哮喘联盟

   摘要
   目的：肺功能检测对于支气管哮喘的诊断和管理必不可少。脉冲震荡（IOS）系统是检测某些患者肺机械力学的一种选择。本试验研究IOS、体积描记法和肺活量检测在检测过敏原和乙酰甲胆碱诱导的支气管收缩中的相对敏感性。
   方法：22名受试者接受单次过敏原吸入，8名受试者进行3次乙酰甲胆碱激发试验。当FEV1下降20%时检测终止。在进行激发试验时，采用IOS（R5, R20, R5-R20, X5, AX, fres）、体积描记法（sRaw, sGaw, FRC, 肺容量）和肺活量检测（FEV1、FVC、PEF、FEF50%）方法检测肺功能，将结果表示为与激发试验前的变化百分数。
   结果：所有受试者均为非吸烟的成人轻度过敏性哮喘患者。过敏原激发后，最敏感的IOS指标是R5-R20；最敏感的体积描记法和肺活量检测指标是sRaw、sGaw和FEF50%。乙酰甲胆碱激发后，最敏感的IOS指标是AX；最敏感的体积描记法指标是sRaw。总体来说，过敏原和乙酰甲胆碱诱导的支气管收缩检测中，IOS（R5-R20, AX, X5Hz）的敏感性强于体积描记法和肺活量检测法。
   结论：本研究结果显示，过敏原和乙酰甲胆碱激发后，IOS检测肺功能的敏感性强于其他方法。此外，在进行体积描记法和肺活量检测时，如果患者难以配合，IOS可作为气道阻力和阻塞检测的一个备选方法。
 

（刘国梁 审校）
RespirMed.2013Jan23.pii:S0954-6111(13)00003-6.doi:10.1016/j.rmed.2012.12.022. [Epub ahead of print]

 

Comparison of changes in lung function measured by plethymography and IOS after bronchoprovocation.
 
Naji N, Keung E, Kane J, Watson RM, Killian KJ, Gauvreau GM.

Source
Cardiorespiratory Research Laboratory, Department of Medicine, McMaster University, 1200 Main St West, Hamilton, ON L8N 3Z5, Canada.

Abstract 
AIM: Lung function tests are essential for the diagnosis and management of bronchialasthma. Impulse oscillation (IOS) system is an alternative way to measure lung mechanics for some patients. We investigated the relative sensitivities of IOS, body plethysmography and spirometry in detecting allergen- and methacholine-induced bronchoconstriction.
METHOD: Twenty-two subjects had single allergen inhalation and 8 subjects had 3 methacholine challenges. The tests were stopped when FEV(1) fell by 20%. Lung function was measured using IOS (R5, R20, R5-R20, X5, AX, fres), plethysmography (sRaw, sGaw, FRC, lung volumes) and spirometry (FEV(1), FVC, PEF, FEF(50%)) during inhalation challenges, and expressed as percent change from pre-challenge baseline.
RESULTS: All subjects were non-smoking adults with mild allergic asthma. Following allergen challenges, the most sensitive IOS index was R5-R20 and the most sensitive plethysmography and spirometry measurements were sRaw, sGaw and FEF(50%). Following methacholine challenge the most sensitive IOS index was AX, the most sensitive plethysmography measurement was sRaw. Overall, IOS (R5-R20, AX, X5Hz) proved to be more sensitive than plethysmography and spirometry measurements following allergen-induced and methacholine-induced bronchoconstriction.
CONCLUSION: Our result shows that IOS is more sensitive than other lung function tests following allergen and methacholine challenge. In addition, IOS can act as an alternative measurement technique of airway resistance and obstruction in patients where manoeuvres involved in plethysmography and spirometry prove difficult to perform

RespirMed.2013 Jan 23. pii: S0954-6111(13)00003-6. doi: 10.1016/j.rmed.2012.12.022. [Epub ahead of print]