Study of a 5-Grade Evaluation Method of Breathing Patterns by the Expired Air Gas Analysis

触診法による腹部隆起と斜角筋の収縮タイミングから呼吸パターンを5つのgradeに分類する評価法を考案し, この5段階評価法を検討した。呼吸器疾患147例を対象に5段階評価法でのgrade分類とHugh-Jones評価, 安静時呼気ガス分析を行い, 評価法との関連性を検討した。その結果, 一回換気量(平均値)は5度: 627.8 ml/min, 4度: 627.6 ml/min, 3度: 513.9 ml/min, 2度: 436.9 ml/minでありgradeの低下とともに減少する傾向にあった。呼吸数(平均値)は逆に5度: 13.7 f/min, 4度: 15.5 f/min, 3度: 17.2 f/min, 2度: 20.5 f/minと増加傾向にあった。O_2に対する換気当量(平均値)は5度: 41.8, 4度: 49.5, 3度: 50.8, 2度: 55.2であり, 吸気相で早期に斜角筋が収縮する症例ほど換気効率が低下する傾向が示された。また, Hugh-Jones分類との有意な相関(r=-0.444)も認められた。これらのことから5段階評価法は, 呼吸器疾患の呼吸機能特性を反映していると推測された。We have newly developed a 5-grade evaluation method, which consists in classifying breathing patterns from abdominal rising and scalenic contraction timing via palpation, and examined the reliability of the method. In 147 cases of respiratory diseases, grade classification with the 5-grade evaluation method, Hugh-Jones\u27 evaluation and resting expired air gas analysis were performed, and their results were compared each other. The average value of tidal volume (V_T) tended to decrease with decreasing the grade; 627.8 ml/min in degree 5. 627.6 ml/min in degree 4, 513.9 ml/min in degree 3, and 436.9 ml/min in degree 2. The average value of respiratory rate (RR) tended to increase; 13.7 f/min in degree 5, 15.5 f/min in degree 4, 17.2 f/min in degree 3, and 20.5 f/min in degree 2, and ventilatory equivalent for oxygen (V_E/VO_2) tended to increase; 41.8 in degree 5, 49.5 in degree 4, 50.8 in degree 3, and 55.2 in degree 2. Cases of earlier scalenic contraction at inspired air phase showed a tendency of lower respiratory efficiency. The results of the 5-grade evaluation method exhibited a significant correlation (r=-0.444) with those of Hugh-Jones\u27 classification. These results suggest that the present 5-grade evaluation method can reflect the respiratory function of patients with respiratory diseases