Assessment of functional tests on determining resistance of respiratory tract in patients with bronchial asthma, COPD and their combination

K. V. Nazarenko, S. G. Opimakh, M. O. Polianskaja
2017 Medičnì Perspektivi  
Ɉ Ɉɐ ɐȱ ȱɇ ɇɄ ɄȺ Ⱥ Ɏ Ɏɍ ɍɇ ɇɄ Ʉɐ ɐȱ ȱɈ Ɉɇ ɇȺ ȺɅ Ʌɖ ɖɇ ɇɂ ɂɏ ɏ Ɍ Ɍȿ ȿɋ ɋɌ Ɍȱ ȱȼ ȼ Ɂ Ɂ ȼ ȼɂ ɂɁ Ɂɇ ɇȺ Ⱥɑ ɑȿ ȿɇ ɇɇ ɇə ə Ɉ Ɉɉ ɉɈ ɈɊ Ɋɍ ɍ Ⱦ Ⱦɂ ɂɏ ɏȺ ȺɅ Ʌɖ ɖɇ ɇɂ ɂɏ ɏ ɒ ɒɅ Ʌə əɏ ɏȱ ȱȼ ȼ ɍ ɍ ɏ ɏȼ ȼɈ ɈɊ Ɋɂ ɂɏ ɏ ɇ ɇȺ Ⱥ Ȼ ȻɊ ɊɈ Ɉɇ ɇɏ ɏȱ ȱȺ ȺɅ Ʌɖ ɖɇ ɇɍ ɍ Ⱥ Ⱥɋ ɋɌ ɌɆ Ɇɍ ɍ ɏ ɏɊ ɊɈ Ɉɇ ɇȱ ȱɑ ɑɇ ɇȿ ȿ Ɉ ɈȻ Ȼɋ ɋɌ ɌɊ Ɋɍ ɍɄ ɄɌ Ɍɂ ɂȼ ȼɇ ɇȿ ȿ Ɂ ɁȺ Ⱥɏ ɏȼ ȼɈ ɈɊ Ɋɘ ɘȼ ȼȺ Ⱥɇ ɇɇ ɇə ə Ʌ Ʌȿ ȿȽ Ƚȿ ȿɇ ɇɖ ɖ Ɍ ɌȺ Ⱥ Ȳ Ȳɏ ɏ ɉ ɉɈ Ɉȯ ȯȾ Ⱦɇ ɇȺ Ⱥɇ ɇɇ ɇə ə Ⱦɍ «ɇɚɰɿɨɧɚɥɶɧɢɣ ɿɧɫɬɢɬɭɬ ɮɬɢɡɿɚɬɪɿʀ ɿ ɩɭɥɶɦɨɧɨɥɨɝɿʀ ɿɦ. Ɏ.Ƚ. əɧɨɜɫɶɤɨɝɨ ɇȺɆɇ
more » ... ɚʀɧɢ» ȼɿɞɞɿɥɟɧɧɹ ɩɭɥɶɦɨɧɨɥɨɝɿʀ * (ɡɚɜ. -ɚɤɚɞ. ɇȺɆɇ ɍɤɪɚʀɧɢ, ɞ. ɦɟɞ. ɧ., ɩɪɨɮ. ɘ.ȱ. Ɏɟɳɟɧɤɨ) ɜɭɥ. Ⱥɦɨɫɨɜɚ, 10, Ʉɢʀɜ, 03680, ɍɤɪɚʀɧɚ ȼɿɞɞɿɥɟɧɧɹ ɞɿɚɝɧɨɫɬɢɤɢ ɿ ɬɟɪɚɩɿʀ ɬɚ ɤɥɿɧɿɱɧɨʀ ɮɚɪɦɚɤɨɥɨɝɿʀ ɡɚɯɜɨɪɸɜɚɧɶ ɥɟɝɟɧɿɜ ** (ɡɚɜ. -ɞ. ɦɟɞ. ɧ., ɩɪɨɮ. Ʌ.Ɉ. əɲɢɧɚ) ɜɭɥ. Ⱥɦɨɫɨɜɚ, 10, Ʉɢʀɜ, 03680, ɍɤɪɚʀɧɚ SO «National institute of phthysiology and pulmonology named after F.G. Ianovsky Ʉɥɸɱɨɜɿ ɫɥɨɜɚ ɚɫɬɦɚ, ɏɈɁɅ, ɚɫɬɦɚ-ɏɈɁɅ ɩɟɪɟɯɪɟɫɬ, ɨɩɿɪ ɞɢɯɚɥɶɧɢɯ ɲɥɹɯɿɜ .H\ ZRUGV asthma, COPD, asthma-COPD overlap, airway resistance Ɋɟɮɟɪɚɬ Ɉɰɟɧɤɚ ɮɭɧɤɰɢɨɧɚɥɶɧɵɯ ɬɟɫɬɨɜ ɩɨ ɨɩɪɟɞɟɥɟɧɢɸ ɫɨɩɪɨɬɢɜɥɟɧɢɹ ɞɵɯɚɬɟɥɶɧɵɯ ɩɭɬɟɣ ɭ ɛɨɥɶɧɵɯ ɛɪɨɧɯɢɚɥɶɧɨɣ ɚɫɬɦɨɣ ɯɪɨɧɢɱɟɫɤɢɦ ɨɛɫɬɪɭɤɬɢɜɧɵɦ ɡɚɛɨɥɟɜɚɧɢɟɦ ɥɟɝɤɢɯ ɢ ɢɯ ɫɨɱɟɬɚɧɢɟɦ ɇɚɡɚɪɟɧɤɨ Ʉȼ Ɉɩɢɦɚɯ ɋȽ ɉɨɥɹɧɫɤɚɹ ɆȺ Ɇɟɯɚɧɢɱɟɫɤɢɟ ɫɜɨɣɫɬɜɚ ɞɵɯɚɬɟɥɶɧɵɯ ɩɭɬɟɣ (ɜ ɬɨɦ ɱɢɫɥɟ ɫɨɩɪɨɬɢɜɥɟɧɢɟ ɞɵɯɚɬɟɥɶɧɵɯ ɩɭɬɟɣ) ɹɜɥɹɟɬɫɹ ɜɚɠɧɵɦ ɩɨɤɚɡɚɬɟɥɟɦ ɥɟɝɨɱɧɨɣ ɮɭɧɤɰɢɢ, ɚ ɨɩɪɟɞɟɥɟɧɢɟ ɫɨɩɪɨɬɢɜɥɟɧɢɹ ɢɫɩɨɥɶɡɭɟɬɫɹ ɞɥɹ ɞɢɚɝɧɨɫɬɢɤɢ ɢ ɦɨɧɢɬɨɪɢɧɝɚ ɨɛɫɬɪɭɤɬɢɜɧɵɯ ɡɚɛɨɥɟɜɚɧɢɣ ɥɟɝɤɢɯ. Ⱦɚɧɧɚɹ ɪɚɛɨɬɚ ɜɵɩɨɥɧɹɟɬɫɹ ɫ ɰɟɥɶɸ ɨɰɟɧɢɬɶ ɢ ɫɪɚɜɧɢɬɶ ɪɟɡɭɥɶɬɚɬɵ ɮɭɧɤɰɢɨɧɚɥɶɧɵɯ ɬɟɫɬɨɜ ɩɨ ɨɩɪɟɞɟɥɟɧɢɸ ɫɨɩɪɨɬɢɜɥɟɧɢɹ ɞɵɯɚɬɟɥɶɧɵɯ ɩɭɬɟɣ ɭ ɛɨɥɶɧɵɯ ɛɪɨɧɯɢɚɥɶɧɨɣ ɚɫɬɦɨɣ, ɯɪɨɧɢɱɟɫɤɢɦ ɨɛɫɬɪɭɤɬɢɜɧɵɦ ɡɚɛɨɥɟɜɚɧɢɟɦ ɥɟɝɤɢɯ ɢ ɢɯ ɫɨɱɟɬɚɧɢɟɦ. ȼ ɢɫɫɥɟɞɨɜɚɧɢɢ ɩɪɢɧɹɥɢ ɭɱɚɫɬɢɟ 191 ɛɨɥɶɧɨɣ: ɫ ɛɪɨɧɯɢɚɥɶɧɨɣ ɚɫɬɦɨɣ (n=34), ɫ ɯɪɨɧɢɱɟɫɤɢɦ ɨɛɫɬɪɭɤɬɢɜɧɵɦ ɡɚɛɨɥɟɜɚɧɢɟɦ ɥɟɝɤɢɯ (n=17) ɢ ɢɯ ɫɨɱɟɬɚɧɢɟɦ (n=140), ɤɨɬɨɪɵɦ ɩɪɨɜɟɞɟɧɨ ɛɨɞɢɩɥɟɬɢɡɦɨɝɪɚɮɢɹ ɢ ɢɦɩɭɥɶɫɧɚɹ ɨɫɰɢɥɨɦɟɬɪɢɹ. ɋɬɚɬɢɫɬɢɱɟɫɤɢ ɡɧɚɱɢɦɚɹ ɤɨɪɪɟɥɹɰɢɨɧɧɚɹ ɫɜɹɡɶ ɫɪɟɞɧɟɣ ɫɢɥɵ ɫɭɳɟɫɬɜɭɟɬ ɦɟɠɞɭ ɩɚɪɚɦɟɬɪɚɦɢ ɨɛɳɟɝɨ ɫɨɩɪɨɬɢɜɥɟɧɢɹ, ɨɩɪɟɞɟɥɟɧɧɨɝɨ ɫ ɩɨɦɨɳɶɸ ɛɨɞɢɩɥɟɬɢɡɦɨɝɪɚɮɢɢ ɢ ɢɦɩɭɥɶɫɧɨɣ ɨɫɰɢɥɨɦɟɬɪɢɢ, r=0,57, ɪ<0,001. ɉɨ ɞɚɧɧɵɦ ROC-ɚɧɚɥɢɡɚ, ɥɭɱɲɟɣ ɬɨɱɤɨɣ ɪɚɫɩɪɟɞɟɥɟɧɢɹ ɧɨɪɦɚɥɶɧɵɯ ɢ ɩɚɬɨɥɨɝɢɱɟɫɤɢɯ ɩɨɤɚɡɚɬɟɥɟɣ ɢɦɩɭɥɶɫɧɨɣ ɨɫɰɢɥɨɦɟɬɪɢɢ (R5Hz) ɜ ɤɚɱɟɫɬɜɟ ɞɢɚɝɧɨɫɬɢɤɢ ɩɨɜɵɲɟɧɧɨɝɨ ɞɵɯɚɬɟɥɶɧɨɝɨ ɫɨɩɪɨɬɢɜɥɟɧɢɹ ɹɜɥɹɟɬɫɹ 130% ɢ ɜɵɲɟ ɨɬ ɞɨɥɠɧɵɯ ɜɟɥɢɱɢɧ. ɉɪɢ ɷɬɨɦ ɩɥɨɳɚɞɶ ɩɨɞ ROC-ɤɪɢɜɨɣ ɫɨɫɬɚɜɥɹɟɬ 0,807. ɉɪɢ ɢɧɬɟɪɩɪɟɬɚɰɢɢ ɪɟɡɭɥɶɬɚɬɨɜ ɢɦɩɭɥɶɫɧɨɣ ɨɫɰɢɥɨɦɟɬɪɢɢ ɭ ɛɨɥɶɧɵɯ ɛɪɨɧɯɢɚɥɶɧɨɣ ɚɫɬɦɨɣ, ɯɪɨɧɢɱɟɫɤɢɦ ɨɛɫɬɪɭɤɬɢɜɧɵɦ ɡɚɛɨɥɟɜɚɧɢɟɦ ɥɟɝɤɢɯ ɢ ɢɯ ɫɨɱɟɬɚɧɢɟɦ ɭɪɨɜɟɧɶ R5Hz, ɪɚɜɧɵɣ ɢɥɢ ɩɪɟɜɵɲɚɸɳɢɣ 130% ɨɬ ɞɨɥɠɧɵɯ ɜɟɥɢɱɢɧ, ɩɪɟɞɥɚɝɚɟɬɫɹ ɪɚɫɰɟɧɢɜɚɬɶ ɤɚɤ ɩɪɢɡɧɚɤ ɩɨɜɵɲɟɧɧɨɝɨ ɞɵɯɚɬɟɥɶɧɨɝɨ ɫɨɩɪɨɬɢɜɥɟɧɢɹ ɫ ɱɭɜɫɬɜɢɬɟɥɶɧɨɫɬɶɸ ɦɟɬɨɞɢɤɢ 64,0%, ɫɩɟɰɢɮɢɱɧɨɫɬɶɸ -87,5% ɢ ɩɪɨɝɧɨɫɬɢɱɟɫɤɨɣ ɰɟɧɧɨɫɬɶɸ ɩɨɥɨɠɢɬɟɥɶɧɨɝɨ ɪɟɡɭɥɶɬɚɬɚ -98,2%. $EVWUDFW $VVHVVPHQW RI IXQFWLRQDO WHVWV RQ GHWHUPLQLQJ UHVLVWDQFH RI UHVSLUDWRU\ WUDFW LQ SDWLHQWV ZLWK EURQFKLDO DVWKPD &23' DQG WKHLU FRPELQDWLRQ 1D]DUHQNR .9 2SLPDNK 6* 3ROLDQVNDMD 02 The mechanical properties of the respiratory tract (including airway resistance) is an important indicator of pulmonary function, and definition of resistance is used to diagnose and monitor obstructive lung diseases. This study was performed in order to evaluate and compare functional results of tests to determine the resistance of the airways in patients with asthma, chronic obstructive pulmonary disease and their combination. The study involved 191 patients: with asthma (n=34), with COPD (n=17) and their combination (n=140). Patients underwent bodyplethysmography and impulse oscillometry. A statistically significant correlation of medium strength between parameters of the total resistance, determined with the help of bodyplethysmography and impulse oscillometry, r=0.57, p<0.001. According to ROCanalysis, the best point of distribution of normal and pathological parameters of impulse oscillometry (R5Hz) as a
doi:10.26641/2307-0404.2017.3.111929 fatcat:erjkj4lpibbchealpf5toujkga