哮喘及疑诊哮喘患儿运动激发试验中肺功能及目标心率到达与维持时间分析  

Analysis of pulmonary function and target heart rate arrival and maintenance time during exercise challenge test in asthmatic and suspected asthmatic children

作　　者：黄君 罗健[1] HUANG Jun;LUO Jian(Department of Respiration, Children′s Hospital Affiliated to Chongqing Medical University, National Clinical Research Center for Child Health and Disorders, Ministry of Education Key Laboratory of Child Development and Disorders, Chongqing Key Laboratory of Pediatrics, Chongqing 400014, China)

机构地区：[1]重庆医科大学附属儿童医院呼吸科,国家儿童健康与疾病临床医学研究中心,儿童发育疾病研究教育部重点实验室,儿科学重庆市重点实验室,重庆400014

出　　处：《中国临床新医学》2021年第5期492-496,共5页CHINESE JOURNAL OF NEW CLINICAL MEDICINE

摘　　要：目的分析儿童运动激发试验中肺功能指标随时间的变化及目标心率到达与维持时间对肺功能指标下降率的影响。方法回顾性分析2016-11~2020-09在重庆医科大学附属儿童医院就诊的哮喘及疑诊哮喘患儿共60例,所有患儿均顺利完成踏车法运动激发试验,以第1秒用力呼气容积(FEV1)下降≥10%为试验阳性,收集基本资料及运动前后肺功能数据。根据目标心率到达时间≤4 min和>4 min分为两组,目标心率维持时间≥4 min和<4 min分为两组,比较两组间肺功能指标下降率的差别及肺功能指标随时间的变化。结果60例患儿中试验阳性者11例(18.33%),阴性49例(81.67%)。阳性组目标心率维持时间明显长于阴性组,差异有统计学意义(P<0.05)。大小气道指标在运动后有不同程度下降,在20 min后逐渐恢复。目标心率维持时间≥4 min组的大气道指标[用力肺活量(FVC)、FEV1、呼气峰值流速(PEF)、用力呼出25%肺活量时的瞬间流量(FEF25)]下降率均高于<4 min组(P均<0.05)。结论儿童运动激发试验中,大小气道在运动后有不同程度的收缩,在20 min后逐渐恢复。目标心率维持时间会影响大气道收缩,儿科医师查看报告时应关注是否达到了指南要求,以评估结果的可靠性和适用性,从而更加合理地制定临床诊疗方案。Objective To analyze the variation of pulmonary function indexes with time and the effect of target heart rate arrival and maintenance time on the decline rates of pulmonary function indexes during children′s exercise challenge test(ECT).Methods A retrospective analysis was conducted on 60 cases of asthma and suspected asthma children treated in Children′s Hospital Affiliated to Chongqing Medical University from November 2016 to September 2020.All the children successfully completed bicycle ergometer ECT.A decrease of≥10%in forced expiratory volume in one second(FEV1)was considered as positive test.The basic data and pulmonary function data before and after the test were collected.The children were divided into two groups according to their target heart rate arrival time≤4 min and>4 min.The children were divided into two groups according to their target heart rate maintenance time≥4 min and<4 min.The variation of pulmonary function indexes with time and the differences in the decline rates of pulmonary function indexes were compared between the two groups.Results Among the 60 children,11 cases(18.33%)were positive and 49 cases(81.67%)were negative.The target heart rate maintenance time in the positive group was significantly longer than that in the negative group,and the difference was statistically significant(P<0.05).The large and small airway parameters decreased in different degrees after exercise,and gradually recovered after 20 min.The decline rates of the large airway parameters[forced vital capacity(FVC),FEV1,peak expiratory flow(PEF),and forced expiratory flow at 25%vital capacity(FEF25)]in the target heart rate maintenance time≥4 min group were higher than those in the target heart rate maintenance time<4 min group(P<0.05).Conclusion During children′s ECT,the large airway and the small airway have different degrees of contraction after exercise,and gradually recover after 20 minutes.The target heart rate maintenance time can affect the contraction of the large airway.When reviewing the rep

关 键 词：运动激发试验 儿童 目标心率 时间 肺功能 

分 类 号：R725.6[医药卫生—儿科]