摘要
目的:观察Ⅱ、Ⅲ级慢性阻塞性肺疾病(COPD)稳定期患者的深吸气量(IC)及吸气分数(IC/TLC)与呼吸肌力的关系。方法:将78例稳定期COPD患者根据中华医学会呼吸病学会制订的诊断标准分为Ⅱ级(40例)和Ⅲ级(38例)两组。所有患者受试前8h内均未应用支气管舒张剂,并在吸入沙丁胺醇400μg后接受常规肺功能和呼吸肌力测试。结果:Ⅲ级COPD患者的IC、第一秒用力呼气容积(FEV1)、呼气峰流速(PEF)和最大通气量(MVV)均显著低于Ⅱ级COPD患者,两组患者的最大吸气压(PImax)和最大呼气压(PEmax)均显著降低,但两者间无显著差异。38例Ⅲ级COPD患者中IC/TLC≤25%者有11例(28.9%),而仅有2例(5%)Ⅱ级COPD患者的IC/TLC≤25%。COPD患者的IC与PImax和PEmax呈显著相关(r分别为0.375与0.386,P<0.01),IC/TLC与RV/TLC呈明显负相关(r=-0.782,P<0.01),而与PImax和PEmax无关。结论:稳定期Ⅱ、Ⅲ级COPD患者已存在较严重的呼吸肌功能障碍。随着气流受限与肺过度充气的加重,Ⅲ级COPD患者其IC值显著降低,且更易出现IC/TLC≤25%,而IC/TLC变化不能反映COPD患者的呼吸肌功能受损程度。
Objective To compare the inspiratory fraction[inspiratory capacity-to-total lung capacity （IC/TLC）] ratio and respiratory muscle strength in patients with chronic obstructive pulmonary disease （COPD）. Methods Seventy-eight stable COPD patients with Global Initiative for Chronic Obstructive Lung Disease（GOLD） stages Ⅱ-Ⅲ [post-bronchodilator forced expiratory volume in one second （FEV1） ranging 31%-79% pred] were enrolled. Lung function testing and respiratory muscle strength were measured after brochodilator （salbutamol 400 μg） inhalation. Results The IC, maximal voluntary ventilation （MVV） and peak expiratory flow （PEF） in 38 severe COPD patients [GOLD stage Ⅲ （FEV1 31%-49% pred）] showed much lower. There were no differences founded in maximal inspiratory and expiatory pressure（Plmax/ PEmax） between moderate and severe COPD patients. The IC/TLC≤25% wre revealed in 11 patients （28.9%） with severe COPD and only 2 patients （5%） with moderate COPD. IC level was significantly correlated with PImax and PEmax （r= 0.375 and 0.386, P〈0.01）, also correlated with FEV1 and PEF. IC/TLC was remarkably correlated with residual volume （RV）/TLC （r=-0.782, P〈0.01）. No relationship was found between IC/TLC and Plmax, PEmax. Conclusions Plmax and PEmax obviously decrease in stable moderate to severe COPD patients on account of the severe dysfunction of respiratory muscle strength. Reduced IC level was associated with aggravated hyperinflation in severe COPD patients. Seldom of moderate COPD patients＇ IC/TLC might be below 25%.
出处
《诊断学理论与实践》
2007年第5期409-411,共3页
Journal of Diagnostics Concepts & Practice
关键词
慢性阻塞性肺疾病
吸气分数
深吸气量
Chronic obstructive pulmonary disease
Inspiratory fraction
Inspiratory capacity
