| Background and purpose:Vibration Response Imaging (VRI) of pulmonary respiratory imaging diagnostic system is a new device, which uses VRI technology for dynamic imaging of lung. It collects signals generated by pulmonary flow vibration, processes them through digital-analog conversion and computer, and then the pulmonary sound is able to be converted to dynamic images, which can identify wet and dry rales and calculate each particular pulmonary region's vibrational energy percentage of both lungs. The system is a non-invasive examination method without radiation damage. The operation is simple and easy to grasp, and clinicians can operate bedsides.Currently, the examination method has attracted wide attention at home and abroad, and the studies involve related respiratory system diseases, cardiovascular diseases and heart failure and so on. The present study indicates that Vibration Response Imaging System(VRIXP) is stable,repeatable for healthy people and highly reliable for examinees;its sensitivity and specificity are good in rales detection; there is significant difference in chronic obstructive pulmonary diseases (COPD) VRI image and so on.This experiment continues to study the VRI differences between patients suffered chronic obstructive pulmonary disease and healthy samples in order to provide new basis for clinically diagnosing such diseases, what's more, it studies VRI score changes before and after related treatment and compares lung function and blood-routine indicators in order to provide new basis for treatment efficacy observation and follow-up in the future.Materials and methods:Select 40 patients suffered acute chronic obstructive pulmonary disease and 40 healthy volunteers.The patients were hospitalized in respiratory ward of Henan Chest Hospital from September 2010 to February 2011.COPD group meets the diagnostic criteria in COPD Diagnosis and Treatment Guidelines (2007):lung function FEV1/FVC<70%(Forced expiratory volume in one second/forced vital capacity), age betweenl8-78 years old, recently either used bronchodilators or were washed off. Healthy samples' selection criteria:age between 18-65 years old, lung function 80%≤FEVlpred%≤120% (Forced vital capacity),80%≤FVC≤120%(forced vital capacity), FEV1/FVC> 75% (Forced expiratory volume in one second/forced vital capacity),do not smoke, recently did not use bronchodilators, good condition, without basic cardiopulmonary diseases. Exclusion criteria of both:hirsutism, thoracic, spinal deformity (eg:chicken breast, scoliosis), install cardiac pacemakers which may affect collecting pulmonary sounds and so on. Among the COPD patients, 31 patients were male and 9 patients were female;average age was 54.24±11.17 years old. Among the healthy people,22 patients were male and 18 patients were female;average age was 41.46±9.38 years old. After 10-18 days'anti-inflammatory and asthma treatment,for all COPD patients, their symptoms of chest tightness and asthma are eased; general condition was improved. Another examination of lung function and VRI were performed. Observe:VRI image characteristics of both healthy people and COPD patients; the relationship between rales auscultation and VRI monitoring of rales; VRI scores and lung function changes before and after treatment for COPD patients. describe the relationship between dry and wet rales auscultation and VRI monitoring of rales involving both COPD patients and healthy volunteers, the differences of MEF, vibration curve, jumping sense, EVP and so on about both COPD patients and healthy volunteers; the differences of MEF, vibration curve, jumping sense, EVP and so on between before and after treatment for COPD patients.The date was processed by SPSS 13.0 statistic software package and analyzed statistical.Measurement data was expressed in x±s, and non-normally distributed data was expressed in the arithmetic mean. Groups comparison was tested by t; rates comparison was tested byχ2;P<0.05 was considered statistically significant.Results:1. For healthy volunteers, vibration energy curve is smooth and continuous; there are 3-4 cycles in 12 seconds; the range of the maximum vibrational energy value is from 1.5 to 3.5; each cycle is composed by inspiratory and expiratory phase; both lungs appear at the same time in the vibration energy diagram; dynamic images change simultaneously. The image does not jump and dry and wet rales are rare. Few defects appeared in the maximum energy diagram and the edge was smooth and complete. Volunteers' gender and age had no effect on general assessment about VRI image (the number of rales, abnormal curve, jumping sense, abnormal morphology of MEF) (P> 0.05).2. For healthy volunteers, rales were found in all of them by auscultationin, rales were found only in 3 cases by VRI monitoring and auscultation meeting rate was 92.5%. For COPD patients, rales were found in 33 cases by auscultationin, rales were found only in 29 cases by VRI monitoring and the meeting rate was 87.9%. For both healthy volunteers and COPD patients, the overall meeting rate by both VRI monitoring and auscultation was 90.4%.3. VRI observation of COPD patients:rales appeared; curve expiratory phase was low and flat; images did not change simultaneously; the amplitude of EVP (Envelope of Acoustic Signal) was different; EVP was not simultaneous; the size of MEF's left side did not equal the right side; in terms of MEF proportion missing, COPD group was significantly higher than healthy group. (P<0.05 between the two groups)4.There were significant differences between the general assessment about VRI image (the number of rales, abnormal curve, jumping sense, abnormal morphology of MEF)before and after treatment for COPD patients (P>0.05), however, the separate evaluation of abnormal curve was not significantly different (P>0.05). There were linear correlation between VRI improved value and FEV1 improved rate r =-0.617(P<0.05). The regression equation Y=0.067-0.156X (Y:FEV1 improved rate, X:VRI Image improved value).Conclusion:1. For healthy people, there are no significant differences between different age and gender after VRI examination, which has good stability. It indicates that VRI examination could be considered as an objective index to evaluate lung function.2. For both COPD patients and healthy volunteers, VRI monitoring of rales is Consistent with auscultation, which meets the requirements of clinical treatment.3. In terms of VRI results, there are significant differences between COPD patients and healthy people and the results can help diagnose COPD.4. There are significant differences between the general assessment about VRI image before and after treatment for COPD patients, there is correlation between VRI improved value and FEV1 improved rate. So It can be considered as an indicator to evaluate treatment besides. |
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