不同呼吸系统症状儿童的心肺功能特征分析  

Analysis of cardiopulmonary function in children with different respiratory system symptoms

作　　者：张娜 赵桂华 张艳丽[3] 徐金义 曹振锋[2] 郭现平 邱妍妍 陈琼 吴蕊 ZHANG Na;ZHAO Gui-hua;ZHANG Yan-li;XU Jin-yi;CAO Zhen-feng;GUO Xian-ping;QIU Yan-yan;CHEN Qiong;WU Rui(Department of Cardiorespiratory Function,Henan Provincial People's Hospital,Zhengzhou 450003,China;Department of Paediatrics,Henan Provincial People's Hospital,Zhengzhou 450003,China;Department of Paediatrics Zhengzhou University,the Third Affiliated Hospital,Zhengzhou 450003,China;Department of Cardiorespiratory Function Fuwai Central China Cardiovascular Hospital,Zhengzhou 450003,China)

机构地区：[1]河南省人民医院心肺功能科郑州大学人民医院,河南省郑州市450003 [2]河南省人民医院儿科,河南省郑州市450003 [3]郑州大学第三附属医院儿科 [4]郑州大学人民医院阜外华中心血管病医院心肺功能科

出　　处：《中国心血管病研究》2022年第4期334-339,共6页Chinese Journal of Cardiovascular Research

基　　金：河南省医学科技公关项目(LHGJ20190342,LHGJ20200055)。

摘　　要：目的分析以胸闷、咳嗽或者长叹气为主诉儿童心功能、基础肺功能和气道反应的特点.方法选取2016年1月至2019年6月来我院就诊儿童1262例为研究对象,根据患儿主诉分为正常对照组、胸闷组、咳嗽组和长叹气组,取得家长知情同意后完成活动平板运动试验和基础肺通气功能检测,进一步选择行支气管激发试验或支气管舒张试验.对比不同组别心功能及肺功能指标的统计学差异.结果四组患儿最高心率、代谢当量和运动时间比较差异均无统计学意义(P>0.05).咳嗽组和长叹气组较正常对照组、胸闷组基础肺通气功能指标FVC、VCmax、PEF、FEV_(0.5)明显降低,小气道功能指标FEF_(50)、FEF_(75)、MMEF明显降低,差异有统计学意义(P<0.05).咳嗽组气道反应阳性率较胸闷组和长叹气组显著增高,差异有统计学意义(P<0.05).胸闷组PD_(20)-FEV_(1)值为(0.97±0.83)mg,较咳嗽组和长叹气组增高,差异无统计学意义(P>0.05).咳嗽组舒张试验阳性率为51.14%,较长叹气和胸闷组增高,差异无统计学意义(P>0.05).结论对于胸闷、长叹气等不适的患儿,心肺功能联合筛查在避免误诊漏诊和明确诊断方面意义重大.Objective To explore the changes of the cardiopulmonary function in children with different respiratory system symptoms.Methods 1262 children who came to our hospital from January 2016 to June 2019were collected and divided into the normal control group,chest tightness group,cough group and long sigh group according to the children’s main complaints.After obtaining the consent of their parents,they completed treadmill exercise test and basic pulmonary ventilation functiontes,and further bronchial provocation test or bronchodilation test.The statistical differences of cardiac and pulmonary function indexes in different groups were compared.Results There was no significant difference in the highest heart rate,metabolic equivalent and exercise time among the four groups(P>0.05).The basic pulmonary ventilation function indexes FVC,VCmax,PEF and FEV_(0.5)in the cough group and long sigh group were lower than those in the normal control group and chest tightness group;FEF_(50),FEF_(75)and MMEF decreased significantly(P<0.05).The positive rate of airway reaction in the cough group was significantly higher than that in the chest tightness group and long sigh group(P<0.05).The value of PD_(20)-FEV_(1)in the chest tightness group was(0.97±0.83)mg,which was higher than that in the cough group and long sigh group(P>0.05).The positive rate of diastolic test in the cough group was 51.14%,which was higher than those in the long sigh and chest tightness group but with no significant difference(P>0.05).Conclusions For children with chest tightness,long sigh and other discomfort,combined cardiopulmonary function screening is of great significance in avoiding misdiagnosis and missed diagnosis.

关 键 词：胸闷 咳嗽 长叹气 活动平板运动试验 气道高反应性 

分 类 号：R54[医药卫生—心血管疾病]