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慢性阻塞性肺疾病(COPD)通气患者的呼吸力学:强迫振荡技术与阻断技术的比较

Respiratory mechanics in ventilated COPD patients: forced oscillation versus occlusion techniques.

作者信息

Farré R, Ferrer M, Rotger M, Torres A, Navajas D

机构信息

Laboratory Biofisica i Bioenginyeria, Facultat de Medicina, IDIBAPS, Universitat de Barcelona, Spain.

出版信息

Eur Respir J. 1998 Jul;12(1):170-6. doi: 10.1183/09031936.98.12010170.

Abstract

The respiratory mechanics of artificially ventilated chronic obstructive pulmonary disease (COPD) patients were investigated by means of the forced oscillation (FOT) and the end-inspiratory airway occlusion (AOT) techniques. FOT was applied to measure respiratory resistance (Rrs) and reactance (Xrs) from 0.25-16 Hz. Maximum (Rmax) and minimum (Rmin) resistances, static elastance (Est) and time constant (T) were computed by AOT. FOT and AOT data were interpreted with models featuring airway wall shunt, tissue viscoelasticity and parallel inhomogeneity. Rrs* and Xrs*, predicted from the AOT data, were computed and compared with Rrs and Xrs measured by FOT. Rrs and Xrs (hPa x s x L(-1)) decreased from 31.2+/-10.3 to 5.9+/-4.6 and increased from -20.3+/-7.1 to -8.0+/-4.4 from 0.25-16 Hz, respectively. Central resistance (Rc) and peripheral resistance (Rp) (in hPa x s x L(-1)), and shunt elastance (Esh) and tissue elastance (Et) (in hPa x L(-1)) were 4.4+/-5.4, 28.4+/-153, 723+/-393 and 31.8+/-10.1, respectively. Rmin, Rmax and Est were 18.4+/-5.9, 28.4+/-12.8 and 18.1+/-4.2 respectively, and T=0.76+/-0.25 s. The frequency dependence of predicted Rrs* and Xrs* differed markedly from that of measured Rrs and Xrs. The use of different models to interpret the measured data suggests that both airway and tissue properties determined the frequency dependence of respiratory resistance and respiratory reactance in ventilated chronic obstructive pulmonary disease patients at the investigated frequencies (0.25-16 Hz).

摘要

采用强迫振荡(FOT)和吸气末气道阻断(AOT)技术研究了人工通气的慢性阻塞性肺疾病(COPD)患者的呼吸力学。应用FOT测量0.25 - 16 Hz范围内的呼吸阻力(Rrs)和电抗(Xrs)。通过AOT计算最大(Rmax)和最小(Rmin)阻力、静态弹性(Est)和时间常数(T)。FOT和AOT数据采用具有气道壁分流、组织粘弹性和平行不均匀性的模型进行解释。根据AOT数据计算预测的Rrs和Xrs,并与FOT测量的Rrs和Xrs进行比较。Rrs和Xrs(hPa×s×L⁻¹)在0.25 - 16 Hz范围内分别从31.2±10.3降至5.9±4.6,从 - 20.3±7.1增至 - 8.0±4.4。中心阻力(Rc)和外周阻力(Rp)(hPa×s×L⁻¹)以及分流弹性(Esh)和组织弹性(Et)(hPa×L⁻¹)分别为4.4±5.4、28.4±15.3、723±393和31.8±10.1。Rmin、Rmax和Est分别为18.4±5.9、28.4±12.8和18.1±4.2,T = 0.76±0.25 s。预测的Rrs和Xrs的频率依赖性与测量的Rrs和Xrs明显不同。使用不同模型解释测量数据表明,在研究频率(0.25 - 16 Hz)下,气道和组织特性均决定了通气慢性阻塞性肺疾病患者呼吸阻力和呼吸电抗的频率依赖性。

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