JP5896609B2 - Respiratory function testing device - Google Patents

Description

  The present invention relates to a respiratory function test apparatus that measures a respiratory flow rate and a respiratory volume of a subject. In particular, the present invention relates to a respiratory function test apparatus that enables a subject to test a respiratory function without performing maximum exhalation and maximum inspiration.

  Conventionally, as shown in Patent Document 1, a respiratory function test apparatus has been proposed that measures a “spiratory capacity” by causing a subject to perform maximum expiration and maximum inspiration with slow breathing. Inspiratory vital capacity is the difference in volume from the maximum expiratory position in which no further breathing is possible to the maximum inspiratory position in which no further breathing is possible, and the expiratory vital capacity is the maximum This is the difference in volume from the inspiratory position to the maximum expiratory position in the state where the user continues to exhale and can no longer exhale. Usually, among the test results performed several times, the largest test result is used as the vital capacity irrespective of the inspiratory vital capacity or the expiratory vital capacity. The “forced vital capacity” is a difference in capacity when the maximum inspiratory position is reached at a stroke and the maximum expiratory position is reached. Furthermore, the capacity called for the first second at this time is defined as “one second amount”. This 1-second amount is an important item used for examination of chronic obstructive pulmonary disease (hereinafter referred to as “COPD”).

JP 2007-229101 A

Medical Science International Co., Ltd. “Lung Function Test”, page 21, Fig. 1-19

  The respiratory function testing device disclosed in Patent Document 1 has a voice guide function that prompts the subject to perform maximum exhalation and maximum inspiration, so that the subject can reliably perform maximum exhalation and maximum inspiration, and reliability High vital capacity and 1 second dose can be measured. However, there is a fact that it is a great burden on the subject to force the maximum exhalation and the maximum inspiration in the examination of the respiratory function. In particular, it is not easy for an elderly person or an infant to reliably perform maximum exhalation and maximum inspiration, and severe COPD patients are extremely painful to perform maximum exhalation and maximum inspiration. Furthermore, even a healthy person needs a corresponding effort for maximum exhalation and maximum inspiration, which has been a factor that hinders examinations for prevention of respiratory diseases such as COPD.

On the other hand, as shown in Non-Patent Document 1, a method of examining respiratory function by measuring the amount of change in respiratory flow rate and respiratory volume during rest breathing has also been proposed. This method is called the Negative Expiratory Pressure (hereinafter referred to as “NEP”) method, and is a method of applying a slight negative expiratory pressure (usually −5 cmH ₂₀ ) at the mouth during resting exhalation. That is, when the driving pressure of the exhalation airflow is increased by 5 cmH ₂ O, the amount of change in the respiratory flow rate and the respiratory capacity is increased for a healthy person, and the amount of change in the respiratory flow rate and the respiratory capacity is reduced for a COPD patient. Is a method for examining respiratory function based on the above. The problem of this NEP method is that the negative pressure of exhalation, that is, the pressure change when a pressure that promotes exhalation is applied must be made steep, and the facility becomes large.

  The present invention has been made based on such a background, and an object of the present invention is to make it possible to test a respiratory function with a simple device without causing a subject to perform maximum expiration and maximum inspiration. It is to provide a function inspection device.

[Respiratory characteristics of COPD patients]
In patients with COPD, breathing difficulty is likely to occur because there is a site (resistance that prevents breathing) that causes airflow obstruction in the airway (the path through which air in the lungs passes). This airflow obstruction often affects exhalation rather than inspiration. This tendency becomes more prominent as the symptoms of COPD become more severe, and hinders stairs and walking.

  Thus, patients with COPD have a high potential expiratory resistance. The inventor paid attention to this point and tried to measure the respiratory flow rate and the respiratory capacity in a state where an intentional load resistance, that is, a resistance for suppressing exhalation is loaded. If the subject is healthy, the potential expiratory resistance is small, so the influence of the load resistance on the respiratory flow and the respiratory capacity is large. If the patient is COPD, the potential expiratory resistance is large and the respiratory flow and the respiratory capacity due to the load resistance are large. The following measures were taken to solve the above problems based on the fact that the impact on the environment was relatively small. The reference numerals used in the description of the best mode for carrying out the invention and the drawings to be described later are appended in parentheses for reference, but the constituent elements of the present invention are not limited to the appended description.

The respiratory function testing device according to the present invention 1
A respiratory function test apparatus for measuring a respiratory flow rate and a respiratory volume of a subject,
An exhalation path through which the subject's exhalation passes and an inhalation path through which the inhalation of the subject passes are formed,
It is possible to switch between a suppressed state in which the airflow resistance is made larger than that of the inspiratory route by applying a positive pressure load to the exhalation route and a non-suppressed state in which the positive pressure load is not applied to the expiratory route,
Respiratory flow and respiratory volume measured in the suppressed state without prompting the subject for maximum exhalation and inspiratory, and Respiratory flow and respiratory volume measured in the non-suppressed state without prompting the subject for maximum expiratory and maximum inspiration And a display means for displaying in a comparable manner.

The respiratory function testing device according to the present invention 2
A respiratory function test apparatus for measuring a respiratory flow rate and a respiratory volume of a subject,
An exhalation path through which the subject's exhalation passes and an inhalation path through which the inhalation of the subject passes are formed,
Applying a first positive pressure load to the exhalation path to apply a second positive pressure load different from the first positive pressure load to the exhalation path, and a first suppression state in which the airflow resistance is greater than that of the inhalation path. Can be switched between the second suppression state in which the airflow resistance is larger than that of the intake path,
Respiratory flow and respiratory volume measured in the first suppression state without prompting the subject for maximum exhalation and maximum inspiration, and Respiratory flow measured in the second suppression state without prompting the subject for maximum expiration and maximum inspiration It is characterized by comprising display means for displaying the breathing volume in a comparable manner.

A respiratory function test apparatus according to the present invention 3
The respiratory function testing device of the present invention 1,
A flow sensor for transmitting the pressure before and after the resistor provided in the respiratory passage path to the main body part, having a common respiratory passage path through which both exhalation and inspiration of the subject pass;
A body part for measuring the respiratory flow rate and the respiratory volume of the subject based on the pressure transmitted from the flow sensor,
The expiratory path and the inspiratory path are connected to one end side of the respiratory passage path.

The respiratory function testing device according to the present invention 4
A respiratory function testing device according to the present invention 2,
A flow sensor for transmitting the pressure before and after the resistor provided in the respiratory passage path to the main body part, having a common respiratory passage path through which both exhalation and inspiration of the subject pass;
A body part for measuring the respiratory flow rate and the respiratory volume of the subject based on the pressure transmitted from the flow sensor,
The expiratory path and the inspiratory path are connected to one end side of the respiratory passage path.

  A respiratory function testing device according to the present invention 5
  A respiratory function testing device of the present invention 3,
  On the subject side of the flow sensor and the exhalation path and the inhalation path, a common path through which both the exhalation and inspiration of the subject pass is provided,
  An intraoral pressure measuring unit for measuring intraoral pressure is connected to the common path,
  The display means, the oral pressure measured in the suppressed state without prompting the subject to the maximum exhalation and maximum inspiration, and the oral pressure measured in the non-suppressed state without prompting the subject to the maximum exhalation and maximum inspiration, Are displayed in a comparable manner.

  In the present invention, resistance is intentionally loaded on exhaled breath. By doing in this way, a test subject can test | inspect a respiratory function in the state which does not require a respiratory effort, for example, a resting-breathing state, without performing a test subject's maximum expiration and maximum inspiration. At this time, a large-scale facility is not necessary, and the respiratory function can be inspected with a simple device. If the subject is healthy, the potential expiratory resistance is small when there is no load, so the respiratory flow and volume are easily affected by the load resistance when there is a load. For example, the arc diameter of the flow volume curve is unloaded. There is a feature that it is clearly smaller than time. On the other hand, since the potential expiratory resistance of a COPD patient is large, even if an intentional load resistance, that is, a resistance for suppressing respiration is loaded, if the load resistance is equal to or less than a predetermined value, the respiratory flow rate and the respiratory The capacity is not easily affected, and for example, the diameter of the arc formed by the flow volume curve has a characteristic that it does not change much compared to when no load is applied. Based on these characteristics, the respiratory function of the subject can be diagnosed.

  Further, depending on the potential expiratory resistance that a COPD patient has, when this load resistance exceeds a predetermined value, it affects the respiratory flow and respiratory capacity of the COPD patient. Based on this event, it is also possible to measure the progress of COPD by increasing or decreasing the load resistance and observing changes in respiratory flow rate and respiratory volume accompanying the increase and decrease. For example, if the diameter of the arc formed by the flow volume curve becomes smaller than when there is no load when the load resistance is relatively small, it will be mild. Even if the load resistance becomes large, the diameter of the arc formed by the flow volume curve will be unloaded. It is possible to diagnose the symptoms of COPD, such as severe if it is almost equivalent to time.

FIG. 1 is a functional block diagram of the respiratory function testing device according to the first embodiment. FIG. 2 is a diagram illustrating a connection state of the flow sensor, the respiratory path, the needle valve, the filter, and the mouthpiece of the respiratory function testing device according to the first embodiment. FIG. 3 is a diagram showing another connection mode of the flow sensor and the respiratory path, the needle valve, the filter, and the mouthpiece of the respiratory function testing device according to the first embodiment. FIG. 4 is a graph showing the relationship between the flow rate and the differential pressure for each rotation speed of the needle valve. FIG. 5 is a graph showing the relationship between the number of rotations of the needle valve and the percentage 1 second amount of each subject. FIG. 6 is a functional block diagram of the respiratory function testing device according to the second embodiment. FIG. 7 is a diagram illustrating a connection state of the flow sensor, the expiration path, the inspiration path, the load resistance, and the two-way valve assembly of the respiratory function testing device according to the second embodiment. FIG. 8 is a perspective view of a resistor of the respiratory function testing device according to the second embodiment. FIG. 9 is a diagram showing an example of an unloaded flow volume curve and a loaded flow volume curve (an example of a healthy person) displayed on the display of the respiratory function testing device according to the second embodiment. FIG. 10 is a diagram illustrating an example of an unloaded intraoral pressure transition and a loaded intraoral pressure transition (an example of a healthy person) displayed on the display of the respiratory function testing device according to the second embodiment. FIG. 11 is a diagram showing another example of the unloaded flow volume curve and the loaded flow volume curve (example of COPD patient) displayed on the display of the respiratory function testing device according to the second embodiment. . FIG. 12 is a diagram showing another example of the intra-oral pressure transition during no load and the intra-oral pressure transition during load (example of COPD patient) displayed on the display of the respiratory function testing apparatus according to the second embodiment. FIG. 13 is a functional block diagram of the respiratory function testing apparatus according to the third embodiment.

  As specific aspects of the present invention, the respiratory function test apparatus according to the first embodiment, the respiratory function test apparatus according to the second embodiment, and the respiratory function test apparatus according to the third embodiment shown below are exemplified. The invention is not limited to these embodiments.

[1. Respiratory function testing device according to the first embodiment]
First, the respiratory function testing device according to the first embodiment will be described with reference to FIGS. As shown in FIG. 1, the respiratory function testing device 1 in this example includes a main body 15, a flow sensor 5, a respiratory path 60 connected to the flow sensor 5, a needle valve 70, and the like. The main body 15 includes a power switch 3, an operation key 4, a display 7, a speaker 20, a printer 8, a pressure sensor 10, an A / D converter 11, a CPU 12, an EEPROM 13, a RAM 14, and an RS232C connector 9. The main body 15 and the flow sensor 5 are connected by a differential pressure tube 16, and their external appearance is the same as that of the respiratory function test apparatus disclosed in Patent Document 1, for example.

  The flow sensor 5 is detachably mounted on the main body 15 and generates a differential pressure proportional to the respiratory flow rate. The flow sensor 5 includes a connection port 17 for connecting the filter 51 and the mouthpiece 50. As shown in FIG. 2, when the subject connects the needle valve 70, the filter 51, and the mouthpiece 50 to the connection port 17 and breathes through the mouthpiece, a differential pressure is generated in the flow sensor 5. The differential pressure is transmitted to the pressure sensor 10 in the main body 15 via a differential pressure tube 16 constituted by two tubes.

  The power switch 3 is a switch for supplying a DC voltage to each electrical component inside the main body. By turning this switch ON, the DC voltage converted from the AC voltage on the power board is supplied to each electrical component inside the main body. Supplied. At this time, a DC / DC converter is used to obtain a voltage value corresponding to the drive voltage of each electrical component.

  The operation key 4 is used when selecting a measurement item or setting a measurement period. For example, it consists of 10 numeric keys from 0 to 9, direction keys for selecting measurement items, and the like. Also included is a print key operated when printing out data output to the display 7. As shown in FIG. 1, the flow sensor 5 is provided outside the main body, and one end of a differential pressure tube 16 composed of two tubes is connected, and the other end is connected to a differential pressure tube connection port (not shown) of the main body 15. Connected). In the state where the subject holds the flow sensor 5, the mouthpiece connected to the connection port 17 is included in the mouth, and various measurements are performed as will be described later by breathing.

  The pressure sensor 10 outputs an analog signal proportional to the detected differential pressure. In this example, it is a semiconductor differential pressure sensor, for detecting a differential pressure between tube connection ports, and for outputting a voltage proportional to the differential pressure detected by the differential pressure detection unit. An output terminal is provided. In this example, the voltage is output as an analog signal. However, the present invention is not limited to this, and a current proportional to the differential pressure detected as an analog signal may be output.

  The A / D converter 11 is for converting an analog electronic signal into a digital signal. In this example, it is a semiconductor A / D converter, which converts an analog signal output from the output terminal of the pressure sensor 10 into a digital signal that can be processed by the CPU 12 to be described later, and outputs the digital signal from the digital output terminal.

  The CPU 12 executes the measurement program stored in the EEPROM 13 by using the RAM 14 as a work area, thereby controlling the operation of each connected component or receiving a signal from each component to perform various processes. Is to do. In this example, a process for calculating a respiratory flow rate is performed based on a digital signal that is an output from the A / D converter 11 and indicates a value proportional to the differential pressure. This calculation is performed based on a relational expression between a differential pressure and a respiratory flow rate that are stored in advance. That is, the differential pressure is specified from the digital signal, and the specified differential pressure is input to the relational expression to calculate the respiratory flow rate. In this example, the respiratory volume is calculated by integrating the respiratory flow rate. The data measured here is stored in the RAM 14, and when the measurement is completed, the data stored in the RAM 14 is stored in the EEPROM 13.

  The EEPROM 13, which is a non-volatile memory, stores the measurement data as described above, and also stores a respiratory function measurement program such as a respiratory flow rate and respiratory volume measurement program. The EEPROM 13 also stores audio data for guidance, and this audio data is reproduced by the speaker 20. The display 7 is an LCD display, and is provided on the upper surface of the main body 15 and outputs predetermined data to the screen by performing output control from the CPU 12 via an LCD driver circuit (not shown). The printer 8 is, for example, a thermal printer, and outputs predetermined data on paper so that the CPU 12 can perform print control via a thermal head driver so that the data can be visually recognized. Print data. The speaker 20 is an audio output means for prompting the subject to exhale or inhale by an audio guide, and outputs audio based on audio data stored in the EEPROM 13 in advance.

  The RS232C connector 9 is a terminal for transmitting and receiving data via an information terminal outside the respiratory function testing device 1 and a cable for RS232C. For example, when transmitting measurement data to an external PC, the RS232C connector 9 is connected to the RS232C connector on the PC side with a cable for RS232C, and the measurement data is transmitted to the PC by performing a predetermined operation with the operation key 4. Send to. In this example, the RS232C connector is used as an interface with the external PC. However, the present invention is not limited to this and may be another interface such as a USB connector.

  The periphery of the flow sensor 5 will be described in detail with reference to FIG. The flow sensor 5 is covered with a flow sensor case 5a serving as a housing, and a connection port 17 for connecting a filter or the like to the flow sensor 5 is provided on a side surface of the flow sensor case 5a. In the conventional respiratory function test apparatus, one end of the filter 51 is connected to the connection port 17, and the mouthpiece 50 is connected to the other end of the filter 51. However, in the present embodiment, as shown in FIG. 2, one end of the needle valve 70 is connected to the connection port 17 via the respiratory path 60, and the other end (subject side) of the needle valve 70 is connected via the respiratory path 60. The filter 51 and the mouthpiece 50 are connected to each other. A handle 5b for holding the flow sensor case 5a is provided below the flow sensor case 5a. While the subject holds the handle 5b, the mouthpiece 50 attached to the connection port 17 of the flow sensor 5 via the needle valve 70 and the filter 51 is included in the mouth, and breathing is performed by breathing. A capacity measurement is performed.

  Here, in the example of FIG. 2, the needle valve 70 is connected to the connection port 17 via the breathing path 60. However, the present invention is not limited to this, and the resistance of the needle valve 70 and the like is as shown in FIG. May be connected to the exhalation outlet side (opposite to the subject). Since the exhalation is configured to escape from the exhalation exit side of the flow sensor 5, the resistance is disposed in the exhalation path by connecting the resistance to the exhalation exit side. As a result, the resistances of the flow sensor 5 and the needle valve 70 are firmly fixed, and the configuration around the flow sensor can be made compact. There is also an advantage that the subject can easily perform measurement by holding the handle 5b. Further, in the example of FIG. 3, the filter 51 is connected to the connection port 17 via the breathing path 60, but the connection port 17 and the filter 51 may be directly connected without passing through the breathing path 60. Thereby, the structure around the flow sensor can be further reduced in size.

  A resistor is disposed in the flow tube of the flow sensor 5. This resistor is disposed, for example, such that a film-like resistor blocks the flow of gas in the flow tube. When a gas flow occurs in the flow tube, a differential pressure is generated before and after the resistor. The pressure before and after the resistor is supplied to a differential pressure tube connection port (not shown) of the main body via a pressure port disposed before and after the resistor and a differential pressure tube 16 connected to each of the pressure ports. ). That is, one of the two tubes constituting the differential pressure tube 16 transmits the pressure before the resistor to one tube connection port connected to the tube, and the other is connected to the pressure after the resistor. To the other tube connection port. On the main body 15 side, the flow rate of the gas flowing in the flow tube, that is, the respiratory flow rate can be measured by detecting the differential pressure between these two tube connection ports. This respiratory flow rate is also called a respiratory flow rate. Note that this type of flow sensor is a so-called differential pressure type and is widely used.

  As shown in FIGS. 1 and 2 (FIG. 3), in the present embodiment, a needle valve 70 is connected to the flow sensor 5. The needle valve 70 is capable of controlling the flow rate according to the number of rotations, and is called a so-called speed controller. In this example, “AS600” manufactured by SMC Corporation was used. As shown in FIG. 2, the needle valve 70 is disposed in the middle of the respiratory path 60 connecting the filter 51 and the connection port 17, and when the subject exhales with the mouthpiece 50 included in the mouth. When exhalation passes through the breathing path 60 and the speed controller and inhalation takes place, the inspiration passes through the breathing path 60 and the speed controller. That is, in the present embodiment, the exhalation route and the inhalation route are the same. By controlling the number of rotations of the needle valve 70 disposed in the breathing path 60, it is possible to apply a predetermined load resistance to the subject.

  FIG. 4 shows the flow rate and the needle valve when the rotation speed of the needle valve is “0”, “7”, “9”, “10”, “11”, “11.5”, “12”. It is the graph which made the relationship of the differential pressure which arises before and behind. The greater the number of rotations of the needle valve, the greater the differential pressure generated before and after the needle valve at the same flow rate. Therefore, the rotational speed of the needle valve can be increased to increase the load resistance, and the rotational speed of the needle valve can be decreased to decrease the load resistance. Further, when the rotation speed of the needle valve is “0”, the differential pressure is almost 0 regardless of the flow rate, so the load resistance can also be 0. That is, it is possible to appropriately set whether or not to load the resistance by controlling the number of rotations of the needle valve, and it is possible to appropriately adjust the increase and decrease of the load resistance.

  As shown in FIG. 5, a total of nine subjects P01 to P07, P10, and P11 were measured for a percent 1 second amount (% FEV1) using the respiratory function testing device 1 of the present embodiment. . Here, the percent 1 second amount is the ratio of the actually measured 1 second amount to the predicted 1 second amount. The predicted 1-second amount is a predicted value of 1-second amount calculated from the sex, age, and height of the subject. By inputting the gender, age, and height of the subject using the operation keys 4 and measuring the amount of 1 second, the percent 1 second amount is calculated. Here, the rotational speed of the needle valve is set to “0.0”, “7.0”, “8.0”, “9.0”, “10.0”, “10.5”, “11.0”. , “11.5”, “12.0”, “12.3”, and “12.5”, the percent 1 second amount (% FEV1) was measured.

  In the experimental results shown in FIG. 5, subjects P01 to P07 are healthy persons who do not have a respiratory disease. P10 is an asthmatic patient and P11 is a COPD patient. In healthy subjects, the% FEV1 decreases at a stage where the rotational speed is relatively low (approximately 9), but the% FEV1 does not decrease until the rotational speed reaches 12 or more in the subjects P10 and P11 having a respiratory disease. This indicates that a healthy person is easily affected by a load resistance intentionally loaded, and a person having a disease in respiratory function such as a COPD patient is less susceptible to the influence. Moreover, it was also confirmed by this experiment that a COPD patient does not have a sense that the load resistance is larger than usual (a sense that makes exhalation difficult) during exhalation until the rotational speed exceeds 12. This is a result showing that the potential exhalation resistance of the COPD patient is large and the influence on the respiratory flow rate is small at the stage where the load resistance is small. However, if this load resistance exceeds a predetermined value and exceeds the potential exhalation resistance of a COPD patient, it is considered that the influence on the respiratory flow rate increases as the rotational speed exceeds 12 and% FEV1 decreases. .

  In this embodiment,% FEV1 was measured, but the expiratory resistance potentially possessed by the COPD patient is present not only at the time of the maximum exhalation and the maximum inspiration but also at the time of resting breathing. Therefore, the respiratory function test apparatus 1 according to the present embodiment can test the respiratory function by measuring a respiratory flow rate and a respiratory capacity during a resting breathing, for example, in a state that does not require respiratory effort. For example, in a state where the subject is taking a rest breath, the rotation speed of the needle valve is set to 0 to obtain a no-load flow volume curve, and then the rotation speed of the needle valve is set to 11 get. At this time, comparing the no-load flow volume curve with the loaded flow volume curve, if the difference between them (for example, the diameter of the arc formed by the curve) is large, there is a risk of being healthy, and if it is small, there is a risk of COPD. Can be diagnosed. Furthermore, for example, there is a clear difference in the flow volume curve between no load and load at 11 revolutions, so that it is relatively mild. Even if the revolution is 12.5, the flow volume at no load and when there is no load. By adjusting the load resistance such as severe because there is no clear difference in the curves, it can be used for the determination of COPD symptoms.

[2. Respiratory function testing device according to the second embodiment]
Next, a respiratory function testing apparatus according to the second embodiment will be described with reference to FIGS. As shown in FIG. 6, the respiratory function testing device 1 according to the present embodiment includes a body part 15, a flow sensor 5, an expiration path 61 connected to the low sensor 5, a resistor 71, a one-way valve 81, an inhalation path 62, And one-way valve 82 and the like. Since the functions of the main body 15 and the flow sensor 5 are the same as those of the respiratory function testing device of the first embodiment, description thereof is omitted. In the present embodiment, the respiratory path between the flow sensor 5 and the filter 51 is branched into an exhalation path 61 and an inhalation path 62 as shown in FIG. The exhalation path 61 is provided with a direction valve 81 that allows the air to pass only in the exhalation direction, that is, from the subject side to the flow sensor side. The intake path 62 is provided with a directional valve 82 that allows air to pass only in the intake direction, that is, from the flow sensor side to the subject side. Therefore, when the subject exhales, the exhalation passes only through the exhalation path 61, and when inhaling, the inspiration passes through only the inspiration path 62.

  In the present embodiment, a resistor 71 is disposed in the exhalation path 61, thereby providing load resistance to the subject. On the other hand, since a resistance that inhibits inspiration is not arranged in the inhalation path 62, the subject does not feel resistance during inspiration and can perform a quiet inspiration smoothly. Furthermore, in this embodiment, the intraoral pressure measuring unit 90 for measuring the intraoral pressure of the subject is connected between the filter and the branch point (the branch point of the exhalation path 61 and the inhalation path 62).

  FIG. 7 is a diagram illustrating a connection mode of each component connected to the flow sensor 5 of the respiratory function testing device according to the second embodiment. A T-shaped branch member 85 for branching the exhalation path 61 and the inhalation path 62 is connected to the connection port 17 of the flow sensor 5. A branch portion of the branch member 85 is connected to the connection port 17, and one of the two branch portions (exhalation side branch portion) is connected to one end of the exhalation path 61, and the other (intake side branch section) is connected to one end of the inhalation path 62. Each constitutes a part of the exhalation route and the inhalation route.

  On the other hand, as shown in FIG. 7, the filter 51 is connected to a support portion of a branching member 83 constituting the two-way valve assembly 80. The two-way valve assembly 80 includes a T-shaped branch member 83 for branching the exhalation path 61 and the inhalation path 62, and one valves 81 and 82 provided in the pipe. A branch of the branch member 83 is connected to the filter 51. Of the two branch portions of the branch member 83, one (exhalation side branch portion) is connected to the other end of the exhalation path 61, and the other (inhalation side branch section) is connected to the other end of the inhalation path 62. Part of it. A one-way valve 81 is provided in the pipe of the exhalation side branch connected to the exhalation path 61 so that air flows only in the exhalation direction (the direction from the mouthpiece 50 toward the flow sensor 5). On the other hand, a one-way valve 82 is provided in the pipe of the intake side branch portion connected to the intake path 62 so that air flows only in the intake direction (the direction from the flow sensor 5 toward the mouthpiece 50). As described above, for example, “T-Shape2700 / 112079” of Hans Rudolf (USA) can be used as the two-way valve assembly 80 including the branch member 83 and the one-way valves 81 and 82 provided in the pipe. it can.

  In the present embodiment, a resistor 71 is provided in the exhalation path 61 as shown in FIG. The resistor 71 is provided with a disk-like object 71a shown in FIG. 8 in a tube of a cylindrical casing that constitutes a part of the exhalation path. A through hole is provided in the center of the disk-like object 71a, and exhaled air passes through this hole. Since this through-hole is smaller than the diameter of the exhalation path, resistance occurs as the exhalation passes. In the present embodiment, as shown in FIGS. 6 and 7, an intraoral pressure measuring unit 90 for measuring the internal pressure of the support (= the intraoral pressure of the subject) is connected to the branching member 83.

  When the subject exhales from the mouthpiece 50, the exhaled air passes through the filter 51 and the branch of the branch member 83 and the exhalation side branch, and then passes through the one valve 81 and the hole of the disk-shaped object 71a. It passes through the path 61, and further passes through the exhalation-side branch part and the branch part of the branch member 85 to reach the flow sensor 5. On the other hand, when the subject inhales from the mouthpiece 50, the inhalation passes from the flow sensor 5 through the support portion of the branching member 85 and the inhalation side branch, then through the intake path 62, through the one-way valve 82, and further branched. The filter 83 and the mouthpiece 50 are reached through the intake side branching portion and the support portion of the member 83. Therefore, resistance is applied only when the subject exhales, and resistance does not occur when inhaling, so that breathing can be performed smoothly with the mouthpiece 50 included in the mouth.

  Here, the resistor 71 is detachable from the exhalation path 61. When the resistor 71 is not loaded, the resistor 71 is detached from the exhalation path 61, and the exhalation path 61 is directly connected to the exhalation side branch portion of the branch member 83 for measurement. Just do it. When the resistor 71 is loaded, as shown in FIG. 7, one end of the resistor 71 is connected to the exhalation-side branch portion of the branch member 83 and the other end is connected to the exhalation path 61 to perform measurement. In this way, whether or not to load the resistor 71 can be set as appropriate. Moreover, if the diameter of the hole of the disk-shaped object 71a shown in FIG. 8 is increased, the resistance is decreased, and if it is decreased, the resistance is increased. Thus, it is also possible to adjust the increase and decrease of the load resistance by preparing a plurality of resistors 71 having different hole diameters and replacing them appropriately.

  Using the respiratory function test apparatus 1 of the present embodiment, a flow volume curve of a healthy person who has no disease in the respiratory system was acquired. First of all, with the resistor 71 removed from the respiratory function test apparatus 1, the subject performs normal breathing without rest effort (rest breathing in this example) to obtain a no-load flow volume curve, Next, in a state where the resistor 71 is connected to the respiratory function testing device 1, a normal breathing (rest breathing in this example) in which the subject does not make a breathing effort is performed, and a flow volume curve under load is obtained. Then, as shown in FIG. 9, these flow volume curves are arranged on the left and right and displayed on the display 7. A no-load flow volume curve is displayed on the left side of the display, and a no-load flow volume curve is displayed on the right side of the display. When there is no load, the diameter of the arc formed by the curve is large, but when there is a load, the diameter of the arc formed by the curve is clearly small. Therefore, the respiratory flow rate and the respiratory capacity are greatly affected by the load resistance. This result suggests that the subject's respiratory function is normal.

  In FIG. 10, the result of having measured the intraoral pressure at the time of a call by the intraoral pressure measurement part 90 is shown. The left graph shows the temporal variation of the intraoral pressure when there is no load, and the right graph shows the temporal variation of the intraoral pressure when there is a load. The peak value of the intraoral pressure at the time of loading increased several times that at the time of loading, and it is clear that the oral pressure is affected by the load resistance.

  Next, the test | inspection similar to a healthy subject was performed for the pseudo COPD patient. In the pseudo COPD patient, a resistor similar to that shown in FIG. 8 is separately connected between the branch of the branch member 83 shown in FIG. 7 and the filter 51, and in this state, a healthy person breathes from the mouthpiece 50. Is to do. That is, the resistance of the resistor connected at this time is regarded as the expiratory resistance that the COPD patient potentially has, and a situation in which the COPD patient is breathing is created in a pseudo manner. By including an artificial exhalation resistance interposed between the branch of the branch member 83 and the filter 51 in the exhalation path of the healthy person, the same situation as when the COPD patient was breathing was created.

  First, with the resistor 71 removed from the respiratory function testing device 1, the subject is allowed to perform normal breathing without resting effort (rest breathing in this example) to obtain a no-load flow volume curve, In the state where the resistor 71 is connected to the respiratory function testing device 1, the subject is allowed to perform normal breathing (rest breathing in this example) without breathing effort, and a flow volume curve under load is obtained. Then, as shown in FIG. 11, these flow volume curves were arranged on the left and right and displayed on the display 7. A no-load flow volume curve is displayed on the left side of the display, and a no-load flow volume curve is displayed on the right side of the display. There is no clear difference in the size of the arc formed by the curve when there is no load and when there is load. Therefore, the respiration flow rate and the respiration capacity of the subject are not significantly affected by the load resistance. This result shows that the subject is likely to have COPD.

  In FIG. 12, the result of having measured the intraoral pressure at the time of calling by the intraoral pressure measuring means 90 is shown. Since the intraoral pressure is not measured in the actual oral cavity but is measured only at the branch of the branch member 83, the situation is the same as when the COPD patient is breathing. The left graph shows the temporal variation of the intraoral pressure when there is no load, and the right graph shows the temporal variation of the intraoral pressure when there is a load.

  Here, in this example, the subject's unloaded flow volume curve and unloaded flow volume curve are displayed on the display 7, but the unloaded flow, which is the time fluctuation of the unloaded respiratory flow. In addition, the on-load flow, which is the time fluctuation of the respiratory flow at the time of the load, may be displayed so as to be comparable. Further, the ratio of the respiration flow rate when there is no load and the respiration flow rate when there is a load may be displayed on the display 7. Since the ratio between the two is presented as a numerical value, quantitative comparison and diagnosis are possible, which can be used for the determination of COPD. Similarly, a no-load volume that is a time fluctuation of the respiratory capacity at the time of no load and a load time volume that is a time fluctuation of the respiratory flow at the time of the load may be displayed in a comparable manner. Further, the ratio between the respiratory capacity at the time of no load and the respiratory capacity at the time of load may be displayed on the display 7.

  Further, in this example, the time variation of the intraoral pressure when the subject is unloaded and the time variation of the intraoral pressure when the subject is loaded are displayed on the display 7. The ratio with the intraoral pressure may be displayed. Since the ratio between the two is presented as a numerical value, quantitative comparison and diagnosis are possible, which can be used for the determination of COPD. In particular, it is possible to make the determination of COPD highly reliable by analyzing the tendency of both the ratio of intraoral pressure and the ratio of the respiratory flow described above.

[3. Respiratory function testing device according to the third embodiment]
Finally, a respiratory function testing apparatus according to the third embodiment will be described with reference to FIG. As shown in FIG. 13, the respiratory function testing device 1 according to the present embodiment uses a resistor 71 of the respiratory function testing device according to the second embodiment as a needle valve 70 ′ similar to the needle valve 70 according to the first embodiment. It is constructed by replacing with. This makes it easy to set whether or not to load the load resistance depending on whether or not the needle valve speed is zero, and to easily adjust the load resistance increase or decrease by controlling the speed. It is.

DESCRIPTION OF SYMBOLS 1 ... Respiratory function inspection apparatus 5 ... Flow sensor 7 ... Display 15 ... Main-body part 60 ... Respiratory route 61 ... Exhalation route 62 ... Inspiratory route 70 ... Needle valve 71 ... Resistor 81 ... One valve 82 ... One valve

Claims (5)

A respiratory function test apparatus for measuring a respiratory flow rate and a respiratory volume of a subject,
An exhalation path through which the subject's exhalation passes and an inhalation path through which the inhalation of the subject passes are formed,
It is possible to switch between a suppressed state in which the airflow resistance is made larger than that of the inspiratory route by applying a positive pressure load to the exhalation route and a non-suppressed state in which the positive pressure load is not applied to the expiratory route,
Respiratory flow and respiratory volume measured in the suppressed state without prompting the subject for maximum exhalation and inspiratory, and Respiratory flow and respiratory volume measured in the non-suppressed state without prompting the subject for maximum expiratory and maximum inspiration , A respiratory function testing device comprising display means for displaying in a comparable manner. A respiratory function test apparatus for measuring a respiratory flow rate and a respiratory volume of a subject,
An exhalation path through which the subject's exhalation passes and an inhalation path through which the inhalation of the subject passes are formed,
Applying a first positive pressure load to the exhalation path to apply a second positive pressure load different from the first positive pressure load to the exhalation path, and a first suppression state in which the airflow resistance is greater than that of the inhalation path. Can be switched between the second suppression state in which the airflow resistance is larger than that of the intake path,
Respiratory flow and respiratory volume measured in the first suppression state without prompting the subject for maximum exhalation and maximum inspiration, and Respiratory flow measured in the second suppression state without prompting the subject for maximum expiration and maximum inspiration A respiratory function testing device comprising display means for displaying the respiratory volume in a comparable manner. The respiratory function testing device according to claim 1,
A flow sensor for transmitting the pressure before and after the resistor provided in the respiratory passage path to the main body part, having a common respiratory passage path through which both exhalation and inspiration of the subject pass;
A body part for measuring the respiratory flow rate and the respiratory volume of the subject based on the pressure transmitted from the flow sensor,
The respiratory function test apparatus, wherein the exhalation path and the inhalation path are connected to one end side of the respiratory passage path. A respiratory function testing device according to claim 2,
A flow sensor for transmitting the pressure before and after the resistor provided in the respiratory passage path to the main body part, having a common respiratory passage path through which both exhalation and inspiration of the subject pass;
A body part for measuring the respiratory flow rate and the respiratory volume of the subject based on the pressure transmitted from the flow sensor,
The respiratory function test apparatus, wherein the exhalation path and the inhalation path are connected to one end side of the respiratory passage path. A respiratory function testing device according to claim 3,
On the subject side of the flow sensor and the exhalation path and the inhalation path, a common path through which both the exhalation and inspiration of the subject pass is provided,
An intraoral pressure measuring unit for measuring intraoral pressure is connected to the common path,
The display means, the oral pressure measured in the suppressed state without prompting the subject to the maximum exhalation and maximum inspiration, and the oral pressure measured in the non-suppressed state without prompting the subject to the maximum exhalation and maximum inspiration, Is displayed in a comparable manner, a respiratory function testing device.

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