(P<0.05).Among the pulsed oscillation test indexes,R5,R20,Z5,R5-20 and Fres were negatively correlated with the conventional lung function indexes(P<0.05). Conclusion:Pulsed oscillation method has a good effect on the condition evaluation of patients with COPD,and there is a significant correlation between the test results and the results of conventional lung function test.Therefore,it can be used in the condition evaluation of patients with COPD to improve the diagnostic accuracy of patients' conditions and lay a foundation for clinical treatment.
引文
[1]卢晓来,尹虹雷,唐正梁,等.探讨肺功能检查脉冲振荡法对早期小气道病变诊断的临床价值[J].中国继续医学教育,2018,10(10):92-94.
[2]徐英,崔晓媛,徐宏伟,等.肺功能检查脉冲震荡法对早期小气道病变诊断价值的临床研究[J].中国卫生标准管理,2018,9(4):30-31.
[3]禇岩.肺功能测定鉴别支气管哮喘、慢阻肺及哮喘慢阻肺重叠综合征的临床价值分析[J].中国现代医生,2018,56(3):38-40.
[4]何光辉,黄民强,伍北寿.脉冲震荡肺功能检查在噻托溴铵联合沙美特罗替卡松治疗稳定期慢性阻塞性肺疾病中的价值[J].实用医院临床杂志,2017,14(6):158-161.
[5]孟丹,张晓燕,朱健武,等.脉冲振荡肺功能测定在稳定期慢性阻塞性肺疾病治疗中的应用价值[J/OL].中华肺部疾病杂志(电子版),2017,10(3):313-316.
[6]张黎娟,朱晓萍.超声评估慢阻肺患者膈肌移动度与肺功能和BODE指数的关系[J].宁夏医科大学学报,2017,39(5):534-536,483.
[7]潘天宇,郭忠良,鲁立文,等.支气管哮喘-慢性阻塞性肺疾病重叠综合征患者血浆纤维蛋白原变化及其与肺功能的相关性分析[J].疑难病杂志,2017,16(5):469-472.
[8]何光辉,黄民强,伍北寿.脉冲震荡肺功能(IOS)与慢性阻塞性肺疾病病情严重程度的相关性[J].临床肺科杂志,2017,22(2):259-261.
[9]周寅川.夜间低氧与日间呼吸衰竭对稳定期慢阻肺患者肺功能损害程度的影响[J].现代诊断与治疗,2016,27(22):4335-4336.
[10]张海瑞.稳定期慢阻肺患者夜间低氧和日间呼吸衰竭与肺功能损害程度的关系分析[J].河南医学研究,2016,25(9):1603-1604.
[11]韩美荣,陈燕,李剑平.肺功能测定鉴别支气管哮喘、慢阻肺及哮喘慢阻肺重叠综合征的临床意义[J].临床肺科杂志,2016,21(5):934-937.
[12]何光辉,黄民强,伍北寿,等.脉冲震荡肺功能在稳定期COPD治疗中的应用价值[J].现代生物医学进展,2016,16(11):2099-2101.
[13]张莹,杨生岳,王东超,等.中度高原地区慢性阻塞性肺疾病患者脉冲振荡法与常规肺功能检测的相关性及意义[J/OL].中华肺部疾病杂志(电子版),2015,8(3):332-334.
[14]梁辰,马云.脉冲振荡气道阻力测定对运动员肺功能异常诊断价值的研究[J].中国运动医学杂志,2015,34(3):262-265.
[15]赵珊,王浩彦.脉冲振荡法在慢性阻塞性肺疾病中诊断价值的探讨[J].心肺血管病杂志,2015,34(2):96-100.
[16]李平平,王锐英,许建英.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[J].国际呼吸杂志,2016,36(16):1239-1243.
[17]张晓战,张振荣,程鲲.新建立的脉冲振荡肺功能预计值公式在澳门45岁以上慢性阻塞性肺疾病患者诊断中的价值[J].中华结核和呼吸杂志,2016,39(1):41-46.
[18]白翠芬.脉冲振荡肺功能检查对哮喘儿童病情评估的价值及与血清指标的相关性分析[J].海南医学院学报,2016,22(10):1016-1019.
[19]耿旭红,杨华,巩晓红,等.河北省健康成人脉冲震荡肺功能正常参考值测定分析[J].国际呼吸杂志,2016,36(24):1882-1885.
[20]陈丽,尚云晓,韩晓华.脉冲震荡肺功能与常规肺通气功能在儿童哮喘气道监测的敏感性研究[J].国际儿科学杂志,2016,43(6):497.
[2]徐英,崔晓媛,徐宏伟,等.肺功能检查脉冲震荡法对早期小气道病变诊断价值的临床研究[J].中国卫生标准管理,2018,9(4):30-31.
[3]禇岩.肺功能测定鉴别支气管哮喘、慢阻肺及哮喘慢阻肺重叠综合征的临床价值分析[J].中国现代医生,2018,56(3):38-40.
[4]何光辉,黄民强,伍北寿.脉冲震荡肺功能检查在噻托溴铵联合沙美特罗替卡松治疗稳定期慢性阻塞性肺疾病中的价值[J].实用医院临床杂志,2017,14(6):158-161.
[5]孟丹,张晓燕,朱健武,等.脉冲振荡肺功能测定在稳定期慢性阻塞性肺疾病治疗中的应用价值[J/OL].中华肺部疾病杂志(电子版),2017,10(3):313-316.
[6]张黎娟,朱晓萍.超声评估慢阻肺患者膈肌移动度与肺功能和BODE指数的关系[J].宁夏医科大学学报,2017,39(5):534-536,483.
[7]潘天宇,郭忠良,鲁立文,等.支气管哮喘-慢性阻塞性肺疾病重叠综合征患者血浆纤维蛋白原变化及其与肺功能的相关性分析[J].疑难病杂志,2017,16(5):469-472.
[8]何光辉,黄民强,伍北寿.脉冲震荡肺功能(IOS)与慢性阻塞性肺疾病病情严重程度的相关性[J].临床肺科杂志,2017,22(2):259-261.
[9]周寅川.夜间低氧与日间呼吸衰竭对稳定期慢阻肺患者肺功能损害程度的影响[J].现代诊断与治疗,2016,27(22):4335-4336.
[10]张海瑞.稳定期慢阻肺患者夜间低氧和日间呼吸衰竭与肺功能损害程度的关系分析[J].河南医学研究,2016,25(9):1603-1604.
[11]韩美荣,陈燕,李剑平.肺功能测定鉴别支气管哮喘、慢阻肺及哮喘慢阻肺重叠综合征的临床意义[J].临床肺科杂志,2016,21(5):934-937.
[12]何光辉,黄民强,伍北寿,等.脉冲震荡肺功能在稳定期COPD治疗中的应用价值[J].现代生物医学进展,2016,16(11):2099-2101.
[13]张莹,杨生岳,王东超,等.中度高原地区慢性阻塞性肺疾病患者脉冲振荡法与常规肺功能检测的相关性及意义[J/OL].中华肺部疾病杂志(电子版),2015,8(3):332-334.
[14]梁辰,马云.脉冲振荡气道阻力测定对运动员肺功能异常诊断价值的研究[J].中国运动医学杂志,2015,34(3):262-265.
[15]赵珊,王浩彦.脉冲振荡法在慢性阻塞性肺疾病中诊断价值的探讨[J].心肺血管病杂志,2015,34(2):96-100.
[16]李平平,王锐英,许建英.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[J].国际呼吸杂志,2016,36(16):1239-1243.
[17]张晓战,张振荣,程鲲.新建立的脉冲振荡肺功能预计值公式在澳门45岁以上慢性阻塞性肺疾病患者诊断中的价值[J].中华结核和呼吸杂志,2016,39(1):41-46.
[18]白翠芬.脉冲振荡肺功能检查对哮喘儿童病情评估的价值及与血清指标的相关性分析[J].海南医学院学报,2016,22(10):1016-1019.
[19]耿旭红,杨华,巩晓红,等.河北省健康成人脉冲震荡肺功能正常参考值测定分析[J].国际呼吸杂志,2016,36(24):1882-1885.
[20]陈丽,尚云晓,韩晓华.脉冲震荡肺功能与常规肺通气功能在儿童哮喘气道监测的敏感性研究[J].国际儿科学杂志,2016,43(6):497.