【作者】 欧宗兴；

【导师】 罗百灵；

【作者基本信息】 中南大学 ， 呼吸内科， 2010， 硕士

【摘要】 目的探讨呼气负压技术检测呼气流速受限(EFL)在慢性阻塞性肺病(COPD)患者中的临床价值。方法采用呼气负压技术(NEP)检测59例COPD患者在坐位及卧位EFL’隋况。结果59例患者中49例顺利完成了各项指标的检测,其中10例患者因严重呼吸困难或剧烈咳嗽无法完成本次常规肺功能测定。在49例COPD患者中22例在坐位及卧位均出现EFL,20例仅在卧位出现,坐位无EFL,有7例在坐位及卧位均无EFL；中度EFL组、重度EFL组、极重度EFL组的FEV1占预计值%均显著低于无EFL组(P均<0.000),极重度EFL组的FEV1占预计值%最低,与轻度、中度、重度EFL组比较差异有统计学意义(P<0.05)。5分法EFL评分与MRC呼吸困难评分呈显著正相关(r=0.903,P<0.005)；5分法EFL评分与FEV1呈负相关(r=-0.934,P<0.001)。多元回归分析结果表明,性别、年龄、身高、体重、FEV1、6min步行距离及5分法EFL评分7个变量中,6min步行距离、FEV1及5分法EFL评分与MRC呼吸困难评分有显著相关,其中5分法EFL评分相关性最强。结论1、五分法EFL评分与COPD患者呼吸困难分级有很好的相关性,是评价COPD患者呼吸困难可靠的客观指标。2、呼气负压技术是一种操作简单、非侵袭性、不需患者主动配合的肺功能检查方法,可用于不能完成常规肺功能检查患者的检测。更多还原

【Abstract】 Objective To evaluate the relationship between expiratory flow limitation (EFL) and chronic dyspnea in patients with chronic obstructive pulmonary disease (COPD).Methods EFL was detected by using negative expiratory pressure technique(NEP) in 59 patients with COPD at the sitting and the supine position.Results 49 cases of 59 patients successfully completed each target tests, of which 10 patients with severe dyspnea or severe cough can not accomplish the routine pulmonary function test. EFL was detected in 22 (44.9%) of the 49 COPD patients in both seated and supine positions and in 20 (40.8%) only in supine position. And 7 patients were not flow-limted either seated or supine. The values of FEV1% of the patients in the moderate, severe and very severe EFL group were all significantly lower than that of them in NO EFL group(P< 0.000). And the values of FEV1% of them in very severe EFL group were the lowest, which is significantly different with that of the patient in the mild, the moderate, severe EFL group(P<0.005).five-point EFL were significantly correlated with FEV1 (r=-0.934, P<0.000). There was a significant correlation between MRC dyspnea score and five-point EFL score (r=0.903, P<0.01). the multiple regression analysis showed that 6-min walking distance, FEV1% and five-point EFL score were correlated with MRC dyspnea score among the variables of sexes, age, height, body weight,FEV1%,6-min walking distance and five-point EFL score, and five-point EFL score showed the best correlativity with MRC dyspnea score. (regression coefficient was 0.47,P<0.005).Conclusions There was a significant relationship between expiratory flow limitation (EFL) and chronic dyspnea in patients with chronic obstructive pulmonary disease (COPD). EFL are measured by negative expiratory pressure (NEP) technique may be more reliable in the evaluation of dyspnea in COPD. Negative expiratory pressure technique is a is simple, non-invasive test, which dos not require any initiative cooperation from the patients, it can be applied in the patients who can not accomplish routine pulmonary function tests.更多还原