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目的探讨不同严重程度的慢性阻塞性肺疾病(COPD)患者在不同干粉吸入器阻力状态下的吸气能力。方法 54例中老年COPD患者纳入研究,年龄(67.7±8.4)岁,采用In-Check DIAL吸气峰流量仪,测定模拟准纳器阻力状态下的吸气峰流量(PIF-Diskus,PIF-D)以及模拟都保阻力状态下的吸气峰流量(PIF-Turbuhaler,PIF-T),同时测定呼气峰流量(PEF)以及舒张后肺功能。结果 1例(1.9%)COPD患者未能达到Diskus的最低吸气流量(30L/min)要求,12例(22.2%)未能达到Turbuhaler的最低吸气流量(60L/min)要求,两组间有统计差异(χ2=10.581,P=0.001)。对于PIF-D,7.1%的Ⅳ级COPD患者低于理想吸气流量,Ⅱ级和Ⅲ级的PIF-D均达到理想吸气流量或以上,不同级别COPD患者的PIF-D分级分布情况无统计学差异(χ2=5.665,P=0.226)。对于PIF-T,Ⅱ级、Ⅲ级、Ⅳ级的COPD患者的比例为11.8%、26.1%、28.6%,不同级别COPD患者的PIF-T分级分布情况无统计学差异(χ2=3.222,P=0.521)。经直线回归分析表明,COPD患者PEF测定值与PIF-D和PIF-T测定值均呈正相关(r值分别为0.584和0.478,P均=0.01)。结论通过COPD患者的疾病严重程度,无法判断患者是否真正有效地吸入药物。In-Check DIAL吸气峰流量仪可测定COPD患者在不同吸入器阻力状态下吸气流量,临床医生可根据患者的测定结果来为患者选用不同的吸入器,并开具合理的药物处方,适于在临床上推广应用。
Objective To investigate the inspiratory capacity of patients with chronic obstructive pulmonary disease (COPD) of different severity in resistance status of different dry powder inhalers. Methods Fifty-four elderly patients with COPD were enrolled and aged (67.7 ± 8.4) years old. Inhalation peak flow (PIF-Diskus, PIF-D ) And simulated peak inspiratory flow (PIF-Turbuhaler, PIF-T) at both endurance levels, as well as peak expiratory flow (PEF) and post-diastolic pulmonary function. Results One case (1.9%) of patients with COPD failed to meet the minimum inspiratory flow (30 L / min) for Diskus and 12 patients (22.2%) failed to meet the Turbuhaler minimum inspiratory flow (60 L / min) There are statistical differences (χ2 = 10.581, P = 0.001). For PIF-D, 7.1% of patients with grade 4 COPD were below the ideal inspiratory flow, grade 2 and 3 of PIF-D achieved optimal inspiratory flow or above, and no statistical significance was observed in the distribution of PIF-D among patients with different grades of COPD Learning difference (χ2 = 5.665, P = 0.226). For PIF-T, grade II, grade III, and grade IV COPD patients were 11.8%, 26.1%, 28.6% respectively. There was no significant difference in PIF-T grade distribution between patients with different grades of COPD (χ2 = 3.222, P = 0.521). Linear regression analysis showed that there was a positive correlation between PEF and PIF-D and PIF-T in COPD patients (r = 0.584 and 0.478, respectively, P = 0.01). Conclusion The severity of the disease in patients with COPD can not determine whether the patient is truly effective inhalation of drugs. In-Check DIAL Peak Inspirometer measures the inspiratory flow in COPD patients at various inhaler resistance states. Clinicians can select different inhalers for patients based on the patient’s assay results and develop a rational drug prescription that is appropriate Promote the clinical application.