CAJ | 학술논문

目的探讨振动反应成像系统(vibration response imaging,VRI)在间质性肺疾病(ILD)患者肺功能评价中的应用价值.方法选取我院2010年6月至2011年9月临床诊断为ILD的患者80例,进行VRIxp肺功能检查,并与传统肺功能进行比较,观察患者肺功能检查前后病情变化,分析VRIxp和传统肺功能在ILD患者肺功能评价上的优劣.结果 VRIxp主要参数变化及意义:①观察气流分布图及最大振动能量图发现所有受试者均存在图像不同步、大小不一等不同程度的异常；②69例受检者存在能量分布异常,根据不同疾病类型分组及CT表现分组比较能量值,差异无统计学意义;③能量曲线出现平台及曲线分离等异常表现；④VRIxp可客观定性、定量检出异常呼吸音,且检出率较传统听诊高,分别为90.00％、82.50％;⑤结合气流分布图及区域能量分布可定位病灶,本组73例VRIxp与CT定位一致,病灶定位准确率达91.25％.与传统肺功能比较:①传统肺功能通气功能正常者VRI检测结果均存在异常,且病变部位与HRCT相符；②肺功能检查前后受检者病情变化评分,传统肺功能检测评分差值为6.59,VRI检测前后评分差值为0.32.VRI对患者病情影响较小.结论 VRIxp是一种在患者平静呼吸状态下即可进行肺功能测定的一种新方法,较传统肺功能有诸多优势:可动态、直接、快速且准确地观测到肺容积的变化、判断病变部位和更为敏感地发现肺部异常呼吸音,且对患者病情无影响,特别适用于以呼吸困难为突出表现的ILD患者.
목적 탐토진동반응성상계통(vibration response imaging,VRI)재간질성폐질병(ILD)환자폐공능평개중적응용개치.방법 선취아원2010년6월지2011년9월림상진단위ILD적환자80례,진행VRIxp폐공능검사,병여전통폐공능진행비교,관찰환자폐공능검사전후병정변화,분석VRIxp화전통폐공능재ILD환자폐공능평개상적우렬.결과 VRIxp주요삼수변화급의의:①관찰기류분포도급최대진동능량도발현소유수시자균존재도상불동보、대소불일등불동정도적이상；②69례수검자존재능량분포이상,근거불동질병류형분조급CT표현분조비교능량치,차이무통계학의의;③능량곡선출현평태급곡선분리등이상표현；④VRIxp가객관정성、정량검출이상호흡음,차검출솔교전통은진고,분별위90.00％、82.50％;⑤결합기류분포도급구역능량분포가정위병조,본조73례VRIxp여CT정위일치,병조정위준학솔체91.25％.여전통폐공능비교:①전통폐공능통기공능정상자VRI검측결과균존재이상,차병변부위여HRCT상부；②폐공능검사전후수검자병정변화평분,전통폐공능검측평분차치위6.59,VRI검측전후평분차치위0.32.VRI대환자병정영향교소.결론 VRIxp시일충재환자평정호흡상태하즉가진행폐공능측정적일충신방법,교전통폐공능유제다우세:가동태、직접、쾌속차준학지관측도폐용적적변화、판단병변부위화경위민감지발현폐부이상호흡음,차대환자병정무영향,특별괄용우이호흡곤난위돌출표현적ILD환자.
Objective To discuss the value of vibration response imagine (VRI) on evaluating the pulmonary function of interstitial lung disease (ILD).Methods 80 patients who were diagnosed as ILD from June 2010 to September 2011 enrolled in this study.Then,all the patients took the VRIxp pulmonary function test so as to make a comparison with the traditional pulmonary function test.This paper analyzed the advantage and disadvantage of VRIxp and the traditional pulmonary function teat in evaluating the pulmonary function of ILD by observing the changes of patients' condition after the test respectively.Results The changes and significance of the main VRIxp parameters:①By observing airflow distribution map and maximum vibration energy diagram,a variety of abnormities were discovered such as the out-sync of the images and the size difference in all patients.②It is found that 69 patients had abnormal energy distribution.According to grouping of the various disease types and CT scan,the energy values were compared which indicated that the abnormities had no statistical significance.③ The energy curve had some abnormities such as the platform and curve separation.④The study showed that VRIxp could qualitatively,quantificationally detect the abnormal breath sounds and VRIxp was more sensitive than that of traditional auscultation (the positive rate were 90.00％ vs 82.50％,respectively).⑤VRIxp could locate the lesion directly by combining air distribution figure with regional energy distribution.The accuracy rate was as high as 91.25％ compared with CT scan.Comparing with traditional pulmonary function technology,there were some advantages of VRI.①For some patients,their ventilatory functions were detected as normal by traditional pulmonary function technology,while through VRI test,the results were abnormal.And the lesions were consistent with HRCT.② By evaluating conditions of patients before and after pulmonary function test,VRIxp was less secondary effects than traditional pulmonary function technology (the positive rate were 0.32 vs 6.59,respectively).Conclusions VRIxp,as a new method,can test the pulmonary function of subjects in normal breathing state.VRIxp has many advantages over traditional pulmonary function technology,such as displaying the volume change of lung in a dynamic,direct,fast,and accurate way.It also can detect the lesion and the abnormal breath sounds more sensitively.More importantly,it has no side effect on the patients' condition.It is especially suitable for the patients of ILD who have serious dyspnea.