临床儿科杂志 ›› 2015, Vol. 33 ›› Issue (5): 450-.doi: 10.3969 j.issn.1000-3606.2015.05.013

• 综合报道 • 上一篇    下一篇

哮喘儿童支气管舒张试验中大小气道功能指标变化对比研究

王莉1,鲁正荣1,夏万敏1,樊映红1,黎桂菊1,艾涛1,王次林1,罗荣华1,吴英1,鲁佾2   

  1. 1. 成都市妇女儿童中心医院儿童呼吸科( 四川成都 610091);2. 郫县人民医院呼吸科( 四川成都 611730)
  • 收稿日期:2015-05-15 出版日期:2015-05-15 发布日期:2015-05-15
  • 通讯作者: 鲁正荣 E-mail:cdllll@163.com
  • 基金资助:
    四川省卫生厅2011 年科研课题(No.110060)

Comparative study of changes in airway size and its function in childhood asthma using bronchodilator reversibility test

WANG Li 1, LU Zhengrong1, XIA Wanmin1, FAN Yinghong1, LI Guiju1, AI Tao1, WANG Cilin 1, LUO Ronghua 1, WU Ying 1, LU Yi1   

  1. 1. Department of Respiratory Medicine, Chengdu Women & Children’s Center Hospital, Chengdu 610091, Sichuan, China; 2.Department of Respiratory Medicine, Pi County People's Hospital, Chengdu 611730, Sichuan, China
  • Received:2015-05-15 Online:2015-05-15 Published:2015-05-15

摘要: 目的 探讨儿童哮喘发作时支气管舒张试验中大小气道功能指标变化的临床意义。方法 选择2012年10月至2014年4月哮喘初次发作患儿51例,采用Master Screen肺功能仪,在雾化吸入硫酸沙丁胺醇前、后进行肺功能检测;比较用力肺活量(FVC)、呼气峰流速(PEF)、1秒用力肺活量(FEV1)、1秒率(FEV1/FVC)、最大呼气中段流量(MMEF)、用力呼气流速(FEF)25、FEF50、FEF75的变化。结果 51例患儿的平均年龄(7.30±2.33)岁。患儿哮喘发作时支气管舒张试验总阳性率58.8%,并有随病情加重而升高的趋势;与舒张试验前比较,舒张试验后大小气道各指标的绝对值、占预计值百分比均明显增加,差异有统计学意义(P均<0.01);以代表大气道指标的FEV1改善率≥12% 判定为舒张试验阳性,阳性率58.8%;以代表小气道指标的MMEF改善率≥25%判定为舒张试验阳性,阳性率70.6%,两者比较差异无统计学意义(P=0.214)。结论 哮喘发作患儿FEV1基础值>70%亦可行支气管舒张实验,同时结合大、小气道指标以判断气道可逆性可以更全面反映哮喘的病情严重程度。

Abstract:  Objective To investigate the clinical significance of changes of the airway size and its function indicators in asthmatic children using dilation test. Methods From October 2012 to April 2014, 51 children with initial attack of asthma were selected. Master Screen spirometer were used before and after nebulized albuterol sulfate pulmonary function testing; forced vital capacity (FVC), peak expiratory flow (PEF), one second forced vital capacity (FEV1), 1 second ratio (FEV1 / FVC), peak expiratory flow in the middle (MMEF), forced expiratory flow (FEF)25, FEF50, FEF75 changes were compared. Results The average age of 51 children included in this study was (7.30 ± 2.33) years. The positive rate of dilation test was 58.8% in children with asthma onset, and increased with severity of the disease. The size of the airway absolute value of each index, percentage predicted after the test increased significantly than that before the test (P<0.05); FEV1 positive rate was 58.8%, and MMEF positive rate was 70.6%, which showed no statistically significant difference (P>0.05). Conclusions Asthmatic children with baseline FEV1>70% can be given relaxation experiments, and indicators of large and small airways could be combined to determine the airway reversibility, which can be a better reflection of the severity of asthma.