儿童哮喘呼吸阻抗特点及临床意义分析  

Characteristics and clinical significance of respiratory impedance in children with asthma

作　　者：任立歆[1] 万莉雅[1] 张琴[1] 袁艳[1] 董汉权[1] 

机构地区：[1]天津儿童医院,天津300074

出　　处：《中国实用儿科杂志》2011年第1期44-46,共3页Chinese Journal of Practical Pediatrics

摘　　要：目的探究儿童哮喘的呼吸阻抗特点及其临床意义。方法对2005年7月至2006年6月就诊于天津儿童医院的80例哮喘患儿、同期于天津儿童医院保健门诊体检的112名健康儿童及天津胸科医院呼吸科的62例成人哮喘患者应用脉冲振荡法(IOS)测定呼吸阻抗,部分患者作常规通气肺功能检测。对其组间指标进行统计学处理。结果 IOS测定显示儿童哮喘组气道总阻力5Hz时气道黏性阻力(R5)明显增高[(142.19±36.40)%],中心气道阻力(20Hz时气道黏性阻力(R20)正常[(88.53±17.83)%]。成人哮喘组R5、R20均增高,分别为(190.03±49.97)%、(152.53±39.11)%。两组电抗值X5和共振频率Fres均有不同程度减低和后移,Fres变化更显著。常规通气肺功能检查成人组FVC、FEV1/FVC实测值占预计值百分比分别为(81.19±15.42)%、(55.57±12.93)%,儿童组分别为(79.12±18.65)%、(64.81±9.78)%。结论儿童与成人哮喘患者呼吸阻抗特点差异存在统计学意义,儿童哮喘病变以小气道为主,吸入药物治疗应尽可能达到小气道水平。Objective To investigate the characteristics of respiratory impedance in children and adults with asthma and explore the clinical significance. Methods From Jul. 2005 to Jun. 2006 in Tianjin Children＇s Hospital, IOS （Impulse Oseillometry） was performed in 80 children and 62 adults with asthma and 112 healthy children to obtain respiratory impedance data; at the same time, the conventional pulmonary function test was also performed in some of the patients. Data coming from different groups were analyzed statistically. Results Based on IOS data, total resistance R5 inereased （142.19 ± 36.40）% and central resistance R20 was normal [ （88.53 ± 17.83）% ] in child asthma group. Both R5 and R20 increased in adult asthma group [ （190.03 ± 49.97）%, （152.53 ± 39.11）% ]. In two groups, reactance X5 and Fres decreased or baeked off in various degrees, more obviously for Fres. The conventional pulmonary test data also implied that the percentages of FVC and FEV1/FVC were （81.19 ± 15.42）% and （55.57 ± 12.93）% respectively in aduh group, and （79.12 ± 18.65）% and （64.81 ±9.78）% respectively in child group. Conclusion The characteristics of respiratory impedance between children and adults are different. The pathological changes of child asthma are mainly in the small airway where inhaled medicine should reach as far as possible.

关 键 词：儿童 小气道 哮喘 呼吸阻抗 

分 类 号：R72[医药卫生—儿科]