619例儿童哮喘肺功能FEV1和PEF与小气道的关系  

Association of FEV1 and PEF with small airway function in asthmatic children:cross-sectional analysis of 619 cases

作　　者：吴雪郡[1] 黄英[1] 王莹[1] 龚财惠[1] 

机构地区：[1]重庆医科大学附属儿童医院呼吸中心/儿童发育疾病研究省部共建教育部重点实验室,重庆400014

出　　处：《南方医科大学学报》2011年第11期1900-1902,1906,共4页Journal of Southern Medical University

基　　金：十一五"国家科技支撑计划(2007BA124B05)~~

摘　　要：目的探讨哮喘儿童不同年龄段和不同性别间、肺功能检查指标中第一秒最大呼气量（FEV1）及最大呼气流速峰值（PEF）与小气道各项指标相关性。方法选择3~13岁缓解期哮喘患儿619例,分为3~5岁（314例）、6~9岁（207例）和10~14岁（98例）三组,采用肺功能仪测定哮喘患儿的FEV1和PEF等呼吸生理参数。结果缓解期哮喘患儿大气道功能指标均以PEF异常率最高,异常率均〉85%;小气道功能指标异常率在不同年龄段及性别间有所不同,6~9岁男、女性哮喘患儿均以用力呼气25%流量（MEF25）异常率最高,3~5岁和10~14岁男性患儿以MEF25异常率最高,女性以用力呼气50%流量（MEF50）异常率最高。3~5岁女性哮喘患儿FEV1与MEF25相关系数（r）为0.19（P〉0.01）,与用力呼气75%流量（MEF75）r为0.492（P〈0.01）,其余哮喘患儿FEV1与小气道各项指标r值均大于0.5（P〈0.01）;3~5岁女性哮喘患儿PEF与MEF25的r值为0.086（P〉0.05）,与MEF50的r值为0.447（P〈0.01）,3~5岁男性哮喘患儿PEF与MEF25的r值为0.431（P〈0.01）,与MEF50的r值为0.482（P〈0.01）,其余哮喘患儿PEF与小气道各项指标r值均大于0.5（P〈0.01）。结论除3~5岁女性哮喘患儿MEF25与FEV1、PEF无相关关系外,其余小气道指标与FEV1及PEF均呈正相关关系,这种正相关显示肺功能FEV1及PEF对辅助诊断哮喘有重要价值。Objective To investigate the association of forced expiratory volume in 1 second（FEV1） and the maximum peak expiratory flow（PEF） with small airway function in asthmatic children of different ages and genders.Methods This cross-sectional study was conducted among 619 asthmatic children with disease remission aged 3 to 13 years.The children were divided into 3 age groups,namely 3 to 5 years group（314 cases）,6 to 9 years group（207 cases） and 10 to 13 years group（98 cases）,and their respiratory physiological parameters such as FEV1 and PEF were measured.Results Of the airway function parameters,PEF showed the highest abnormality rate（85%） in these asthmatic children.In male and female asthmatic children aged 6 to 9 years,abnormalities in forced expiratory flow rate 25% （MEF25） showed the highest frequency（56% and 63%,respectively）.In 3-5 years and 10-13 years groups,MEF25 abnormalities were the most frequent in male children（43% and 71%,respectively）,whereas abnormalities in MEF50 were the most common in female children（33% and 69%,respectively）.FEV1 and PEF were positively correlated to all the parameters of small airway functions in these asthmatic children（r0.5,P0.01） except for MEF25 in female asthmatic children aged 3 to 5 years（r=0.19,P=0.168;r=0.086,P=0.535）.Conclusion In asthmatic children,FEV1 and PEF are positively correlated to the parameters of small airway function with only the exception of MEF25 in female children aged 3 to 5 years,suggesting the value of FEV1 in the diagnosis of asthma in children.

关 键 词：哮喘 儿童 肺功能 第一秒最大呼气量 最大呼气流速峰值 小气道 

分 类 号：R725.6[医药卫生—儿科]