Sackner M A, Gonzalez H, Rodriguez M, Belsito A, Sackner D R, Grenvik S
Am Rev Respir Dis. 1984 Oct;130(4):588-93. doi: 10.1164/arrd.1984.130.4.588.
Both scalar tracings and XY plots of rib cage (RC) and abdominal (AB) excursions were analyzed to detect asynchronous and/or paradoxic motion of one compartment with respect to the other in an effort to distinguish differences between normal subjects and patients with chronic obstructive pulmonary disease (COPD). An inspiratory asynchrony index (IAI) was obtained by connecting a straight line from beginning inspiration to end inspiration of the RC-AB loop, and dividing the area enclosed by the inspiratory portion by the tidal volume. In like manner, an expiratory asynchrony index (EAI) was computed. Values of IAI and EAI in the supine posture were greater in patients with COPD than in normal subjects, and such differences were consistently demonstrated during natural and voluntarily controlled abdominal breathing. Paradoxic motion as percent of volume or time period of inspiratory and expiratory compartmental excursions was indicated when RC or AB compartments moved in an opposite direction to the sum of the two. During natural breathing, paradoxic motion was almost absent in normal subjects and variably present in patients with COPD. Voluntarily controlled breathing patterns produced increased IAI, EAI, and paradoxic motion. Passive tilting from supine to the upright posture did not affect indexes in normal subjects but reduced asynchronous and paradoxic motion of the RC in patients with COPD. Other indexes of loop analysis, such as phase angle and maximal compartment amplitude/tidal volume, were not as consistent in distinguishing between normal subjects and patients with COPD during natural and voluntarily controlled breathing patterns.(ABSTRACT TRUNCATED AT 250 WORDS)
分析了胸廓(RC)和腹部(AB)活动的标量描记图和XY图,以检测一个腔室相对于另一个腔室的不同步和/或反常运动,从而区分正常受试者和慢性阻塞性肺疾病(COPD)患者之间的差异。吸气不同步指数(IAI)通过从RC-AB环的吸气开始到吸气结束连接一条直线,并将吸气部分所包围的面积除以潮气量来获得。以类似的方式计算呼气不同步指数(EAI)。COPD患者仰卧位时的IAI和EAI值高于正常受试者,并且在自然呼吸和自主控制的腹部呼吸过程中,这种差异始终存在。当RC或AB腔室向与两者之和相反的方向移动时,吸气和呼气腔室活动的体积或时间段百分比显示为反常运动。在自然呼吸过程中,正常受试者几乎不存在反常运动,而COPD患者则不同程度地存在。自主控制的呼吸模式会使IAI、EAI和反常运动增加。从仰卧位被动倾斜到直立位对正常受试者的指数没有影响,但可减少COPD患者RC的不同步和反常运动。在自然呼吸和自主控制的呼吸模式下,环分析的其他指标(如相位角和最大腔室幅度/潮气量)在区分正常受试者和COPD患者时并不那么一致。(摘要截短为250字)