Bolus 呼吸道微粒沉積測試系統的建置與比對測試

Establishment a Precision Aerosol Bolus Injection System for Regional Lung Deposition Studies

本先前的一個本土研究顯示台灣人的局部呼吸道微粒沉積率與過去的文獻資料相比較，雖然整體的趨勢與西方人的局部沉積曲線相符，且相差都僅約在1~3%之間，但是在肺部較深層區塊（400~500 ml處）的沉積率卻比文獻數據高出許多，而該研究的結論推測，造成如此差異的可能原因為：1. 量測儀器設備不同：文獻中使用bolus系統，而本土研究則使用自行開發之快速量測系統；2. 受測者所使用的呼吸型態不同：文獻中在呼氣階段的取樣方式是讓受測者呼氣至殘氣容積(residual volume)，而本土研究則是讓受測者在正常的呼吸狀態下進行吸氣與呼氣中微粒濃度的量測。因此，為了做進一步的釐清，本研究建立了一套與文獻相當之Bolus測試系統，並與過去所開發之快速量測系統進行比對測試。本研究完成了一套Bolus呼吸道微粒沉積測試系統的設計與建置。比對測試的結果發現，當同一位受測者在相同的呼吸型態下，Bolus系統與快速量測系統所測得的微粒回復率(recovery rate)是一致的，兩者相差小於5％；而相較於正常呼吸之下，一旦受測者將呼氣吐至殘氣容積時，確實會得到顯著較高的微粒回復率（意即微粒沉積率較低）。因此，呼吸型態的不同是造成先前研究結果差異的主要原因。

A domestic study showed that the trend of Taiwanese regional lung deposition was similar to Kim’s data. However, the local deposition efficiency measured in the domestic study was slightly higher (about 1~3 %) than Kim’s. Yet, the difference in local deposition efficiency increased sharply when entering the deep penetration volume (400-500 mL). This mismatch were likely due to (1) the two experimental systems not being exactly the same: the bolus technique was used in Kim’s study, while the rapid measurement system was employed in the domestic study, and (2) the breathing procedures differed: inhaled a prescribed volume, and exhaled to residual volume (RV) at a constant flow rate was adopted in Kim’s study, while the sinusoidal normal breathing patterns was used in the domestic study. Therefore, the aim of this study was to development and characterization of an aerosol bolus system for lung deposition measurement. The results obtained from the rapid measurement system and the bolus system, respectively, were then compared. A bolus system was successfully designed and set up in this study. For the same subject with identical breathing pattern, the preliminary data obtained using the bolus system had a good agreement with those obtained from the rapid measurement system. The difference of aerosol recovery rate (RC) was less than 5%. However, it showed a significant higher RC by comparing the data obtained from Kim’s breathing procedure to those with normal breathing pattern.