摘要
目的探讨潮气呼吸肺功能在婴幼儿喘息性疾病诊断中的作用。方法选择年龄在2个月～3岁同期住院婴幼儿哮喘患儿54例、毛细支气管炎患儿54例、支气管肺炎患儿45例作为研究组,非心胸疾患外科择期手术术前患儿51例作为正常对照组,进行潮气呼吸流速容量曲线测定,然后予复方异丙托溴胺溶液1.25ml,雾化吸入15min后再次测定潮气呼吸流速容量曲线,观察各研究组吸入支气管扩张剂前后肺功能指标变化及改善率的差异。结果①婴幼儿哮喘组、支气管肺炎组与正常对照组比较RR增快,Ti、Te、TPTEF/Te及VPTEF/Ve明显降低;支气管肺炎组Vt/kg减少,各指标差异均有统计学意义。毛细支气管炎组TPTEF/Te、VPTEF/Ve值与正常参考值比较均明显降低。②婴幼儿哮喘组吸入支气管扩张剂后Vt/kg增加,TPTEF/Te、VPTEF/Ve升高,差异均有统计学意义;毛细支气管炎组、支气管肺炎组吸入支气管扩张剂后RR减慢,余指标差异无统计学意义。③婴幼儿哮喘组与毛细支气管炎组、支气管肺炎组比较TPTEF/Te、VPTEF/Ve改善率差异均有统计学意义;而毛细支气管炎组与支气管肺炎组比较TPTEF/Te、VPTEF/Ve改善率差异无统计学意义。④以TPTEF/Te、VPTEF/Ve任意一个改善率≥15%作为支气管舒张试验的阳性标准,灵敏度为31.3%,特异度为82.6%。结论①潮气呼吸肺功能检测适宜于婴幼儿肺功能检测,间接反映婴幼儿哮喘、毛细支气管炎、支气管肺炎的病理生理特征;②TPTEF/Te、VPTEF/Ve可以显示气道阻塞;③吸入支气管扩张剂后TPTEF/Te、VPTEF/Ve的改善率可以为婴幼儿哮喘的临床诊断提供一定帮助。
Objectives To examine the results of tidal breathing flow-volume loop（TBFV）measurement in infants with asthma,bronchiolitis and bronchopneumonia,and to explore the significance of these parameters in diagnosis of wheezing diseases in infants. Methods Fifty-four infants with asthma（asthma group）,fifty-four infants with bronchiolitis（bronchiolitis group）,and forty-five infants with bronchopneumonia（bronchopneumonia group）were enrolled in the study,fifty-one infants with non-cardiac diseases before operation were studied as control. All the recruits were hospitalized at the same time,and their ages were between two months and three years. Each group received aerosol inhalation of salbutamol and ipratropium bromide. TBFV parameters were obtained before and 15 minutes after aerosol inhalation to evaluate the effects to the drugs. Results （1）In comparison with the normal controls,respiratory rate （RR）was significantly higher,Ti,Te,TPTEF/Te,and VPTEF/Ve were significantly lower in both asthma and bronchopneumonia groups;Vt/Kg was lower in bronchopneumonia group;before inhalation. TPTEF/Te,VPTEF/Ve in the bronchiolitis group were significantly lower than the normal standards. （2）Significant recovery（increase）in TPTEF/Te and VPTEF/Ve were found in asthma group but no improvement in bronchiolitis and bronchopneumonia groups except lower RR after inhalation. （3）The improvement rates of TPTEF/Te、VPTEF/Ve in asthma group were significant compared with that of the groups of bronchiolitis and bronchopneumonia,but no significant changes in groups of bronchiolitis and bronchopneumonia. （4）Taking improvement rate ≥ 15% either in TPTEF/Te or in VPTEF/Ve as a positive marker of bronchodilation,the specificity was 82.6%,the sensitivity was 31.3%. Conclusions （1）TBFV could be used to test pulmonary function of infants,as it reflects the pathophysio-logical features of infants with asthma,bronchiolitis and bronchopneumonia. （2）TPTEF/Te and VPTEF/Ve can reflect the airway obstruction. （3）The changes of TPTEF/Te and VPTEF/Ve before and after the inhalation of drugs may be used as a supplement index for clinical diagnosis of asthma in infants.
出处
《临床儿科杂志》
CAS
CSCD
北大核心
2008年第9期779-783,共5页
Journal of Clinical Pediatrics
