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目的评价脉冲振荡法（ＩＯＳ）测定粘性阻力在慢性阻塞性肺疾病（ＣＯＰＤ）肺功能检查中的临床意义。方法用ＩＯＳ法测定 ５８例老年ＣＯＰＤ病人和５７例健康老年人的粘性阻力值（Ｒ）并与常规肺功能结果比较。结果ＣＯＰＤ患者各振荡频率的粘性阻力值较健 康人均有不同程度的增高，并呈频率依赖性，即随着频率减低差异越大，反映总气道粘性阻力的Ｒ５和反映周围气道粘性阻力的Ｒ５～２０检 出ＣＯＰＤ的敏感性分别为６２．１％和７０．７％。ＦＥＶ１／ＦＶＣ越低，检出率越高。Ｒ５、Ｒ５～２０与常规肺功能中ＦＥＶ１／ＦＶＣ、最大呼气流量－容积 曲线衍生指标存在一定的相关性，但反映中央气道阻力的Ｒ２０与上述常规肺功能指标无明显相关。结论ＩＯＳ法测定的粘性阻力Ｒ５和 Ｒ５～２０值能反映ＣＯＰＤ的气流阻塞，适用于老年患者呼吸阻力的检测。
Objective To evaluate the clinical significance of determining the viscous resistance by Pulsed Oscillation (IOS) in pulmonary function tests of chronic obstructive pulmonary disease (COPD). Methods The IOS method was used to measure the viscous resistance value (R) of 58 elderly COPD patients and 57 healthy elderly people and compared with the results of routine pulmonary function tests. Results The viscous resistance values at various oscillation frequencies in patients with COPD were significantly higher than those in healthy people, and were frequency-dependent. That is, the greater the difference in frequency, the R5 reflecting the total airway viscosity resistance and the viscosity resistance reflecting the airway resistance The sensitivity of R5 ~ 20 to detect COPD was 62.1% and 70.7% respectively. The lower the FEV1 / FVC, the higher the detection rate. R5 and R5-20 had some correlation with FEV1 / FVC and maximum expiratory flow-volume curve derived index in routine pulmonary function, but there was no significant correlation between R20 which reflected central airway resistance and the above-mentioned routine pulmonary function indexes. Conclusions The viscous resistance values R5 and R5 ~ 20 measured by IOS method can reflect the airflow obstruction in COPD and is suitable for the detection of respiratory resistance in elderly patients.