呼吸道合胞病毒肺炎治疗前后肺功能的变化及其临床意义

Study on the Changes of Pulmonary Function Conducted Pre-and PostTherapeutically in Infants with Respiratory Syncytial Virus Pneumonia and Clinical Significance

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。方法对急性肺炎患儿行多病原联合检测。采用直接免疫荧光法检测新鲜痰液中RSV抗原,细菌培养检测细菌,并采用潮气呼吸分析法测定肺炎患儿的流速容量环及其各项指标。选取呼吸道合胞病毒肺炎患儿24例为研究对象,20名同龄健康儿童作对照。结果治疗后TBFVL呼气降枝趋于圆润,t-PTEFt、-PTEF/t-E、25/PF较治疗前增高,PTEF、PTEF/t-PTEF、RR、PTEF/Ve较治疗前降低,均有显著性差异,但只有PTEF和RR同健康婴幼儿比较无差异性,t-PTEF、t-PTEF/t-E、25/PF、PTEF/t-PTEF、PTEF/Ve仍然存在显著差异,说明治疗后肺炎患儿肺功能,主要是小气道功能,仍然存在异常。VT/kg、ME、MI、ME/MI治疗前后与健康对照组比较均没有显著意义,表明RSV肺炎主要表现为小气道的阻塞,对于大气道影响不大。结论RSV肺炎短期内肺功能依然存在一定程度的异常;潮气呼吸分析法对于评价RSV肺炎患儿病情轻重、疗效判断、预后评估提供客观依据。

Objective To discuss the changes of pulmonary function studied prea-nd post-thera- peutically in infants with respiratory syncytial virus pneumonia. Methods Associated measurements was taken to detect the pathogens of infants with acute pneumonia. Bacteria and virus were tested using sputum culture and direct immunofluoresence respectively. TBFVLs and relative parameters were obtained by tidal breathing analysis. Twenty-four infants admitted with RSV pneumonia, were en- rolled. Results After treatment, the expiratory declined limbs became smooth and circular, and t- PTEF, t-PTEF/t-E and 25/PF significantly increased while PTEF, PTEF/t-PTEF, RR as well as PTEF/Ve significantly decreased as compared with those of pre-treatmeant. But there was significant difference in t-PTEF, t-PTEF/t-E, 25/PF, PTEF/t-PTEF, PTEF/Ve compared with the controls which indicated abnormality of the small airway function post-therapeutically still existed. ME/MI which related to the obstruction site and damage degree of big airways showed no significant difference. Conclusion To some degree, there exist abnormality of pulmonary function post-therapeutically in infants with RSV pneumonia. The tidal breathing analysis can provide criteria of evaluation for the severity, curative effect and prognosis.