新型冠状病毒感染后小气道功能障碍及肺通气均匀性诊断方法的应用

O. Savushkina, A. Cherniak
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引用次数: 2

摘要

在本讲座中,我们讨论了小气道功能障碍的诊断方法和途径,如多次呼吸氮冲洗试验,脉冲振荡测定法,以及作为总肺活量与肺泡容积之比的不良通讯分数(PCF)的计算。在上述诊断工具的帮助下检测小气道功能障碍,可以在支气管肺疾病的早期阶段确定呼吸系统功能障碍,而传统的肺功能检查结果仍在正常值范围内。因此,检测周围气道功能障碍的一种标准化和最容易获得的方法是身体体积脉搏图,它被用来诊断“空气陷阱”的存在。然而,在支气管肺疾病的早期阶段,这种方法的可能性有限。讲座主要介绍我们对新型冠状病毒感染合并病毒性肺炎患者的研究结果。对纳入分析的所有患者进行肺活量测定、体容积描记、弥散试验、脉冲振荡测定、多次呼吸氮冲洗试验,并计算PCF指数。在俄罗斯文献中首次给出了PCF指数的描述、计算方法、正常值范围以及临床应用的可能性。讲座中描述的评估小气道功能障碍的方法目前尚未广泛应用,但我们希望目前在科学实验室应用的知识将逐步引入常规临床实践。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Methods for diagnosing dysfunction of small airways and uniformity of lung ventilation: their use after a novel coronavirus infection
In this lecture, we discussed methods and approaches to the diagnosis of small airways dysfunction, such as multiple breath nitrogen washout test, impulse oscillometry, as well as the calculation of poorly communicating fraction (PCF) as the ratio of total lung capacity to alveolar volume. The detection of the small airways dysfunction with the help of the diagnostic tools listed above makes it possible to establish functional disorders of the respiratory system in the early stages of bronchopulmonary diseases, when the results of traditional pulmonary functional tests remain within normal values. Thus, a well-standardized and the most accessible method for detecting the peripheral airways dysfunction is body plethysmography, which is used to diagnose the presence of “air trappings”. However, in the early stages of bronchopulmonary diseases, the possibilities of this method are limited. The lecture focuses primarily on the results of our own researches which were performed on patients who have suffered from a novel coronavirus infection complicated by viral pneumonia. Spirometry, body plethysmography, diffusion test, impulse oscillometry, multiple breath nitrogen washout test were conducted, and PCF index was calculated in all patients included in this analysis. The description of the PCF index, the method of its calculation, the range of normal values, as well as the possibilities of application in clinical practice are given for the first time in the Russian literature. The approaches to assessing the dysfunction of the small airways described in the lecture are not widely used at present, however, we hope that the knowledge that is currently being applied in scientific laboratories will gradually be introduced into routine clinical practice.
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