潮气呼吸法支气管舒张试验在5岁以下儿童哮喘诊断中的价值  

Bronchodilation test by tidal breathing in asthmatic children under 5 years old

作　　者：刘辉[1] 潘家华[1] 何金根[1] 计明红[1] 陶松雪[1] 吕勇[1] 

机构地区：[1]安徽医科大学附属省立医院儿科,安徽合肥230001

出　　处：《临床儿科杂志》2008年第5期427-429,441,共4页Journal of Clinical Pediatrics

摘　　要：目的利用潮气呼吸法对小年龄哮喘患儿进行支气管舒张试验,探讨支气管舒张试验在5岁以下患儿哮喘诊断中的价值。方法将2006年1月-2007年5月就诊的哮喘患儿246例,根据不同年龄段分为4组,Ⅰ组0～1岁,Ⅱ组～3岁,Ⅲ组～5岁,Ⅳ组～6岁。以0.5%沙丁胺醇作为支气管舒张药物,用潮气呼吸肺功能分析各组吸药前后肺功能指标变化。结果Ⅰ、Ⅱ、Ⅲ组吸药前后达峰时间比(tPTEF/tE)、达峰容积比(VPEF/VE)差异均无统计学意义(t=0.065～0.179,P>0.05);Ⅳ组吸药前后tPTEF/tE和VPEF/VE差异均有统计学意义(t=-4.295、5.029,P<0.05)。tPTEF/tE和VPEF/VE吸药前后差值与年龄呈正相关(P<0.05)。随年龄增大,差值逐渐增高。tPTEF/tE改善率和VPEF/VE改善率组间比较差异有统计学意义(P<0.05)。结论潮气呼吸法支气管舒张试验在5岁以下哮喘患儿诊断中无明确临床价值,对于>5岁哮喘患儿诊断与成人哮喘相同具有诊断意义。Objectives To evaluate the bronchodilation test by tidal breathing in diagnosing asthma in children. Methods A total of 246 children who came to the Affiliated Provincial Hospital of Anhui Medical University, presented with wheeze, aged 3 - 72 months were recruited. They were divided into four groups according to their ages： group 1 （0- 1 year old, n=57）, group2 （ -3yearsold, n=59）, group3 （ - 5 years old, n=70）, group 4（ - 6years old, n = 60）. All received salbutamol. Tidal breathing flow-volume loop and parameters obtained before and after aerosol inhalation were evaluated. Results （ 1 ） There were no significant recovery in tPTEF/tE and VPEF/VE in groups 1, 2 and 3 after inhaling the drug （P 〉 0.05）, while significant recovery was observed in group 4 （P 〈 0.05）. （2） The improvement of tPTEF/tE and VPEF/VE after inhalation was positively correlated with age. （3） There were significant differences in the change of tPTEF/tE and VPEF/VE among the four groups. Conclusions Bronchodilation test by tidal breathing had less value in diagnosing asthma for children under five years old.

关 键 词：支气管哮喘 支气管舒张试验 潮气呼吸 儿童 

分 类 号：R725.6[医药卫生—儿科]