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目的 探讨呼吸阻抗对慢性阻塞性肺疾病的诊断价值。方法 用脉冲振荡法对５７ 例ＣＯＰＤ 患者进行呼吸阻抗测定并与常规肺功能比较。结果 ＣＯＰＤ患者５～３５Ｈｚ 振荡频率时粘性阻力和共振频率较健康组明显增大。５～３５Ｈｚ 时电抗明显低于健康组。粘性阻力和电抗有明显的频率依赖性。ＣＯＰＤ 组Ｆｒｅｓ 与肺通气功能指标呈显著负相关，Ｘ５ 正相关，Ｒ２０ 无相关性。Ｆｒｅｓ 与ＦＥＶ１ 和Ｖｍａｘ 相关性最密切。相关关系分别为－ ０－６７１ 和－０－６６６。Ｆｒｅｓ、Ｒ５ 和Ｘ５ 诊断ＣＯＰＤ 的敏感性分别为９４－７４％ 、５９－６５ ％ 和５４－３８％ ，特异性分别为８６－６６％ 、９６－６６％ 和９０％ 。结论 共振频率是诊断ＣＯＰＤ的最敏感指标。ＩＯＳ法测定呼吸阻抗是无创性检查，不需患者特别配合，对严重ＣＯＰＤ急性发作患者可进行动态检测，值得临床应用。
Objective To investigate the diagnostic value of respiratory impedance in chronic obstructive pulmonary disease. Methods Fifty-seven patients with COPD were measured for respiratory impedance by pulse oscillation method and compared with routine pulmonary function. Results The COPD patients with 5 ~ 35Hz oscillation frequency viscous resistance and resonance frequency significantly increased compared with the healthy group. The reactance is obviously lower than that of healthy group at 5 ~ 35Hz. Viscous resistance and reactance have obvious frequency dependence. There was a significant negative correlation between Fres and pulmonary ventilation index in COPD group, positive correlation between X5 and R20. Fres has the highest correlation with FEV1 and Vmax. The correlations are -0-671 and -0-666 respectively. The sensitivity of Fres, R5 and X5 in the diagnosis of COPD was 94-74%, 59-65% and 54-38% respectively, and the specificity was 86-66%, 96-66% and 90% respectively. Conclusions Resonance frequency is the most sensitive index for diagnosis of COPD. Respiratory impedance measured by IOS method is a noninvasive examination without special cooperation with patients. It can be used for dynamic detection of patients with severe COPD and is worthy of clinical application.