Inspiratory flow rates at different levels of resistance in elderly COPD patients
Inspiratory flow rates at different levels of resistance in elderly COPD patients
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DOI：
10.1183/09031936.00024807
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发表时间：
2008-01-01
影响因子：
24.3
通讯作者：
Decramer, M.
中科院分区：
文献类型：
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作者：
Janssens, W.;VandenBrande, P.;Decramer, M.
在老年慢性阻塞性肺疾病（COPD）患者中，干粉吸入器（dpi）越来越多地取代计量吸入器。然而，大多数dpi依赖于吸气流，而吸气流受到衰老过程本身的影响。本研究采用in-check拨号法，比较了26例老年COPD患者和14例匹配对照受试者在预先设定的阻力水平下的峰值吸气流量（PIF）率，分别为Aeroliser (R)、Diskus (R)和Turbuhaler (R)吸入器。结果发现，检入法测得的PIF与肺活量法、用力肺活量法和最大吸气压法测得的PIF呈正相关，与年龄呈显著负相关。肺活量测定法得出的PIF和年龄是决定整个装置PIF的独立变量，而是否存在COPD与PIF无关。当老年COPD患者与匹配的老年对照进行比较时，不同阻力下的PIF未见差异。然而，有相当数量的患者没有达到推荐的流量，特别是在使用Turbuhaler (R)时（30%）。总之，目前的研究表明，在老年患者中，无论是否存在慢性阻塞性肺病，通过干粉吸入器产生足够吸气流量的能力都会受到损害。
Dry powder inhalers (DPIs) are increasingly replacing metered dose inhalers in elderly chronic obstructive pulmonary disease (COPD) patients. However, most DPIs are dependent on inspiratory flow, which is compromised by the ageing process itself. Using the in-check dial method, the present study compared peak inspiratory flow (PIF) rates in 26 elderly COPD patients and 14 matched control subjects, at a pre-set resistance level of the Aeroliser (R), Diskus (R) and Turbuhaler (R) inhalers. It was found that the PIF measured by the in-check method positively correlated with the PIF derived from spirometry, forced vital capacity and maximal inspiratory pressure, while a negative, but significant, correlation was observed with age. PIF derived from spirometry and age were independent variables which determined PIF across the device, whereas the presence or absence of COPD was not related. When comparing elderly COPD patients with matched elderly controls no difference could be found in PIF at the different resistances. However, an important number of patients did not reach the recommended flow rate, especially when using the Turbuhaler (R) (30%). In conclusion, the present study demonstrates that, in elderly patients, the ability to generate sufficient inspiratory flow across a dry powder inhaler is compromised, irrespective of the presence of chronic obstructive pulmonary disease.