论文部分内容阅读
目的 应用脉冲振荡法测定运动激发前后健康志愿者和哮喘患者呼吸阻抗的改变 ,探讨运动激发和脉冲振荡法在支气管哮喘诊断中的意义。方法 健康对照组和哮喘组各 14例 ,应用脉冲振荡仪测定呼吸阻抗基础值 ,随后进行踏车运动激发试验 ,夹鼻经口呼吸室内空气 ,递增负荷 ,在 3～ 4min内使心率达到最大预计值 90 %并维持 6min ,运动结束后l、5、10、15和 2 0min重复测定呼吸阻抗。结果 哮喘患者运动后周围气道阻力比中央气道阻力明显增高 ,共振频率右移。呼吸总阻抗在第 5～ 10min达到峰值。哮喘患者R5 -R2 0变化值均≥ 0 .0 32kPa/L·s(对照组均值与 2个标准差之和 ) ,对照组均低于该值。6 4.3 %患者呼吸总阻抗变化值≥ 0 .12 7kPa/L·s(对照组均值与 2个标准差之和 ) ,对照组均低于该值。71.4%患者X5变化率≥ 41% (对照组均值与 2个标准差之和 ) ,对照组均低于该变化率。 5 7.1%患者运动后在潮气量 -呼吸总阻抗图中出现气体陷闭环 ,而对照组均无该变化。结论 运动激发前后应用脉冲振荡法测定呼吸阻抗能反映哮喘患者运动激发前后气道阻力的变化 ,且不需用力呼气 ,比较简便。运动试验作为临床诊断哮喘的方法和评估药物疗效的手段 ,用脉冲振荡法检测可能更为适宜
Objective To measure the changes of respiratory resistance in healthy volunteers and asthmatic patients before and after exercise excitations by pulse oscillation method and to explore the significance of exercise excitation and pulse oscillation method in the diagnosis of bronchial asthma. Methods The healthy control group and asthma group were 14 cases. The basic value of respiration impedance was measured by pulse shaker. Then treadmill exercise challenge test was carried out. The air in the mouth was inhaled through the nasal cavity with increasing load, and the heart rate was maximal in 3 ~ 4 minutes Value of 90% and maintain 6min, after exercise l, 5,10,15 and 20min repeated measurement of respiratory resistance. Results After the exercise, the airway resistance in asthmatic patients was significantly higher than that in the central airway, and the resonance frequency shifted to the right. The total respiratory impedance peaked at 5 to 10 min. R5 -R2 0 in patients with asthma changes were ≥ 0. 32kPa / L · s (control group mean and 2 standard deviations), the control group were lower than the value. The change of total respiratory resistance in 4.3% of patients was ≥0.127kPa / L · s (the sum of the control group and two standard deviations), and the control group was lower than this value. In 71.4% of patients, the rate of change of X5 was 41% (the sum of the mean value of the control group and 2 standard deviations), while the control group was lower than the rate of change. Gas trapping rings were observed in tidal volume-respiration total impedance after 7.1% of exercise in patients without changes in the control group. Conclusion The determination of respiratory impedance by pulse oscillation before and after exercise can reflect the changes of airway resistance before and after exercise stimulation in asthmatic patients, and it is simple and convenient without expiratory pressure. Exercise testing as a method of clinically diagnosing asthma and as a means of assessing the efficacy of the drug may be more appropriate with pulse oscillation