Wesseling G, Quaedvlieg F C, Wouters E F
Department of Pulmonary Disease, University Hospital, Maastricht, The Netherlands.
Chest. 1992 Dec;102(6):1752-7. doi: 10.1378/chest.102.6.1752.
Respiratory impedance measurements by means of the technique of forced oscillations together with spirometry and measurements of maximal mouth pressures were performed in 27 patients with a variety of neuromuscular disorders to assess the value of adding respiratory impedance measurements in the evaluation of lung function in neuromuscular disease. Using the technique of forced oscillations, impedance measurements are easily performed in physically disabled persons, since they require little active cooperation and no forced respiratory maneuvers. Normal respiratory impedance characteristics were found, although resistance values were somewhat higher than those found in normal subjects, signifying the absence of airflow limitation. Spirometric values were markedly reduced, as were maximal mouth pressures. No significant correlations were found between the forced expiratory volumes in 1 s (FEV1) and the impedance data. A strong curvilinear relationship was observed between Pemax and the RV/TLC ratio and a strong correlation existed between FEV1 and Premax. It is concluded from our study that forced oscillometry is a useful tool for the assessment or exclusion of airflow obstruction in patients with neuromuscular disorders when plethysmography is difficult to perform and forced expiratory flow-volume data reflect muscle weakness rather than airflow limitation.
采用强迫振荡技术结合肺活量测定法以及最大口腔压力测量法，对27例患有各种神经肌肉疾病的患者进行呼吸阻抗测量，以评估在神经肌肉疾病肺功能评估中增加呼吸阻抗测量的价值。使用强迫振荡技术，阻抗测量在身体残疾者中很容易进行，因为它们几乎不需要主动配合，也不需要强制呼吸动作。尽管阻力值略高于正常受试者，但仍发现了正常的呼吸阻抗特征，这表明不存在气流受限。肺活量测定值显著降低，最大口腔压力也是如此。在1秒用力呼气量（FEV1）和阻抗数据之间未发现显著相关性。观察到最大口腔压力（Pemax）与残气量/肺总量（RV/TLC）比值之间存在强烈的曲线关系，FEV1与Pemax之间存在强烈相关性。我们的研究得出结论，当体积描记法难以实施且用力呼气流量-容积数据反映的是肌肉无力而非气流受限时，强迫振荡法是评估或排除神经肌肉疾病患者气流阻塞的有用工具。
