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目的探讨应用呼气负压(NEP)技术检测慢性阻塞性肺疾病(COPD)患者呼气流速受限(EFL)的临床价值。方法采用 NEP 技术检测54例 COPD 患者和8例不能完成常规肺功能检查的 COPD 患者 EFL。结果 54例 COPD 患者中有41例检测到 EFL,5分法 EFL 评分2分组(55.71%±11.77%)、3分组(41.21%±13.69%)、4分组(29.84%±11.65%)1秒钟用力呼气量占预计值百分比(FEV_1%)低于0分组(83.76%±16.44%)。多元逐步回归分析表明,5分法 EFL 评分是最先进入因素,并与呼吸困难相关性最好。8例 COPD 患者均能耐受 NEP 测试。结论与 FEV_1%相比,5分法EFL 评分是评价 COPD 患者呼吸困难更可靠的指标;NEP 技术操作简单、不需患者主动配合,可在不能完成常规肺功能检查的患者中应用。
Objective To investigate the clinical value of using expired-air negative pressure (NEP) in the detection of limited expiratory flow (EFL) in patients with chronic obstructive pulmonary disease (COPD). Methods The NEP technique was used to detect EFL in 54 patients with COPD and 8 patients with COPD who were unable to complete routine pulmonary function tests. Results EFL score was detected in 41 out of 54 patients with COPD. The EFL scores of 2 groups (55.71% ± 11.77%), 3 groups (41.21% ± 13.69%) and 4 groups (29.84% ± 11.65%) for 1 second The forced expiratory volume percentage (FEV_1%) was lower than the 0 group (83.76% ± 16.44%). Multivariate stepwise regression analysis showed that EFL score of 5-point method was the first entry factor and had the best correlation with dyspnea. All 8 patients with COPD were able to tolerate NEP test. Conclusions The 5-point EFL score is a more reliable indicator of dyspnea in patients with COPD compared with FEV_1%. The NEP technique is simple and does not require the patient’s active cooperation. It can be used in patients who can not perform routine pulmonary function tests.