慢性阻塞性肺疾病急性加重患者治疗后气道阻力变化特点

为探索慢性阻塞性肺疾病急性加重(AECOPD)患者经过治疗后气道阻力变化特点,通过选取2017年3月～2018年3月因AECOPD就诊病人共50例,其中男性患者39例,女性患者11例,平均年龄(68. 1±8. 7)岁,所有患者于第1天治疗前及门诊治疗后第7天均行常规肺功能(PFT)联合脉冲振荡肺功能(IOS)检查,比较治疗前后肺功能指标变化。结果表明AECOPD患者治疗后共振频率(Fres)、总气道阻力(R5)、中心气道阻力(R20)、外周气道阻力(R5-R20)、5 Hz时电抗(X5)、低频电抗面积(AX)均明显低于治疗前,R5-R20改善值与FEV1%pred负相关性最强(r=-0. 507,P 0. 05),R20改善值与基线PFT相关性无统计学意义(P 0. 05)。可见AECOPD患者经治疗后全气道阻力下降,其中外周气道阻力的变化指标R5-R20与基线PFT相关性最好,气流受限越重患者治疗后外周气道阻力改善越明显,以R5-R20作为慢阻肺急性加重治疗效果评价指标具有相对可靠的临床适用性。

Characteristics of Airway Resistance Changes after Treatment in Acute Exacerbation of Chronic Obstructive Pulmonary Disease Patients

Objective In order to explore the characteristics of airway resistance after treatment in patients with acute exacerbation of chronic obstructive pulmonary disease (AECOPD), a total of 50 patients between March 2017 and March 2018 to the hospital respiratory medicine clinics because of AECOPD were selected, including 39 males and 11 females, mean age (68.1± 8.7)years. All of the patients were performed routine SPulmonary function test (PFT) combined with impulse oscillation (IOS) before the first day and after the seventh day of the ambulatory treatment, and the changes of parameters were compared. After treatment, Fres, R5, R20, R5-R20, X5 and AX were significantly lower than those before treatment. R5-R20 had the most obvious negative correlation with FEV1/pred (r=-0.507, P<0.05), while there was no statistically significant correlation between R20 and baseline PFT (P>0.05). The results show that the total airway viscosity resistance decreased after treatment in AECOPD patients. R5-R20 is most correlated with baseline PFT. The more severe the airflow limitation is, the more significant the improvement of peripheral airway viscosity resistance will be. R5-R20 has relatively reliable clinical applicability as an evaluation index for the treatment effect of acute exacerbation of COPD.