Piquet J, Harf A, Lorino H, Atlan G, Bignon J
Bull Eur Physiopathol Respir. 1984 Jan-Feb;20(1):31-6.
In 9 healthy subjects and 22 patients with chronic obstructive disease, we computed total lung capacity (TLC) using an integrated flow pressure-corrected body plethysmograph. During panting manoeuvre, TLC derived from oesophageal pressure (TLCes) was compared to TLC derived from mouth pressure (TLCm). In healthy subjects, TLCm was identical to TLCes. Patients with obstructive disease exhibited different behaviours according to experimental conditions: a) in free frequency panting with mouth occlusion close to functional residual capacity (FRC) (9 patients), TLCm appeared to be significantly higher than TLCes (mean difference: 0.25 1; p less than 0.05); b) in panting with both low (less than 1 Hz) and high (2 Hz) frequencies and mouth occlusion close to FRC (7 patients), TLCm appeared to be significantly higher than TLCes only at a high frequency (p less than 0.05); c) in panting with both low and high frequencies and mouth occlusion close to TLC (6 patients), no significant difference was observed between TLCm and TLCes. These results suggest that in patients with chronic obstructive disease plethysmographic lung volume measurements are subject to error, due to the influence of extrathoracic airways. During occlusion at FRC, panting frequency was found to influence the results obtained, the error being minimized with low frequencies. In contrast, by occluding at TLC, we found that panting frequency was less likely to influence the results. However, potential sources of error still exist: for instance, the influence of abdominal gas or the panting pattern.
在9名健康受试者和22名慢性阻塞性疾病患者中,我们使用集成流量压力校正体描仪计算了总肺容量(TLC)。在喘息动作期间,将源自食管压力的TLC(TLCes)与源自口腔压力的TLC(TLCm)进行比较。在健康受试者中,TLCm与TLCes相同。阻塞性疾病患者根据实验条件表现出不同的行为:a)在接近功能残气量(FRC)时进行口部闭塞的自由频率喘息(9名患者),TLCm似乎明显高于TLCes(平均差异:0.25升;p小于0.05);b)在低频率(小于1Hz)和高频率(2Hz)且口部闭塞接近FRC时进行喘息(7名患者),仅在高频率时TLCm似乎明显高于TLCes(p小于0.05);c)在低频率和高频率且口部闭塞接近TLC时进行喘息(6名患者),TLCm和TLCes之间未观察到显著差异。这些结果表明,在慢性阻塞性疾病患者中,由于胸外气道的影响,体积描记法测量肺容积存在误差。在FRC闭塞期间,发现喘息频率会影响获得的结果,低频时误差最小。相比之下,通过在TLC处闭塞,我们发现喘息频率不太可能影响结果。然而,潜在的误差来源仍然存在:例如,腹部气体的影响或喘息模式。