Gong Su-Gang, Yang Wen-Lan, Liu Jin-Ming, Liu Wen-Zeng, Zheng Wei
Department of Pulmonary Circulation, Shanghai Pulmonary Hospital, Tongji University School of Medicine Shanghai 200433, China.
Department of Pulmonary Function, Shanghai Pulmonary Hospital, Tongji University School of Medicine Shanghai 200433, China.
Int J Clin Exp Med. 2015 Nov 15;8(11):21400-6. eCollection 2015.
This study aims to elucidate the change in pulmonary function in stage 0 COPD patients. A total of 48 stage 0 COPD patients and 46 healthy adults were included in the study. The status of their pulmonary function was determined by an impulse oscillometry (IOS) system, and the spirometric indexes such as forced vital capacity, maximum expiratory flow-volume (MEFV) curve, total respiratory impedance (Zrs) and respiratory resistance (Rrs) between the two groups were compared. Significant decreases in the values of forced expiratory flow (FEF) at both 75% and 50% of the vital capacity of the predicted value (EF75/pre and FEF50/pre) were detected in stage 0 COPD patients compared with those in the control (P < 0.05). Significant increases were found in the resonant frequency (Fres) (14.37±3.63 VS 11.26±2.61), total respiratory impedance (Z5) compared with the prediction (Z5/pre) (135.65±19.37 VS 104.69±20.64), total airway resistance at 5 Hz (R5) compared with prediction (R5/pre) (128.46±20.14 VS 100.60±20.98) and peripheral airway resistance (R5-R20) compared with prediction (R5-R20/pre) (282.34±192.83 VS 109.31±80.05) in the study group compared with those in the control(all P < 0.05). The reactance at 5 Hz (X5) (-0.14±0.05 VS -0.08±0.05) in the stage 0 COPD group was markedly lower than that in the healthy group (P < 0.05). Disturbance in the small airway may be detected by the MEFV curve and IOS, and these indexes would be valuable in diagnosing stage 0 COPD.
本研究旨在阐明0期慢性阻塞性肺疾病（COPD）患者的肺功能变化。共有48例0期COPD患者和46例健康成年人纳入本研究。采用脉冲振荡法（IOS）系统测定其肺功能状态，并比较两组间的肺量计指标，如用力肺活量、最大呼气流量-容积（MEFV）曲线、总呼吸阻抗（Zrs）和呼吸阻力（Rrs）。与对照组相比，0期COPD患者预计值肺活量75%和50%时的用力呼气流量（FEF）值（EF75/pre和FEF50/pre）显著降低（P<0.05）。与对照组相比，研究组的共振频率（Fres）（14.37±3.63比11.26±2.61）、与预计值相比的总呼吸阻抗（Z5）（Z5/pre）（135.65±19.37比104.69±20.64）、5 Hz时的总气道阻力与预计值相比（R5）（R5/pre）（128.46±20.14比100.60±20.98）以及外周气道阻力与预计值相比（R5-R20）（R5-R20/pre）（282.34±192.83比109.31±80.05）均显著升高（均P<0.05）。0期COPD组5 Hz时的电抗（X5）（-0.14±0.05比-0.08±0.05）明显低于健康组（P<0.05）。MEFV曲线和IOS可检测到小气道的紊乱，这些指标对0期COPD的诊断具有重要价值。
