婴幼儿呼吸道合胞病毒肺炎治疗前后肺功能分析

The Analysis of Lung Function Before and After Therapy in Infant Respiratory Syncytial Virus Pneumonia

目的探讨婴幼儿呼吸道合胞病毒肺炎治疗前后肺功能的变化。方法采用潮气呼吸法测定23名1～19个月的呼吸道合胞病毒肺炎婴幼儿的肺功能。以26名同龄健康儿童做对照。主要参数为:达峰时间(TPTEF)、达峰时间比(TPTEF/TE)、达峰容积(VPEF)、达峰容积比(VPEF/VE)、呼吸频率(RR)、潮气量(VT/kg)、潮气呼吸容量环(TFVL)。结果治疗前肺炎患儿呼吸频率(RR)为(36.300±7.154)次/分,较同龄对照组(30.950±6.00)次/分明显增快(P<0.01),反映气道阻塞的指标:TPTEF/TE和VPEF/VE分别为(19.650±3.030)%和(23.150±2.860)%,低于健康对照组的(24.580±5.190)%和(26.020±4.340)%,P<0.01。经治疗,患儿呼吸频率逐渐下降为(33.560±5.570)次/分,TPTEF和VPEF、TPTEF/TE、VPEF/VE均明显回升,其中TPTEF/TE、VPEF/VE显著增高,为(24.240±5.700)%和(24.760±3.040)%,P<0.05。TBFV环形态特点:治疗前TBFV环呼气曲线升支陡、高峰提前、降支斜率增大。结论婴幼儿呼吸道合胞病毒肺炎时存在明显的小气道阻塞,潮气呼吸测定能反映肺炎气道病变的程度及临床治疗的效果。

Purpose To study the change of lung function before and after therapy in infant respiratory syncytial virus （RSV） pneumonia. Methods The lung function of 23 RSV pneumonia infants aged 1 - 19 month were tested by tidal breathing analysis. Twenty-six healthy infants were enrolled as control. The main parameters included： time to peak tidal expiratory flow（TPTEF）, ratio of TPTEF to total expiratory time （TPTEF/TE）, volume to peak expiratory flow （VPEF）, ratio of VPEF to total expiratory volume（VPEF/ VE） ,respiratory rate （RR）,tidal volume per kilograme （VT/kg）, tidal flow-volume loop （TFVL）. Resuits Before therapy, RR in study group were 36.30 ± 7. 154 per minute,which was faster than the control group 30.95 ± 6.00 per minute. TPTEF/TE was （19.65± 3.03）%,VPEF/VE was （23. 15 ± 2.86） % ,which were lower than the control group （24.58 ± 5.19） % and （26.02 ± 4.34） % , P〈 0.01. After therapy,RR in pneumonia infants were dropped to 33.56 ± 5.57 per minute and TPTEF, VPEF, TPTEF/TE,VPEF/VE became higher than before. TPTEF/TE rose up to （24.24 ± 5.70） % and VPEF/ VE to （24.76 ± 3.04） % , P 〈 0.05. And before therapy, the ascending ramus of TBFV was steeper and the slope of descending branch was larger. Conclusions There are obstructions in small respiratory tracts of RSV pneumonia infant. Tidal breathing analysis can reflects the degree of respiratory tract lesion and the effect of treatment.