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目的探讨脉冲振荡(IOS)技术在老年慢性阻塞性肺疾病(COPD)诊断中的应用。方法检测75例老年COPD患者(COPD组)和60例老年健康者(对照组)常规肺功能并进行IOS测定。结果 COPD组1秒钟用力呼气容积与用力肺活量比值(FEV1/FVC)、用力肺活量占预计值百分比(FVC%pred)、1秒钟用力呼气容积占预计值百分比(FEV1%pred)、呼出肺活量中间50%时的平均用力呼气流量占预计值百分比(FEV25-75%pred)、呼出肺活量50%时的用力呼气流量占预计值百分比(FEF50%pred)、最大呼气流量占预计值百分比(PEF%perd)均明显低于对照组(P<0.01)。COPD组IOS参数中,气道总阻力占预计值百分比(R5%pred)、周边气道阻力占预计值百分比(X5%pred)、响应频率(Fres)、响应频率占预计值百分比(Fres%pred)和低频电抗面积(AX)均明显高于对照组(P<0.01)。COPD组的Fres、Fres%pred、AX、R5%pred、振荡频率在5-20Hz时的气道阻力(R5-R20)与肺通气功能各指标呈负相关;X5%pred与FVC%pred、FEV1%pred、FEV25-75%pred及FEF50%pred呈负相关。结论 IOS可用于COPD的诊断及明确气流阻塞部位;特别适用于老年人及重症患者。
Objective To investigate the application of pulse oscillation (IOS) technique in the diagnosis of chronic obstructive pulmonary disease (COPD) in the elderly. Methods 75 elderly COPD patients (COPD group) and 60 elderly healthy people (control group) routine lung function and IOS determination. Results The forced expiratory volume and forced vital capacity (FEV1 / FVC), forced vital capacity (FVC% pred), forced expiratory volume per second (FEV1% pred) in COPD group were 1: The mean forced expiratory flow at 50% of the vital capacity was predicted to be a percentage of predicted (FEV25-75% pred), forced expiratory flow at a predicted exhalation (FEF50% pred) at 50% of expiratory volume, and the maximum expiratory flow was estimated Percentage (PEF% perd) were significantly lower than the control group (P <0.01). COPD group IOS parameters, the total airway resistance predicted percentage (R5% pred), peripheral airway resistance accounted for the expected percentage (X5% pred), the response frequency (Fres), the response frequency percentage of the predicted value (Fres% pred ) And low-frequency reactance area (AX) were significantly higher than the control group (P <0.01). Fres, Fres% pred, AX, R5% pred, and airway resistance (R5-R20) at 5-20 Hz oscillation frequency were negatively correlated with each index of pulmonary ventilation function; X5% pred and FVC% pred, FEV1 % pred, FEV25-75% pred and FEF50% pred. Conclusion IOS can be used for the diagnosis of COPD and clear air obstruction site; especially for the elderly and critically ill patients.