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目的 探讨 COPD患者气道粘液纤毛清除功能受损的情况及其与病情程度和一秒钟用力呼气容积占预计值的百分比(FEV1 % )的关系。方法 99m-锝标记的人血清白蛋白 (99m Tc- HSA)气溶胶显像对 1 8例健康人和 70例轻、中、重度 COPD患者进行了MCC测定 ,采用定性观察和定量分析指标进行比较研究。结果 COPD患者肺内气溶胶分布明显不均匀 ,“热团”运动不规则 ,呈“之”字形、螺旋形、来回往返运动 ,甚至停滞。单因素方差分析表明 COPD患者中央区 (C区 )和外周区 (P区 )放射性清除率较正常人显著降低(P <0 .0 5) ,且与病情程度密切相关 ,病情越重 ,Ct越小。直线回归分析表明 Ct与 FEV1 %呈直线相关关系 (P <0 .0 5)。结论 COPD患者气道 MCC明显受损是其易于发生肺部感染和病情恶化的重要因素。
Objective To investigate the impairment of airway mucociliary clearance in COPD patients and its relationship with the degree of illness and the percentage of predicted forced expiratory volume per second (FEV1%). Methods 99m Tc-HSA aerosol imaging was used to compare the MCC of 18 healthy controls with 70 mild, moderate, and severe COPD patients. The results were compared qualitatively and quantitatively the study. Results The distribution of aerosol in the lungs of COPD patients was obviously non-uniform. The movement of “heat mass” was irregular and showed “zigzag” shape, spiral shape, back and forth movement, and even stagnation. One-way analysis of variance showed that the radioactive clearance rate in central area (C area) and peripheral area (P area) of patients with COPD was significantly lower than that of normal people (P <0.05), and was closely related to the severity of illness, small. Linear regression analysis showed a linear correlation between Ct and FEV1% (P <0.05). Conclusion The obvious impairment of airway MCC in patients with COPD is an important factor for its susceptibility to pulmonary infection and exacerbations.