肺炎支原体肺炎患儿的肺功能特点及临床意义

The characteristics and clinical significance of lung function in children with mycoplasma pneumoniae pneumonia

目的探讨肺炎支原体肺炎（MPP）患儿的肺功能特点及临床意义。方法采用德国JAEGER公司生产的肺功能仪检测60例MPP患儿的急性期和正规治疗2～3周后肺功能：用力肺活量（FVC）、第1秒用力呼气容积（FEV1）、呼气峰流速（PEF）、25％用力肺活量时用力呼气流量（FEF25）、50％用力肺活量时用力呼气流量（FEF50）、75％用力肺活量时用力呼气流量（FEF75）和最大呼气中期流速（MMEF75／25）。并计算实测值占预计值百分比。结果60例MPP患儿急性期FVC、FEV1、PEF、FEF25、FEF50、FEF75、MMEF75／25的实测值均低于预计值[（1．56±0．53）L比（1．99±0．69）L、（1．37±0．47）L比（1．68±0．57）L、（2．90±0．86）L／s比（3．95±1．08）L／s、（2．48±0．67）L／s比（3．56±0．89）L／s、（1．42±0．41）L／s比（2．51±0．64）L／s、（0．65±0．20）L／s比（1．28±0．33）L/s、（1．22±0．77）L／s比（2．18±0．61）L／s]，差异有统计学意义（P〈0．01）；而且恢复期FVC、FEV1、PEF、FEF25、FEF50、FEF75、MMEF75／25占预计值百分比明显好于急性期[（98．80±9．34）％比（79．14±6．28）％、（98．67±8．28）％比（81．63±6．56）％、（86．23±6．86）％比（73．17±6．21）％、（85．17±7．86）％比（69．79d-8．16）％、（79．08±7．99）％比（56．57±8．77）％、（70．85±7．48）％比（50．66±9．86）％、（77．35±6．81）％比（56．19±9．61）％]，差异有统计学意义（P〈0．01）。结论在急性期，MPP患儿肺功能表现为混合型通气功能障碍；在恢复期，肺功能指标明显好转，但小气道指标仍存在异常。

Objective To explore the characteristics and clinical significance of lung function in children with mycoplasma pneumoniae pneumonia. Methods The pulmonary ventilation function of 60 cases of mycoplasma pneumoniae pneumonia was tested in the acute stage and 2 weeks after treatment by the pneumatometer made by JAEGER company in Germany. FVC, FEV1, PEF, FEF25,FEFS0, FEF75 and MMEF75/25 was detected. Results In acute phase, lung function indexs （FVC, FEV1, PEF, FEF25, FEFSO, FEF75, MMEF75/25） of 60 children with MPP were less than expected： （1.56 ± 0.53） L vs.（1.99 ± 0.69） L, （1.37 ± 0.47） L vs. （1.68 ± 0.57） L, （2.90 ± 0.86） L/s vs. （3.95 ± 1.08） L/s, （2.48 ± 0.67） L/s vs. （3.56 ± 0.89） L/s, （1.42 ± 0.41） L/s vs. （2.51 ± 0.64） L/s, （0.65 ± 0.20） L/s vs. （1.28 ± 0.33） L/s, （1.22 ± 0.77） L/s vs.（2.18 ± 0.61） L/s], and there were significant difference （P 〈 0.01）. In recovery period, the level of FVC, FEV1, PEF, FEF25, FEF50, FEF75, MMEF75/25 was significantly better than that in acute phase： （98.80 ± 9.34）% vs.（79.14 ± 6.28）%, （98.67 ± 8.28）% vs. （81.63 ± 6.56）%, （86.23 ± 6.86）% vs.（73.17 ± 6.21）%, （85.17 ± 7.86）% vs. （69.79 ± 8.16）%, （79.08 ± 7.99）% vs. （56.57 ± 8.77）%, （70.85 ± 7.48）% vs. （50.66 ± 9.86）%, （77.35 ± 6.81）% vs. （56.19 ± 9.61）%, P 〈 0.01. Conclusions In the acute stage, the pulmonary function of children with MPP shows hybrid ventilation dysfunction. In the recovery period, pulmonary function index improves significantly, but there are still abnormal small airway indicators.