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目的 探讨肺水肿对呼吸力学的影响。方法 用脉冲振荡法测定急性肺损伤 (ALI)犬 5～ 3 5Hz呼吸阻抗。结果 注射油酸前 ,呼吸系粘性阻力随着频率增大有轻微降低 ,电抗随着频率增大有轻微升高。共振频率为( 5 .0 7± 0 .65 )Hz。注射油酸后 5～ 2 5Hz呼吸阻力 (R5～R2 5)明显增大 ,3 5Hz呼吸阻力 (R35)无明显增大。 5Hz电抗 (X5)明显降低 ,周边弹性阻力增大约 4倍。但 10～ 3 5Hz电抗无明显改变。共振频率增加到 ( 7.74± 2 .4 1)Hz。而且R5与PaO2 /FiO2 呈高度负相关 ,X5与PaO2 /FiO2 呈高度正相关。结论 进一步证实ALI存在呼吸动力功能异常。认为R5≥ 1.0kPa/ (L·s)及X5≤ - 0 .2 5kPa/ (L·s)作为辅助诊断ALI的指标较为合适 ,R5和X5可作为评价ALI严重程度检测的可靠指标值得临床使用。
Objective To investigate the effects of pulmonary edema on respiratory mechanics. Methods Respiratory impedance of 5 ~ 35Hz in acute lung injury (ALI) dogs was measured by pulse oscillation method. Results Before oleic acid injection, viscous resistance of respiratory system slightly decreased with increasing frequency, and reactance slightly increased with increasing frequency. Resonance frequency was (5.07 ± 0.65) Hz. Respiratory resistance (R5 ~ R2 5) at 5 ~ 2 5 Hz after injection of oleic acid increased significantly, while respiration at 35 Hz had no significant increase (R35). 5Hz reactance (X5) significantly reduced the surrounding elastic resistance increased by about 4 times. However, 10 ~ 3 5Hz reactance did not change significantly. Resonance frequency increased to (7.74 ± 2.41) Hz. Moreover, R5 was highly negatively correlated with PaO2 / FiO2, and X5 was highly positively correlated with PaO2 / FiO2. Conclusions further confirmed that there is abnormal respiratory function in ALI. It is considered that R5≥1.0kPa / (L · s) and X5≤0.225kPa / (L · s) are suitable for the diagnosis of ALI, and R5 and X5 can be used as reliable indicators to evaluate the severity of ALI. .