本文選題：特發(fā)性肺纖維化 + 脈沖震蕩　； 參考：《吉林大學(xué)》2012年碩士論文

【摘要】：目的：初步探討脈沖震蕩法(IOS)在測(cè)定特發(fā)性肺纖維化疾�。↖PF）患者呼吸阻抗中的診斷價(jià)值。 方法：回顧性分析在我院進(jìn)行常規(guī)肺功能及IOS肺功能測(cè)定的，且已明確診斷為特發(fā)性肺纖維化疾病的45例受試者，其中男20例，女25例；年齡41-65歲，平均（54.21±12.43）歲。選擇健康人27例為對(duì)照組，男12例，女15例；年齡38-62歲，平均（58.64±11.8）歲。應(yīng)用德國(guó)耶格公司生產(chǎn)的常規(guī)肺功能儀(MasterScreenPFT)及脈沖震蕩肺功能儀（MasterIOS）進(jìn)行肺功能測(cè)定，此儀器的技術(shù)參數(shù)滿足美國(guó)胸科協(xié)會(huì)和歐洲呼吸協(xié)會(huì)制定的標(biāo)準(zhǔn)要求。計(jì)算氣道阻力時(shí)取三次呼吸曲線平均值為X5。結(jié)果包括參數(shù)數(shù)值，結(jié)構(gòu)參數(shù)圖，頻譜圖，頻譜微分均值圖和阻抗容積圖。主要觀察反映總氣道阻力的低頻（5Hz）時(shí)的R5，反映中央氣道阻力的高頻（20Hz）時(shí)的R20，反映周邊彈性阻力的X5。計(jì)算氣道阻力時(shí)取三次呼吸曲線平均值為X5。結(jié)果包括參數(shù)數(shù)值，結(jié)構(gòu)參數(shù)圖，頻譜圖，頻譜微分均值圖和阻抗容積圖。主要觀察反映總氣道阻力的低頻（5Hz）時(shí)的R5，反映中央氣道阻力的高頻（20Hz）時(shí)的R20，反映周邊彈性阻力的X5。同時(shí)患者進(jìn)行常規(guī)肺功能測(cè)定，包括肺活量（VC）、單次呼吸法彌散功能（一氧化碳彌散量TLCOSB%），此外還有血?dú)夥治鲋械腜_(A-a)O_2等數(shù)據(jù)的測(cè)定。采用SPSS17.0版軟件包進(jìn)行統(tǒng)計(jì)學(xué)分析，統(tǒng)計(jì)結(jié)果以x±s表示，兩組間比較采用配對(duì)樣本t檢驗(yàn)。 結(jié)果：在肺殘氣位作深吸氣，IPF組與健康組之間肺彈性阻力（X5）有非常顯著性詫異（P0.01），彌散功能測(cè)定（TLCOSB，TLCOSB%）兩組之間亦存在非常顯著差異（P0.01）。IOS陽(yáng)性率明顯高于常規(guī)肺功能及P_(A-a)O_2陽(yáng)性率。選取IOS檢測(cè)指標(biāo)中的X5與TLCOSB%做變量相關(guān)性分析，結(jié)果表明X5與TLCOSB%顯著性相關(guān)，，r為0.5762，P0.01。這表明X5能夠反映IPF的呼吸力學(xué)狀況，與肺彌散功能之間表現(xiàn)出良好的相關(guān)性。 結(jié)論：脈沖震蕩法可以為特發(fā)性肺纖維化患者的早期診斷提供幫助。
[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 鹵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 鹵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 鹵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.
【學(xué)位授予單位】：吉林大學(xué)
【學(xué)位級(jí)別】：碩士
【學(xué)位授予年份】：2012
【分類號(hào)】：R563.9

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