脉冲震荡肺功能检测在小儿支气管哮喘诊疗中的应用价值  

Clinical value of pulse shock pulmonary function test in diagnosis and treatment of children with bronchial asthma

作　　者：何凤[1] 赵丹[1] 王城[1] 黄静[1] 张莉[1] HE Feng;ZHAO Dan;WANG Cheng(Department of Pediatrics Surgery,Affiliated Hospital of North Sichuan Medical College,Nanchong Sichuan 637000,China)

机构地区：[1]川北医学院附属医院儿外科,四川南充637000

出　　处：《临床和实验医学杂志》2023年第5期533-536,共4页Journal of Clinical and Experimental Medicine

基　　金：四川省卫健委科研课题(编号:20PJ147)。

摘　　要：目的分析脉冲震荡肺功能(IOS)检测在小儿支气管哮喘诊疗中的应用价值。方法以回顾性分析为法,观察对象为2021年1月至2022年1月入川北医学院附属医院的40例发作期哮喘患儿(A组)、40例缓解期哮喘患儿(B组)、40例健康体检小儿(C组)。3组研究对象均接受IOS检测与最大呼气流量-容积曲线(MEFV)检测,比较3组IOS参数[呼吸道中心阻力(Rc)、共振频率(Fres)、震荡频率为5 Hz时电抗值(X5)、震荡频率为20 Hz时中心气道黏性阻力(R20)、震荡频率为5 Hz时气道黏性阻力(R5)、震荡频率为5 Hz时呼吸总阻抗(Z5)]与MEFV参数[达峰容积比(VPEF/VE)、达峰时间比(TPTEF/TE)、用力呼出50%肺活量的呼气流量(FEF50%)、用力呼出25%肺活量的呼气流量(FEF25%)、呼气峰流速(PEF)、第1秒用力呼气容积与用力肺活量的比值(FEV1/FVC)],并分析A、B组患儿IOS参数与MEFV参数的相关性。结果A组患儿IOS参数较B、C组更高,MEFV参数较B、C组更低,差异均有统计学意义(P<0.05);B组患儿IOS参数较C组更高,MEFV参数较C组更低,差异均有统计学意义(P<0.05)。Pearson分析显示,A组患儿Z5与TPTEF/TE呈负相关(r=-0.302,P<0.05),Rc、Z5与FEF25%呈负相关(r=-0.354、-0.309,P<0.05),R5、Z5与FEF50%、FEV1/FVC呈负相关(r=-0.329、-0.309、-0.306、-0.520,P<0.05),X5与各项MEFV参数呈负相关(r=-0.520、-0.390、-0.356、-0.352、-0.366、-0.556,P<0.05);B组患儿Z5与TPTEF/TE呈负相关(r=-0.302,P<0.05),Rc、Z5与FEF50%、FEF25%呈负相关(r=-0.375、-0.364、-0.343、-0.316,P<0.05),R5、Z5与FEV1/FVC呈负相关(r=-0.322、-0.413,P<0.05),X5与各项MEFV参数呈负相关(r=-0.525、-0.475、-0.329、-0.355、-0.374、-0.532,P<0.05)。结论IOS检测在小儿支气管哮喘诊疗中的应用价值显著,对拒绝接受MEFV法检测的患儿,IOS检测可快速、精准地诊断其病情,且发作期哮喘患儿诊断中X5最为敏感。Objective To analyze the application effect of pulse oscillation pulmonary function(IOS)test in the diagnosis and treatment of children with bronchial asthma.Methods From January 2021 to January 2022,40 children with exacerbation asthma(group A),40 children with remission asthma(group B),and 40 children with healthy physical examination(group C)who were admitted to the Affiliated Hospital of North Sichuan Medical College were enrolled in the retrospective analysis.All the three groups received IOS test and maximum expiratory flow-volume curve(MEFV)method.The pulmonary function parameters of the three groups of IOS were compared[central airway resistance(Rc),resonance frequency(Fres),reactance value(X5)at 5 Hz oscillation frequency,central airway viscosity resistance(R20)at 20 Hz oscillation frequency,airway viscosity resistance(R5)at 5 Hz oscillation frequency,and oscillation frequency total respiratory impedance(Z5)at 5 Hz]and MEFV parameters[volume to peak ratio(VPEF/VE),time to peak ratio(TPTEF/TE),forced exhalation 50%Expiratory flow of vital capacity(FEF50%),expiratory flow of forced exhaled capacity 25%(FEF25%),peak expiratory flow rate(PEF),ratio of forced expiratory volume in one second to forced vital capacity(FEV1/FVC)],and the correlation between IOS parameters and MEFV parameters in group A and B were analyzed.Results The pulmonary function parameters of IOS in group A were higher than those in groups B and C,and the MEFV parameters were lower than those in groups B and C,and the differences were statistically significant(P<0.05).The pulmonary function parameters of IOS in group B were higher than those in group C,and the MEFV parameters were lower than those in group C,and the differences were statistically significant(P<0.05).Pearson analysis showed that in group A,Z5 was negatively correlated with TPTEF/TE(r=-0.302,P<0.05),Rc and Z5 were negatively correlated with FEF25%(r=-0.354,-0.309;P<0.05),R5 and Z5 were negatively correlated with FEF50%and FEV1/FVC(r=-0.329,-0.309,-0.306,-0.520;P<0.05).X5 was

关 键 词：小儿 哮喘 脉冲震荡肺功能检测 最大呼气流量-容积曲线 

分 类 号：R725.6[医药卫生—儿科]