探讨脉冲振荡技术在职业性哮喘病中的应用价值

摘要

目的 探讨脉冲振荡技术(IOS)在职业性哮喘病中的应用价值.方法 选择60例职业性哮喘急性发作期患者作为研究组,62例健康人作为对照组,分别行IOS检查及用力肺功能检查,将研究组和对照组IOS检查参数、用力肺功能检查参数进行统计学对比分析.结果 ①研究组与对照组比较,IOS参数中呼吸总阻抗(Zrs)、共振频率(Fres)、5 Hz气道阻力(R5)、周边气道阻力(R5-R20)、外周弹性阻力(X5)等指标,研究组均高于对照组,差异有统计学意义(P＜0.05),20 Hz气道阻力(R20)两组间差异无统计学意义;②研究组与对照组比较,用力肺功能检查参数中第一秒用力呼气容积(FEV1),第一秒用力呼气容积占预计值百分比(FEV1％),第一秒用力呼气容积占肺活量比值(FEV1/FVC％),差异无统计学意义,用力呼出25％、50％、75％肺活量的呼气流量占预计值的百分比(FEF25％、FEF50％、FEF75％)差异均有统计学意义(P＜0.05);③研究组R5、R5-R20与FEV1呈负相关,X5与FEF25％、FEF50％呈正相关,R20与各肺通气功能指标均无相关性.结论 IOS检查能更全面地反映职业性哮喘患者的气道阻力情况,对肺功能的判断更加全面,操作简单、可重复性高,是用力肺功能检查的重要补充.%Objective To investigate the application of impulse oscillation system (IOS) in occupational asthma.Methods 60 cases of patients in occupational asthma in the acute phase were chosen as research group,while 62 healthy people were arranged as control group.Both groups were relatively examined by IOS and forced pulmonary function test.All the experimental data for the tests of two groups were statistically contrasted and analyzed.Results ①Compared with control group,the research group's data about the total respiratory impedance parameters (Zrs),resonance frequency (Fres),resistance at 5 Hz (R5),peripheral airway resistance (R5-R20),peripheral elastic resistance (X5) were higher,and the difference was statistically significant (P ＜ 0.05).But there was no statistically significant difference in resistance at 20 Hz (R20) between the study group and the control group.②With the comparison of the data of the forced expired volume in one second (FEV1),percentage of the forced expired volume in one second than predicted values (FEV1 ％),forced expired volume in one second to forced vital capacity ratio (FEV1/FVC％),the differences in both groups were not statistically significant.When comparing the percentage of the forced expired flow at 25％,50％,75％ of FVC than predicted values (FEF25％,FEF50％,FEF75％) in study group and the control group,the differences were statistically significant (P ＜ 0.05);③ In the study group,R5 and R5-R20 were negatively correlated with FEV1,X5 was positively correlated with FEF25％ and FEF50％,and there was no correlation between R20 and pulmonary ventilation function.Conclusion IOS can reflect the airway resistance in patients with occupational asthma more comprehensively.It is more simple and reproducible,as well as an important supplement to the forced pulmonary function test.