支气管舒张试验在婴幼儿哮喘诊治中的应用探讨  

Application of bronchodilatation test in diagnosis and treatment of asthmatic infants

作　　者：贺湘玲[1] 李云[1] 龚萍[1] 田鑫[1] 

机构地区：[1]湖南省人民医院儿科,长沙410005

出　　处：《中国综合临床》2007年第12期1138-1140,共3页Clinical Medicine of China

基　　金：湖南省卫生厅科研课题计划项目(B2004-113)

摘　　要：目的通过潮气呼吸肺功能测定探讨支气管舒张试验在耍幼儿哮喘诊治中的价值。方法选择婴幼儿哮喘患儿35例,在沙丁胺醇溶液雾化前后进行潮气呼吸肺功能测定。结果经沙丁胺醇雾化后呼吸频率(RR)较雾化前减慢(P<0.05);吸气时间(TI)较雾化前延长(P<0.01);达峰时间(TPEF)、迭峰时间比(TPEF/TE)、达峰容积(VPEF)、达峰容积比(VPEF/VE)较雾化前均明显增高(均P<0.01);潮气呼吸呼气流速(FIEF)较雾化前减慢(P<0.01)。大部分哮喘婴幼儿流速客积环变窄,呼气相升支陡峭,高峰提前,降支倾斜,甚至凹向容量轴,即流速容积环呈现特征性阻塞图形;雾化后呼气降支的斜率有所减小。结论利用潮气呼吸肺功能检测技术进行婴幼儿支气管舒张试验。达峰时间比(TPEF/TE)改善率或达峰容积比(VPEF/VE)改善率≥15%。可以作为小年龄儿童支气管舒张试验的评定标准,作为婴幼儿哮喘患儿的诊治的重要依据。Objective To investigate the application of bronchodilatation test in the diagnosis and treatment of asthmatic infants by pulmonary function parameters of tidal respiration measurement, Methods Thirty-five asthmatic infants were chosen. Pulmonary function parameters were investigated before and after salbutamol aerosol atomization treatment. Results After salbutamol aerosol atomization treatment, RR was slower than that of pre-therapy （ P 〈 0.05 ） ; TI was longer （ P 〈 0.01 ） ; TPEF, TPEF/TE, VPEF, VPEF/VE were all remarkably higher （ P 〈 0. 01 ） ; While FIEF was slower （ P 〈 0.01 ）. Flow-volume curve was narrower and peak value in expiratory flow was higher in most pre-therapy asthmatic infants than those of asthmatic infants post-therapy,and the slope of TFV curve was remarkably more increscent. So the flow-volume curve featured with obstruction graphics. After treatment expiratory flow falls slope reduced. Conclusion TPEF/TE can be the diagnostic standard in younger children＇s bronchodilation test by tidal breathing. Pulmonary function parameters of tidal respiration technique in bronchodilatation test of infants may provide important evidence for the treatment of infant asthma.

关 键 词：哮喘 潮气呼吸 肺功能 支气管舒张试验 

分 类 号：R725.6[医药卫生—儿科]