Sepulveda M J, Hankinson J L, Castellan R M, Cocke J B
Br J Ind Med. 1984 Nov;41(4):480-6. doi: 10.1136/oem.41.4.480.
Lung function responses to inhaled cotton dust were evaluated in a group of 58 healthy subjects by spirometry (MEFV curves) and forced random noise impedance parameters. Twenty-one of these subjects were also examined by body plethysmography to assess changes in airway resistance (Raw). For the study group as a whole, alterations in lung mechanical function after exposure to cotton dust were detected by maximal expiratory volumes and flows (p less than 0.001) and impedance parameters (p less than 0.01) but not by Raw. Subjects showing responses in MEFV curves also showed increases in Thevenin or effective resistance at low frequencies (R1, R5-9, R5-9/R20-24), suggesting that the limitation of flow occurred predominantly in the peripheral airways. By contrast, non-responders on MEFV measurements were found to have significant increases in effective resistance both at low and at high frequencies (R1, R5-9, R20-24), suggesting a central airways effect. MEFV curve non-responders also exhibited a significantly lower baseline effective resistance profile than MEFV curve responders. The data indicate that under the conditions of the experiment measures of the Thevenin resistance (real part of impedence) by the forced random noise method are reliable indicators of cotton induced bronchoconstriction. Measurement variability, however, suggests that, at present, these are more appropriate for group studies and should remain adjuncts to standard tests of lung function such as spirometry.
通过肺量计(最大呼气流量容积曲线)和强迫随机噪声阻抗参数,对58名健康受试者吸入棉尘后的肺功能反应进行了评估。其中21名受试者还接受了体容积描记法检查,以评估气道阻力(Raw)的变化。对于整个研究组,接触棉尘后肺机械功能的改变通过最大呼气量和流速(p<0.001)以及阻抗参数(p<0.01)检测到,但未通过Raw检测到。在最大呼气流量容积曲线上有反应的受试者在低频时也显示出戴维南电阻或有效电阻增加(R1、R5-9、R5-9/R20-24),这表明气流受限主要发生在外周气道。相比之下,在最大呼气流量容积测量中无反应的受试者在低频和高频时有效电阻均显著增加(R1、R5-9、R20-24),提示有中央气道效应。最大呼气流量容积曲线无反应者的基线有效电阻曲线也显著低于最大呼气流量容积曲线有反应者。数据表明,在实验条件下,通过强迫随机噪声法测量的戴维南电阻(阻抗的实部)是棉尘诱发支气管收缩的可靠指标。然而,测量变异性表明,目前这些指标更适合用于群体研究,应作为肺功能标准检测(如肺量计)的辅助手段。