振动反应成像技术在鉴别哮喘和慢性阻塞性肺疾病中的应用

中国药物警戒 ›› 2010, Vol. 7 ›› Issue (6): 329-333.

振动反应成像技术在鉴别哮喘和慢性阻塞性肺疾病中的应用

张晓岩, 林江涛, 刘超武

卫生部中日友好医院呼吸内科,北京 100029

收稿日期:2016-02-22 修回日期:2016-02-22 出版日期:2010-06-08 发布日期:2016-02-22
通讯作者: 林江涛,男,博士生导师,支气管哮喘发病机制的研究。E-mail：jiangtao_l@263.net
作者简介:张晓岩,女,硕士,主治医师,支气管哮喘发病机制的研究。

Differentiate Asthma and COPD by Vibration Response Imaging

ZHANG Xiao-yan, LIN Jiang-tao, LIU Chao-wu

Department of Respiratory Medicine, China-Japan Friendship Hospital, Beijing 100029, China

Received:2016-02-22 Revised:2016-02-22 Online:2010-06-08 Published:2016-02-22

摘要/Abstract

摘要： 目的探讨振动反应成像技术（VRI）在鉴别哮喘和慢性阻塞性肺疾病（COPD）中的作用。方法观察60例哮喘和64例COPD患者在应用支气管舒张试验前后的VRI影像（VRI图像和EVP曲线）。采集两组患者的临床资料（病史、体格检查、肺功能检查）做出临床诊断,同时做出VRI图像和EVP曲线诊断。比较VRI图像、EVP曲线诊断与临床诊断的差异。结果哮喘组患者VRI图像中动态图像、MEF、呼吸振动能量曲线的评分较COPD组患者评分有统计学差异,EVP曲线诊断哮喘和COPD的符合率为75%和79.69%,联合VRI图像评分,诊断的符合率达83.87%（哮喘78.33%,COPD 89.06%）。结论 VRI图像和EVP曲线诊断哮喘或COPD与临床诊断符合率高,可为临床鉴别哮喘和COPD的诊断提供客观数据。

关键词: 振动反应成像技术, 哮喘, 慢性阻塞性肺疾病

Abstract: Objective We evaluated the utility of vibration response imaging in differentiating between asthma and COPD. Methods One hundred and twenty-four subjects with asthma or COPD were recorded, before and after the administration of a short-acting bronchodilator, using a computerized lung sound analysis device. Imaging data were compared with the clinical diagnosis, made by the standard Methods(medical history, physical examination, and spirometric indices). Results Blinded evaluation of images demonstrated a significantly higher rate of improvement in image dynamics, MEF, respiratory curve, shape and overall improvement following bronchodilator in subjects with asthma compared with those with COPD. EVP curve showed distinct patterns in timing and amplitude for asthma(accuracy 75%) and COPD(accuracy 79.6%). Combined analyses based on EVP curve evaluation and VRI imaging data demonstrated an overall 83.87% accuracy(78.33% for asthma, 89.06% for COPD) in differentiating between asthma and COPD. Conclusion Combined EVP curve and VRI imaging data evaluations of lung sounds are quite sensitive in distin-guishing between lung sound recordings of COPD and asthma individuals. Lung sound features of synchronization in timing and intensity provide Objective data that may further differentiate these two airway disorders.

Key words: vibration response imaging(VRI), asthma, COPD

中图分类号:

R445

张晓岩, 林江涛, 刘超武. 振动反应成像技术在鉴别哮喘和慢性阻塞性肺疾病中的应用[J]. 中国药物警戒, 2010, 7(6): 329-333.

ZHANG Xiao-yan, LIN Jiang-tao, LIU Chao-wu. Differentiate Asthma and COPD by Vibration Response Imaging[J]. Chinese Journal of Pharmacovigilance, 2010, 7(6): 329-333.

参考文献

[1] Beeh K M,Kommann O,Beier J,et a1.Clinical application of a simple questionnaire for the differentiation of asthma and chronic obstructive pulmonary disease[J].Respir Med,2004,98：591-597．
[2] 吴锦林,李虎进,任毅.哮喘和COPD的鉴别[J].现代临床医学,2009,35：248-250.
[3] Calverley P M, Wedzicha J A. Chronic obstructive pulmonary disease past, present and future[J]. Thorax,2007,62: 1026-1027.
[4] Dupont L J, Demedts M G,Verleden G M. Prospective evaluation of the validity of exhaled nitric oxide for the diagnosis of asthma[J]. Chest,2003,123:751-756.
[5] Perng D W, Huang H Y, Chen H M, et al. Characteristics of airway inflammation and bronchodilator reversibility in COPD: a potential guide to treatment[J]. Chest,2004,126:375-381.
[6] Pasterkamp H, Kraman S S, Wodicka G R. Respiratory sounds.Advances beyond the stethscope[J]. Am J Respir Crit Care Med,1997, 156:974-987.
[7] Dellinger R P, Parrillo J E, Kushnir A,et al.Dynamic Visualization of lung sounds with a Vibration Respone Device:A Case Series[J].Respiration,2008,75:60-72.
[8] Guntupalli K K, Reddy R M, Loutfi R H,et al.Evaluation of Obstructive Lung Disease with Vibration Response Imaging[J]. Journal of Asthma, 2008,45:923-930.
[9] Raghunath A S, Innes A, Norfolk L, et al. Difficulties in the interpretation of lung function tests in the diagnosis of asthma and chronic obstructive pulmonary disease[J]. Journal of Asthma,2006, 43:657-660.
[10] 侯小萌,蔡柏蔷.振动反应成像技术在支气管哮喘患者中的应用价值[J].中华呼吸和结核杂志,2009,32：5365-5368.
[11] Yigla M, Gat M, Meyer J J, et al. Vibration Response ImagingTM Technology in Healthy Subjects[J]. AJR Am J Roentgenol,2008,191:845-852.
[12] Tinkelman D G, Price D B, Nordyke R J, et al. Misdiagnosis of COPD and asthma in primary care patients 40 years of age and over[J]. Journal of Asthma,2006, 43:75-80.