伴喘鸣的婴儿肺炎其TFV环变化及临床意义

The Clinical Significance of TFV Loops in Infants with Wheezing Pneumonia

目的了解伴喘鸣的肺炎婴儿其潮气流速容量（ＴＦＶ）环形态及相关参数的变化，为临床判断此类患儿病情及观察疗效寻找敏感的指标。方法５０例肺炎婴儿，其中伴喘鸣者２７例，应用森迪２６００儿童肺功能仪测定患儿安静睡眠状态下的ＴＦＶ环及相关参数。１３例喘鸣阳性患儿在喘鸣消失后复查，比较喘鸣阳性与阴性、喘鸣发作期与恢复期ＴＦＶ环及相关参数的变化。结果喘鸣阳性患儿，ＴＦＶ环呼气高峰前移，呼气曲线降枝呈“波谷”样凹向容量轴，喘鸣消失后，降枝呈弓背向上的抬高。喘鸣阴性患儿ＴＦＶ环呈“梭形”％ＶＰＦ、Ｔｐ／Ｔｅ、２５／ＰＦ及５０／ＰＦ在喘鸣阳性与阴性两组间差异显著。结论ＴＦＶ环形态及％ＶＰＦ、Ｔｐ／Ｔｅ、２５／ＰＦ及５０／ＰＦ可做为反映婴儿下气道阻塞性疾患的可靠指标。

Objetive To investigate the changes of TFV loop and the related parameters in infants with wheezing pneumonia, Methods 50 infants with pneumonia were involved,including 27 cases with wheezing.The TFV loops and related parameters were measured by useing Sensor Medics 2 600 Pediatric pulmonary laboratory.Results were compared between wheezing and no wheezing groups,and infants with wheezing and after wheezing disappeared.Results In wheezing infants,the expiratory peak of TFV loop goes forward,the latter part of the expiratory curve become concave facing the volume axis,like “wave trough”.After wheezing disappeared,the concave cure rises upward and becomes convex.The TFV loop of no wheezing infant was “Shuttle” shape,and in %V PF、Tp/Te、25/PF and 50/PF.There were significant differences between wheezing and no wheezing groups.Conclusion The shape of TFV loop and %V PF Tp/Te 50/PF and 25/PF are reliable indicators for infants with lower airway obstruction.