比较单阻断法和双阻断法测定呼吸道疾病婴幼儿肺顺应性和呼吸道阻力的差异

Difference in Outcome Results of Pulmonary Compliance and Airway Resistance Measured by Single Occlusion and Double Occlusion Techniques for Infants with Respiratory Disease

目的比较单阻断法和双阻断法测定呼吸道疾病婴幼儿肺顺应性(Crs)和呼吸道阻力(Rrs)的差异。方法选择门诊送检肺功能测定的82例呼吸道疾病婴幼儿,应用Master Screen Paed型肺功能仪对其进行潮气呼吸环测定,并分别采用单阻断法和双阻断法测定其Crs和Rrs。分析参数包括达峰时间比值(TPTEF/TE)、达峰容积比值(VPEF/VE)及单阻断法和双阻断法测定的Crs和Rrs。应用SPSS 11.5软件进行统计学分析。结果 82例患儿的潮气呼吸参数TPTEF/TE为(23.2±11.4)%,VPEF/VE为(25.9±9.5)%。双阻断法测定的Crs显著高于单阻断法[(18.06±12.21)mL.kg-1.kPa-1 vs(14.40±6.93)mL.kg-1.kPa-1,P=0.001],而2种方法测定的Rrs比较差异无统计学意义[(3.66±1.47)kPa.L-1.s-1 vs(3.82±1.91)kPa.L-1.s-1,P=0.288]。经潮气呼吸环测定的TPTEF/TE、VPEF/VE与单阻断法测定的Rrs均呈负相关(r=-0.245,P=0.026;r=-0.257,P=0.020),但与双阻断法测定的Rrs均无相关性。结论在测定Crs和Rrs时,应用单阻断法和双阻断法联合测定有助于更全面分析呼吸道疾病婴幼儿的肺功能状态。

Objective To compare the differences in the outcomes of the pulmonary compliance（Crs） and airway resistance（Rrs） derived from 2 methods of single occlusion and double occlusion techniques for infants with respiratory disease. Methods Eighty-two infants with respiratory disease were selected from the outpatient department,and their pulmonary functions were measured by the passive tidal loops,and their Crs and Rrs were examined by passive single occlusion technique and the double occlusion technique with the Master Screen Paed equipment.The parameters included those derived from tidal loops such as ratio of time to reach tidal peak flow to total expiratory time（TPTEF/TE）,ratio of volume at tidal peak flow to total tidal volume（VPEF/VE） were recorded.Crs and Rrs were examined by the single occlusion technique and the double occlusion technique,respectively. Results The mean levels of the parameters measured by passive tidal loops for all the patients were TPTEF/TE（23.2±11.4）%,VPEF/VE（25.9±9.5）%.Crs examined by the double occlusion technique was significantly higher than that of the results by the single passive occlusion technique[（18.06±12.21） mL·kg-1·kPa-1 vs（14.40±6.93） mL·kg-1·kPa-1,P=0.001],while the results of Rrs by both techniques were shown no significant difference[（3.66±1.47） kPa·L-1·s-1 vs（3.82±1.91） kPa·L-1·s-1,P=0.288].The level of TPTEF/TE and VPEF/VE were negatively related to the levels of Rrs examined by the single passive occlusion technique respectively（r=-0.245,P=0.026;r=-0.257,P0.05）,but not related to the level of Rrs examined by the double passive occlusion technique. Conclusions For measuring pulmonary function of infants,it will be more helpful to evaluate by the single occlusion technique combined with the double occlusion technique.