Guillemi S, Wright J L, Hogg J C, Wiggs B R, Macklem P T, Paré P D
Respiratory Health Network of Centres of Excellence, University of British Columbia, Pulmonary Research Laboratory, St. Paul's Hospital, Vancouver, Canada.
Eur Respir J. 1995 May;8(5):789-94.
The density dependence of maximal expiratory flow is not an effective test of the site of airway narrowing in obstructive lung disease. We hypothesized that the density dependence of pulmonary resistance (DD,RL) would be more closely related to the degree of airway narrowing and peripheral airway pathology in smokers. We measured maximal expiratory flow at 50% vital capacity (V'max50) and lung resistance (RL) breathing air and 80% helium-20% oxygen, and calculated density dependence of V'max50 and RL in 40 patients who had moderate airflow obstruction and in 10 normal subjects. We compared the density dependence of RL and V'max50 with the degree of airway obstruction and bronchiolar pathology scores in 27 patients with resected lung specimens. There were no differences in DD of V'max50 or RL between normal subjects and patients, and no relationship between the degree of obstruction or the bronchiolar pathology score and the DD of these measurements. There were significant relationships between V'max50, RL and the bronchiolar pathology scores. In conclusion, lung resistance and maximal expiratory flow are related to the severity of peripheral airway pathology, but there is no relationship between the severity of obstruction or the severity of peripheral airway pathology and the density dependence of maximal expiratory flow or lung resistance.
最大呼气流量的密度依赖性并非阻塞性肺疾病气道狭窄部位的有效检测方法。我们推测，肺阻力的密度依赖性（DD，RL）与吸烟者气道狭窄程度及外周气道病变的关系更为密切。我们测量了40例中度气流受限患者和10名正常受试者在呼吸空气及80%氦气 - 20%氧气时的50%肺活量最大呼气流量（V'max50）和肺阻力（RL），并计算了V'max50和RL的密度依赖性。我们将27例有切除肺标本患者的RL和V'max50的密度依赖性与气道阻塞程度及细支气管病变评分进行了比较。正常受试者与患者之间V'max50或RL的DD无差异，这些测量的阻塞程度或细支气管病变评分与DD之间也无相关性。V'max50、RL与细支气管病变评分之间存在显著相关性。总之，肺阻力和最大呼气流量与外周气道病变的严重程度相关，但阻塞严重程度或外周气道病变严重程度与最大呼气流量或肺阻力的密度依赖性之间无相关性。
