摘要
目的通过对喘息性疾病患儿进行肺动脉收缩压（PASP）、肺功能测定，筛查肺动脉高压（PAH），并探讨该类患儿PASP与肺功能的相关性。方法回顾性分析2014年11月至2015年4月青岛市妇女儿童医院呼吸科收治的喘息性疾病患儿90例（喘息组），以同期体检健康儿童90例为健康对照组。入院24h内应用超声多普勒测定PASP，潮气呼吸法检测肺功能，结合临床表现与肺功能参数进行喘息程度分级。应用SPSS13．0统计软件对数据进行统计分析。结果喘息组PASP为（3．24±0．66）kPa，较健康对照组[（3．15±0．49）kPa]高，二者比较差异有统计学意义（F=7．50，P〈0．05）；筛查出PAH患儿10例，均分布于喘息组，与健康对照组相比差异有统计学意义（r=10．59，P〈0．05）。喘息组公斤潮气量、达峰时间比（TPEF／TE）、达峰容积比分别为（6．62±1．63）mL／kg、（26．76±6．48）％、（26．66±6．54）％，健康对照组分别为（8．38±0．80）mIMkg、（34．35±2．84）％、（34．23±3．02）％，2组比较差异均有统计学意义（F=86．28、138．08、113．27，P均〈0．05），且喘息组PASP与TPEF／TE呈负相关（r=-9．45，P〈0．05）。随着喘息程度加重，PASP有增高趋势，轻、中度喘息组[（3．43±0．50）kPa、（3．66±0．59）kPa]分别与重度组[（4．20±0．75）kPa]比较，差异均有统计学意义（x^2=24．81，12．55，P均〈0．05）；不同喘息程度患儿PAH例数比较（轻度、中度、重度分别为0、2、8例），差异有统计学意义（x^2=54．92，P〈0．05）。结论患儿呼吸道阻塞越明显、喘息程度越重，PASP越高，PAH发生的风险也越高。根据喘息患儿临床及肺功能情况，应早期测量PASP，筛查PAH，密切关注PAH的发生，以减少对右心功能的损伤。
Objective To study the pulmonary artery shrink pressure（PASP） and pulmonary function in children with asthmatic diseases, and screen pulmonary arterial hypertension （PAH）. To probe the correlation between PASP and pulmonary function. Methods Ninety children with asthmatic diseases from November 2014 to April 2015 at the Department of Respiratory,Women and Children＇s Hospital of Qingdao City were chased as asthmatic group,and 90 healthy children in the same period were selected as healthy control group. PASP and pulmonary function were detected by Doppler ultrasound and tidal flow - volume loop respectively within 24 hours of admission, the respite degrees were assessed by clinical and tidal flow - volume loop. SPSS 13.0 statistical software was used for statistical analysis. Results PASP of the asthmatic group and the healthy control group was （3.24 ±0.66） kPa and （3.15 ± 0.49） kPa, and the difference was statistically significant （ F = 7.50, P 〈 0.05 ）. There were 10 cases of PAH in the asthmatic group, which had statistically difference with the healthy control group （x^2 = 10.59, P 〈 0.05 ）. The tidal volume per kilogram, the ratio of time to peak tidal expiratory flow to total expiratory time, the ratio of volume to peak expiratory flow to total expiratory volume of the asthmatic group were （6.62± 1.63 ） mL/kg, （26.76± 6.48 ） % and （ 26.66 ±6.54 ） %, and these three indicators of the healthy control group were （ 8.38 ± 0.80 ） mL/kg, （ 34.35±2.84 ） % and （ 34.23 ± 3.02） %, but that of the former group were less than that of the lower respectively（ F = 86.28,138.08,113.27, all P 〈 0.05）. PASP had negative correlation with the ratio of time to peak tidal expiratory fow to total expiratory time in the asthmatic group （ r = - 9.45, P 〈 0. 05）. PASP was increased with the aggravation of respite, and it had statistical difference between the mild or moderate asthmatic group [ （3.43 ±0.50） kPa, （ 3.66 ± 0.59） kPa] and the severe group [ （4.20 ± 0.75 ） kPa ] （x^2 = 24.81,12.55, all P 〈 0.05 ）, and the cases of PAH had significant differences among these 3 groups （0,2,8 cases in mild, mode rate and severe group, respectively） （x^2 = 54.92, P 〈 0.05 ）. Conclusions For children with more severe airway obstruction and wheezing, the risk of PASP and PAH will be higher. It is helpful to reduce right ventricular function damage for children with asthmatic diseases by measuring PASP and screening PAH in the early stage according to the clinical condition and lung function.
出处
《中华实用儿科临床杂志》
CSCD
北大核心
2016年第16期1231-1234,共4页
Chinese Journal of Applied Clinical Pediatrics
基金
青岛市民生科技计划项目（15-9-2-83-nsh）
关键词
肺动脉高压
喘息性疾病
肺功能
儿童
Pulmonary arterial hypertension
Asthmatic diseases
Pulmonary function
Child
