不同自然史毛细支气管炎婴幼儿肺功能主要参数的变化

Main parameters changes of lung function in infants with different natural history of bronchiolitis

目的探讨不同自然史毛细支气管炎婴幼儿肺功能的变化,了解特殊自然史患儿该病转归预后的特殊性,指导临床治疗及预后。方法选择本院收治的毛细支气管炎患儿160例,根据是否具有特殊自然史(属特应性体质)分为特殊组(n=80)和一般组(n=80),分别于治疗前后对两组患儿行肺功能检查。治疗后6个月电话随访患儿气喘复发情况。结果两组患儿在急性期呼吸频率(RR)升高,每千克体重潮气量(Vt/kg)、达峰时间比(TPTEF/TE)及达峰容积比(VPTEF/VE)均下降,两组间比较差异无显著性;治疗后两组患儿RR均下降,TPTEF/TE、VPTEF/VE、Vt/kg均上升,与治疗前比较差异具有显著性(P<0.01),但有特殊自然史的患儿较一般患儿恢复程度小,组间比较差异具有显著性(P<0.01)。特殊组患儿随访观察6个月的复发率为52.5%,显著高于一般组患儿(20%),差异具有显著性(P<0.01)。结论有特殊自然史的毛细支气管炎患儿肺功能恢复较一般患儿慢,且易复发,故应密切监测,继续巩固治疗以减少疾病复发。

Objective To explore the different changes of infant pulmonary functions with bronchiolitis; understand the prognosis particularity of the patient with atopic constitution and guide the treatment and prognosis. Method Selected 160 cases of children with bronchiolitis, according to whether had special natural history（genus atopic constitution） divided into special group（n = 80） and general group（n = 80） respectively before and after treatment, two groups of children with pulmonary function test. After treatment in children with asthma recurrence of telephone follow-up 6 months. Result In the acute phase RR, both two groups were increased, and VT/kg, TPTEF/TE and VPTEF/VE were decreased; no statistically significant difference between two groups. After treatment, the RR of both groups were decreased and TPTEF/TE, VPTEF/VE, VT/kg were increased and gradually recovered. There was statistical significance compared with those before treatment. But the atopic children were recovered less than the ordinary children to some degree. There were statistically significant differences between groups. Special groups followed up for 6 months recurrence rate was 52.5%, significantly higher than general group（20%）（P〈0.05）. ConclusionAtopic children with bronchiolitis, tracheal recovery from the pathological changes is slower than the ordinary patients, and easy to relapse, so it should be closely monitored and continue to consolidate the treatment to reduce the recurrence rate.