呼气相气道内负压法检测呼气流速受限在哮喘患儿中的应用  

Expiratory flow limitation detected by negative expiratory pressure in children with asthma

作　　者：李俊梅[1] 郑成中[1] 陈爱欢[1] 

机构地区：[1]北京解放军306医院,100101

出　　处：《国际儿科学杂志》2013年第6期642-645,共4页International Journal of Pediatrics

摘　　要：目的 探讨呼气相气道内负压法（NEP）检测呼气流速受限（EFL）在儿童哮喘患者中实施的可行性,及其与常规阻塞性肺通气功能指标第一秒用力呼气容积（FEV1）、加拿大医学研究委员会推荐的呼吸困难严重程度分级标准（MRC评分）的相关性.方法 选取2012年6～12月在该院就诊的儿童哮喘患者64例,其中46例稳定期,18例急性发作,给予MRC评分,然后分别进行常规肺通气功能检测及NEP检测EFL.结果 （1）所有哮喘患儿均能很好耐受NEP.（2）肺通气功能情况：64例哮喘患儿的FEV1均值为（71.33±13.92）％ pred,18例急性发作患儿FEV1均值为（52.91±13.87）％ pred.（3）MRC评分：64例哮喘患儿中10例MRC评分为2分,其余54例MRC评分为1分.MRC与FEV1的相关系数是-0.635（P＜0.05）.（4）NEP检测EFL情况：46例哮喘患儿坐位和仰卧位均未出现EFL,8例坐位和仰卧位均有EFL,10例坐位时无EFL,仅仰卧位出现EFL.3分法EFL与FEV1及MRC的相关系数分别为-0.607、0.964（P ＜0.05）.5分法EFL与FEV1及MRC的相关系数分别为-0.626、0.966（P＜0.05）.结论 （1）NEP可用于检测儿童哮喘的EFL情况.（2）NEP检测EFL与FEV1显著相关.（3）NEP检测EFL指标和FEV1均与MRC评分显著相关,但EFL与MRC评分的相关性更强.Objective The purpose of this study was to evaluate the feasibility of expiratory flow limitation（EFL） detected by negative（NEP） and the correlation between EFL and routine lung function measurements（Forced expiratory volume in first second,FEV1）,EFL and MRC dyspnea scale,in patients with stable and acute asthma,to find a simple,reliable and objective method for the diagnosis,differential diagnosis,the severity of disease and evaluation of severity and efficacy of treatment for asthma,and a objective method reflecting the severity of dyspnea.Methods Sixty-four children enrolled in No.306 Hospital of PLA from Jun.to Dec.in 2012 were included in this study.The severity of dyspnea was rated according to the dyspnea scale proposed by the Medical Research Council（MRC）.Then routine pulmonary ventilation function tests and NEP technique were performed respectively.Result （1） All asthmatic patients tolerated NEP well.（2） Pulmonary ventilation function tests：The mean FEV1 in 64 was 71.33 ± 13.92％ pred.（3） MRC dyspnea scale：MRC dyspnea scale was 2 in 10,1 in 54 of 64 children with stable asthma.The Spearman＇ s correlation coefficient of MRC dyspnea scale with FEV1 was-0.635（P ＜0.05）.（4）EFL detected by NEP：There were no EFL in 46 children with asthma both in seated and supine positions.There were EFL in 8 children both in seated and supine positions and in 10 only in supine position..The Spearman＇s correlation coefficient of three-point EFL score with FEV1 and MRC dyspnea scale was-0.607 and 0.964（P ＜ 0.05） respectively.The Spearman＇s correlation coefficient of five-point EFL score with FEV1 and MRC dyspnea scale was-0.626 and 0.966 （P ＜ 0.05）respectively.Conclusion （1） NEP technique can be used in children with asthma.（2） There was a significant correlation between EFL detected by NEP technique and FEV1.（3） There is a stronger correlation between EFL and MRC dyspnea scale than that between FEV1 and MRC dyspnea scale.

关 键 词：哮喘 儿童 呼气相气道内负压法 呼气流速受限 第一秒用力呼气容积 

分 类 号：R725.6[医药卫生—儿科]