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目的 探讨肺结核不同病情对呼吸阻抗的影响 ,评价脉冲振荡法 (IOS)测定肺结核患者呼吸阻抗的临床意义。方法 观察比较肺结核轻度组 60例、中度组 4 8例、重度组 4 0例和健康组 30例的IOS各指标 ,148例肺结核患者IOS各指标与肺通气功能指标实测值作相关分析。结果 肺结核各组随病情加重 ,共振频率 (Fres) ,呼吸总阻抗 (Zrs) ,总气道阻力 (R5) ,中心气道阻力 (R2 0 ) ,周边气道阻力 (R5-R2 0 )和周边弹性阻力 (X5的负值 )逐渐增大 ,但与健康组比较 ,肺结核轻度组各项指标无差异(P >0 .0 5) ,肺结核中度组除R2 0 外其余各项均有显著性差异 (P <0 .0 5) ,肺结核重度组各项均有显著性差异 (P <0 .0 1)。 148例肺结核患者IOS各指标与肺通气功能指标相关分析显示 :Fres、Zrs、R5、R2 0和R5-R2 0 分别与肺通气功能各指标呈显著负相关 (P <0 .0 0 1) ,X5与肺通气功能各指标呈显著正相关 (P <0 .0 0 1) ;Fres与MVV相关性最强。结论 肺结核不同病情对呼吸阻抗影响差异很大。IOS法测定呼吸阻抗在肺结核临床应用中前景宽广。
Objective To investigate the effect of pulmonary tuberculosis on respiratory impedance and evaluate the clinical significance of determining the respiratory impedance of patients with pulmonary tuberculosis by pulse oscillation method (IOS). Methods The indexes of IOS in 60 mild tuberculosis patients, 48 moderate patients, 40 severe patients and 30 healthy volunteers were compared. The IOS indexes of 148 tuberculosis patients were compared with those of pulmonary function test. Results Respiratory rate (Fres), total respiratory resistance (Zrs), total airway resistance (R5), central airway resistance (R2 0), peripheral airway resistance (R5-R2 0) The elastic resistance (the negative value of X5) increased gradually, but there was no significant difference between the mild group and the healthy group (P> 0.05) (P <0.05), and there was significant difference in severe pulmonary tuberculosis (P <0.01). Correlation analysis of IOS index and pulmonary ventilation index in 148 cases of pulmonary tuberculosis patients showed that Fres, Zrs, R5, R2 0 and R5-R2 0 were significantly and negatively correlated with the indexes of pulmonary ventilation (P0.01) There was a significant positive correlation between X5 and pulmonary ventilation (P <0.01). Fres had the highest correlation with MVV. Conclusions Different effects of pulmonary tuberculosis on respiratory resistance vary greatly. Respiratory impedance measured by IOS method has broad prospects in the clinical application of pulmonary tuberculosis.