摘要：
目的 明确哮喘和慢性阻塞性肺疾病(慢阻肺)患者呼吸阻抗与通气功能的相关性,以指导诊治疾病.方法 将50例哮喘患者纳为A组、50例慢阻肺患者纳为B组、50例健康体检者纳为C组,分别测定其呼吸阻抗指标:呼吸总阻抗(Zrs),5Hz、20Hz时气道阻力(R5、R20)及其差值(R5-R20),5Hz时电抗(X5),中心阻力(Rc),周边阻力(Rp)、共振频率(Fres);通气功能指标:1s用力呼气容积(FEV1)、FEV1占预计值百分比(FEV1%)、FEV1与用力肺活量比值(FEV1/FVC).分析呼吸阻抗与通气功能的相关性.结果 与C组相比,A组R20明显更高;B组Zrs及R5明显更高;A组及B组R5-R20、Rc、Rp、Fres明显更高、X5明显更低,上述差异均有显著性意义(P<0.05).与A组相比,B组R5-R20、Rp、Fres明显更高,X5明显更低,上述差异均有显著性意义(P<0.05).A组FEV1/FVC及FEV1%与R20均呈负相关,FEV1%与Fres呈负相关;B组FEV1/FVC及FEV1%与Fres呈负相关,上述相关性均有统计学意义(P<0.05).结论 哮喘和慢阻肺均可导致气道阻力增加,但哮喘以增加中心气道阻力为主,慢阻肺以增加外周气道阻力为主;呼吸阻抗能够有效反映通气功能的变化,这对诊治疾病有积极意义.%Objective To identify respiratory resistance and ventilation function of asthma patients and chronic obstructive pulmonary disease (COPD) patients, so as to guide the diagnosis and treatment of diseases.Methods 50 cases of asthma were chosen as the A group, 50 cases of COPD were chosen as the B group and 50 healthy subjects as the C group.Their indexes of respiratory impedance were determined, including total respiratory impedance (Zrs), 5Hz, 20Hz, airway resistance (R5, R20) and the difference (R5-R20), 5Hz.(X5), the center of resistance (Rc), peripheral resistance (Rp), resonance frequency (Fres);ventilation function index: 1s forced expiratory volume (FEV1), FEV1 percentage of predicted value (FEV1%), FEV1/FVC (FEV1/FVC).The relationship between ventilation function and respiratory impedance was analyzed.Results Compared with the C group, R20 was significantly higher in the A group, and Zrs and R5 were significantly higher in the B group.R5-R20, Rc, Rp and Fres were significantly higher and X5 was lower in the A and B groups than in the C group (P<0.05).Compared with the A group, R5-R20, Rp and Fres were significantly higher and X5 was significantly lower in the B group (P<0.05).FEV1/FVC and FEV1% were negatively related with R20, and FEV1% was negatively correlated with Fres in the A group.FEV1/FVC and FEV1% were negatively correlated with Fres (P<0.05).Conclusion Both asthma and COPD can lead to increase airway resistance, but the central airway resistance increases in asthma patients, and peripheral airway resistance in COPD patients.Respiratory impedance can effectively reflect the changes of ventilation function, which has positive significance for the diagnosis and treatment of disease.
