脈沖振蕩肺功能在慢性阻塞性肺疾病中的應用價值
發(fā)布時間：2018-10-25 08:58
【摘要】：目的:探討脈沖振蕩肺功能在慢性阻塞性肺疾病中的應用價值。方法:對98例穩(wěn)定期COPD患者和42例健康成人進行常規(guī)肺功能(PFT)和脈沖振蕩肺功能(IOS)檢查,并用改良版英國醫(yī)學研究委員會呼吸問卷(m MRC)評估COPD患者呼吸困難程度,詢問患者過去一年急性加重次數(shù)。按照2013年《慢性阻塞性肺疾病診治指南》(修訂版)將COPD患者分為A、B、C、D四組。結(jié)果1.COPD組與健康對照組相比,IOS參數(shù)和PFT參數(shù)差異均有統(tǒng)計學意義(P0.05)。在IOS參數(shù)與PFT參數(shù)相關(guān)性分析中,共振頻率(Fres)、振蕩頻率為5Hz時的呼吸阻抗(R5)、振蕩頻率為5Hz與振蕩頻率為20Hz時的呼吸阻抗之差(R5-R20)與用力肺活量占預計值的百分比(FVC%pred)、第一秒用力呼氣容積占預計值的百分比(FEV1%pred)、第一秒用力呼氣容積與用力肺活量之比(FEV1/FVC)呈顯著負相關(guān)(P0.05),振蕩頻率為5Hz時的電抗(X5)與FVC%pred、FEV1%pred、FEV1/FVC呈顯著正相關(guān)(p0.05),其中Fres與FEV1/FVC相關(guān)性最強,X5與FEV1%pred的相關(guān)性最強。振蕩頻率為20Hz時的電抗(R20)與FVC%pred、FEV1%pred、FEV1/FVC之間的均無相關(guān)性。(P0.05)。2.Fres、R5、R5-R20及X5的ROC曲線下面積分別為0.898、0.823、0.762、0.870,FresX5R5R5-R20。3.在COPD綜合評估分組中Fres及X5除B組與C組外,其余各組間差異均有統(tǒng)計學意義。R5及R5-R20:D組明顯大于A組、B組、C組,差異有統(tǒng)計學意義,P0.05,其余各組間差異無統(tǒng)計學意義,P0.05。R20:各組間差異均無統(tǒng)計學意義,P0.05。4.Fres、R5、R20、R5-R20與COPD綜合評估分組呈正相關(guān)(r分別為0.455、0.497、0401),X5與COPD綜合評估分組呈負相關(guān)(r=-0.558)。。結(jié)論1.Fres、X5、R5及R5-R20與PFT參數(shù)具有很好的相關(guān)性,對COPD的分級診斷具有較好的臨床價值,其中Fres價值最高。2.Fres、R5、R5-R20與X5提示的病情的嚴重程度與指南中綜合評估所提示的病情嚴重程度相一致性,可反應COPD患者疾病的嚴重程度。
[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.
【學位授予單位】：寧夏醫(yī)科大學
【學位級別】：碩士
【學位授予年份】：2015
【分類號】：R563.9
[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.
【學位授予單位】：寧夏醫(yī)科大學
【學位級別】：碩士
【學位授予年份】：2015
【分類號】：R563.9
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