摘要目的 探讨脉冲振荡肺功能(IOS)检测在临床COPD患者中的诊断价值.方法 测定142例COPD患者(COPD组)及160例健康成年人(对照组)的各项IOS指标及常规肺功能指标,比较两组IOS检测结果及其与常规肺功能指标的相关性.结果 与对照组比较,COPD组呼吸总阻抗(zrs)、5 Hz与20 Hz时黏性阻力及其差值(R5、R20、R5-R20)、中心阻力(Rc)和周边阻力(Rp)及共振频率(Fres)均明显增高[COPD组分别为(0.71±0.31)kPa/(L·s)、(0.55±0.22)kPa/(L·s)、(0.33±0.11)kPa/(L·S)、(0.22±0.14)kPa/(L·s)、(0.23±0.14)kPa/(L·s)、(0.62±0.25)kPa,(L·s)及(27.50±6.42)Hz,对照组分别为(0.31±0.08)kPa/(L·s)、(0.30±0.12)kPa/(L·S)、(0.22±0.07)kPa/(L·s)、(0.05±0.03)kPa/(L·s)、(0.14±0.08)kPa/(L·s)、(0.20±0.02)kPa/(L·s)及(10.95±2.68)Hz],而5 Hz时弹性阻力和惯性阻力(X5)则明显下降[COPD组为(-0.34±0.12)kPa/(L·S),对照组为(-0.08±0.01)kPa/(L·s)],差异均有统计学意义(P<0.01);COPD组患者的Zrs、Fres、R5、R20R5-R20、Rp与第1秒用力呼气容积(FEV1)占预计值百分比呈负相关,而与X5呈正相关,其中Fres与FEV1占预计值百分比的相关性最强(r=0.6410,P<0.01);Fres、R5、R5-R20、Rp与FEV1/用力肺活量(FVC)呈负相关.结论 IOS法测定呼吸阻抗可用于COPD的诊断,并有助于判断COPD患者的气道阻塞程度,具有非常广阔的应用前景.

abstractsObjective To explore the diagnostic value of impulse oscillometry(IOS) in the patients with COPD. Methods The IOS parameters of 142 cases of COPD (COPD group) were measured and compared with those of 160 normal eases (control group). Linear correlation analysis was done between the IOS parameters and the conventional pulmonary function indexes such as FEV1 / Pred and FEV1/FVC, and the diagnostic value of the IOS parameters in COPD was discussed. Results Compared with those of the control group, respiratory impedance (Zrs),resistance at 5 Hz and 20 Hz (R5,R<<20>) and their difference (R5-R20), central resistance (Re) and peripheral resistance (Rp), resonance frequency (Fres)in the COPD group increased significantly, while reactance at 5 Hz (X5) decreased obviously (P< 0.01 ). In the COPD group, Zrs, Fres, R5, R20, R5-R20 and Rp were all correlated negatively with FEV1 / Pred, but X5 was correlated positively with FEV1/Pred. And the most strong correlation was found between Fres and FEV1/Pred. Fres, R5, R5-R20, Rp were correlated negatively with FEV1/FVC( P all < 0.05). Conclusions IOS is suitable for the diagnosis of COPD,and can be used to evaluate the severity of COPD. The application perspective is very extensive.