A New Method To Assess Lung Volume Dependency Of Respiratory System Resistance Using Forced Oscillation
A New Method To Assess Lung Volume Dependency Of Respiratory System Resistance Using Forced Oscillation
复制标题
一种利用受迫振荡评估呼吸系统阻力肺容量依赖性的新方法
DOI：
10.1164/ajrccm-conference.2010.181.1_meetingabstracts.a1240
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发表时间：
2010
期刊：
影响因子：
--
通讯作者：
W. Hida
中科院分区：
文献类型：
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作者：
H. Kurosawa;J. Ohishi;Y. Shimizu;Y. Tasaku;Daisuke Kobayashi;M. Masuda;Masashi Kanezaki;Etuhiro Nikkuni;M. Kohzuki;W. Hida
气道阻力与肺体积有关。支气管由周围肺组织的径向牵引支撑，其口径随着肺的扩张而增加。低肺容量时阻力较高，如残气量(RV)时阻力较大，而总肺活量(TLC)时阻力较低。在慢性阻塞性肺疾病(COPD)等呼吸不均匀或高气道阻力的患者中，这种依赖性可能会突出，特别是在RV附近的较低肺容量时。为了评估这些生理和病理生理学特性，设计了一种新的方法。用强迫振荡技术测量呼吸系统阻力(RRS)，而不是呼吸道阻力(RRS)，使用商用机器(MostGraph-01，胸部MI co.有限公司，日本东京)。以0.25秒为间隔施加脉冲振荡信号，以获得相对于5~35赫兹振荡频率的RRS特性。由于每0.25s就可以获得RRS曲线，这些曲线沿时间轴连续排列，形成了RRS的三维成像模式。利用该仪器对健康志愿者进行了简单的准静态测量。受试者被建议以大约0.2 L/分钟的流速从TLC到RV缓慢呼气。所有受试者在TLC时的RRS最小，在RV时最大，这清楚地显示了肺体积依赖的RRS的变化。与年长的受试者相比，健康的年轻受试者的依赖程度较轻，这可能反映了年轻受试者的呼吸机能不那么不均匀。由于这是一种非常简单、容易、无创的方法，未来的应用有望成为一种非常有用的生理工具，在这种情况下筛查早期COPD或非常轻微的哮喘。肺容量依赖的RRS特性变化
Airway resistance is lung volume dependent. The bronchi are supported by the radial traction of the surrounding lung tissue, and their caliber is increased as the lung expands. The high resistance should be observed at low lung volume such as residual volume (RV) while the low at the high lung voume such as total lung capacity (TLC). In patients with ventilatory uneveness or high airway resistance such as chronic obstructive pulmonary disease (COPD), the dependency could be prominent especially at the lower lung volume near RV. To assess these physiological and pathophysiological properties, a new method was designed. Instead of airway resistance, respiratory system resistance (Rrs) was measured with forced oscillation technique using a commertially available machine (MostGraph-01, Chest MI co. ltd., Tokyo, Japan). Impulse oscillatory signals at the intervals of 0.25 second were applied to obtain Rrs properties against oscillatory frequency ranged from 5 to 35 Hz. Because the Rrs curves were possible to be obtaied in every 0.25 second, those were serially lined up along time axis, resulted in 3 dimensional imaging pattern of Rrs. Using this machine, simple quasi-static measurements were performed in healthy volunteers. The subjects were advised to expirate slowly at the approximate flow rate of 0.2 L/min from TLC to RV. All the subjects showed the minimum Rrs at TLC and the maximum at RV, which clearly showed lung volume dependent Rrs changes. The dependency was mild in the healthy younger subjects compared to the older, that possibly reflected less inhomogenous ventilatory mechanics in the younger subjects. Because this was very simple, easy, and non-invasive way, the future application can be widely expected as a very useful physiological tool in such a situation to screen the early COPD or very mild asthma. Lung volume dependent changes of Rrs properties