在肺炎、充血性心力衰竭或间质性肺纤维化患者的单次自动听诊过程中，噼啪音音调和速率无明显变化。

Crackle pitch and rate do not vary significantly during a single automated-auscultation session in patients with pneumonia, congestive heart failure, or interstitial pulmonary fibrosis.

机构信息

Brigham and Women's/ Faulkner Hospital, Boston, Massachusetts 02130, USA.

出版信息

Respir Care. 2011 Jun;56(6):806-17. doi: 10.4187/respcare.00999. Epub 2011 Feb 11.

DOI:10.4187/respcare.00999

PMID:21333084

Abstract

OBJECTIVE

To determine the variability of crackle pitch and crackle rate during a single automated-auscultation session with a computerized 16-channel lung-sound analyzer.

METHODS

Forty-nine patients with pneumonia, 52 with congestive heart failure (CHF), and 18 with interstitial pulmonary fibrosis (IPF) performed breathing maneuvers in the following sequence: normal breathing, deep breathing, cough several times; deep breathing, vital-capacity maneuver, and deep breathing. From the auscultation recordings we measured the crackle pitch and crackle rate.

RESULTS

Crackle pitch variability, expressed as a percentage of the average crackle pitch, was small in all patients and in all maneuvers: pneumonia 11%, CHF 11%, pulmonary fibrosis 7%. Crackle rate variability was also small: pneumonia 31%, CHF 32%, IPF 24%. Compared to the first deep-breathing maneuver (100%), the average crackle pitch did not significantly change following coughing (pneumonia 100%, CHF 103%, IPF 100%), the vital-capacity maneuver (pneumonia 100%, CHF 92%, IPF 104%), or during quiet breathing (pneumonia 97%, CHF 100%, IPF 104%). Similarly, the average crackle rate did not change significantly following coughing (pneumonia 105%, CHF 110%, IPF 90%) or the vital-capacity maneuver (pneumonia 102%, CHF 101%, IPF 99%). However, during normal breathing the crackle rate was significantly lower in the patients with pneumonia (74%, P < .001) and significantly higher in the patients with IPF (147%, P < .05) than it was during deep breathing. In patients with CHF the average crackle rate during normal breathing was not significantly different from that during the first deep-breathing maneuver (108%).

CONCLUSIONS

Crackle pitch and rate were surprisingly stable in all 3 conditions. Neither crackle pitch nor crackle rate changed significantly from breath to breath or from one deep-breathing maneuver to another, even when the maneuvers were separated by cough or the vital-capacity maneuver. The observation that crackle rate is a reproducible measurement during one automated-auscultation session suggests that crackle rate can be used to follow the course of cardiopulmonary illnesses such as pneumonia, IPF, and CHF.

摘要

目的

使用计算机化 16 通道肺音分析仪，在单次自动听诊过程中确定爆裂音音调和爆裂音率的可变性。

方法

49 例肺炎患者、52 例充血性心力衰竭（CHF）患者和 18 例间质性肺纤维化（IPF）患者按以下顺序进行呼吸动作：正常呼吸、深呼吸、多次咳嗽；深呼吸、肺活量动作和深呼吸。从听诊记录中测量爆裂音音调和爆裂音率。

结果

在所有患者和所有动作中，爆裂音音调和爆裂率的可变性均较小：肺炎 11%、CHF 11%、肺纤维化 7%。爆裂音率的可变性也较小：肺炎 31%、CHF 32%、IPF 24%。与第一次深呼吸动作（100%）相比，咳嗽后（肺炎 100%、CHF 103%、IPF 100%）、肺活量动作（肺炎 100%、CHF 92%、IPF 104%）或安静呼吸时（肺炎 97%、CHF 100%、IPF 104%），平均爆裂音音高均无显著变化。同样，咳嗽后（肺炎 105%、CHF 110%、IPF 90%）或肺活量动作（肺炎 102%、CHF 101%、IPF 99%）后，平均爆裂音率均无显著变化。然而，在正常呼吸时，肺炎患者的爆裂音率明显较低（74%，P<0.001），间质性肺纤维化患者的爆裂音率明显较高（147%，P<0.05），而深呼吸时的爆裂音率明显较低。充血性心力衰竭患者在正常呼吸时的平均爆裂音率与第一次深呼吸动作时（108%）无显著差异。