肺功能监测在儿童支气管哮喘中的应用研究

Application of pulmonary function monitoring in children with bronchial asthma

目的研究肺功能监测在儿童支气管哮喘中的应用价值。方法选取82例支气管哮喘患儿作为研究对象,所有患儿入院前均未实施正规的吸入激素治疗,在入院后给予支气管扩张剂、糖皮质激素等药物治疗,患儿症状缓解后应用沙美特罗替卡松气雾剂(商品名:舒利迭)进行吸入治疗。对患儿治疗前及治疗1、2、3个月后均进行肺功能检测,比较不同时间段肺功能变化情况及肺功能指标异常情况。结果治疗前,患儿最大呼气流量占预计值的百分比(PEF%)、第1秒用力呼气容积占预计值的百分比(FEV1%)、25%用力呼气肺活量占预计值的百分比(FEF25%)、50%用力呼气肺活量占预计值的百分比(FEF50%)、75%用力呼气肺活量占预计值的百分比(FEF75%)分别为(68.10±3.44)、(72.06±3.22)、(51.22±3.72)、(50.33±3.82)、(43.24±3.39)%;治疗1个月后,患儿PEF%、FEV1%、FEF25%、FEF50%、FEF75%分别为(78.03±3.45)、(79.14±2.26)、(62.09±2.41)、(60.61±3.20)、(52.40±2.26)%;治疗2个月后,患儿PEF%、FEV1%、FEF25%、FEF50%、FEF75%分别为(81.13±2.24)、(82.15±3.28)、(70.19±3.16)、(70.22±4.31)、(68.44±3.32)%;治疗3个月后,患儿PEF%、FEV1%、FEF25%、FEF50%、FEF75%分别为(85.26±4.48)、(84.15±3.32)、(82.03±4.55)、(80.90±2.44)、(81.30±3.60)%;治疗3个月后,患儿PEF%、FEV1%、FEF25%、FEF50%、FEF75%均高于治疗前及治疗1、2个月后,差异有统计学意义(P<0.05);治疗2个月后,患儿PEF%、FEV1%、FEF25%、FEF50%、FEF75%均高于治疗1个月后及治疗前,差异有统计学意义(P<0.05);治疗1个月后,患儿PEF%、FEV1%、FEF25%、FEF50%、FEF75%均高于治疗前,差异有统计学意义(P<0.05)。治疗3个月后,患儿PEF异常率、FEV1异常率、FEF25异常率、FEF50异常率、FEF75异常率均低于治疗前及治疗1、2个月后,差异有统计学意义(P<0.05);治疗2个月后,患儿PEF异常率、FEV1异常率均低于治疗前及治疗1个月后,差异有统计学意义(P<0.05),FEF25异常率、FEF50异常率、FEF75异常率与治疗前及治疗1个月后比较差异无统计学意义(P>0.05);治疗1个月后,患儿PEF异常率、FEV1异常率均低于治疗前,差异有统计学意义(P<0.05),FEF25异常率、FEF50异常率、FEF75异常率与治疗前比较差异无统计学意义(P>0.05)。结论肺功能监测用于儿童支气管哮喘中能诊断患儿病情,对患儿气道功能恢复情况进行动态的观察,为临床治疗方案的制定提供重要参考。

Objective To study the application value of pulmonary function monitoring in children with bronchial asthma.Methods There was 82 children with bronchial asthma as study subjects.Before admission,all the children received no regular inhaled hormone treatment,and,they received bronchodilator,glucocorticoid and other drugs after admission.Salmeterol and fluticasone aerosol(trade name:Seretide)were used for inhalation treatment after symptom relief.Pulmonary function was detected before treatment and 1,2 and 3 months after treatment,and the changes of pulmonary function and the abnormalities of pulmonary function indexes in different periods were compared.Results Before treatment,percentage of peak expiratory flow to predicted value(PEF%),percentage of forced expiratory volume in one second(FEV1%),percentage of 25%forced expiratory flow to predicted value(FEF25%),percentage of 50%forced expiratory flow to predicted value(FEF50%)and percentage of 75%forced expiratory flow to predicted value(FEF75%)were(68.10±3.44),(72.06±3.22),(51.22±3.72),(50.33±3.82)and(43.24±3.39)%respectively,which was(78.03±3.45),(79.14±2.26),(62.09±2.41),(60.61±3.20),(52.40±2.26)%after 1 month of treatment,(81.13±2.24),(82.15±3.28),(70.19±3.16),(70.22±4.31),(68.44±3.32)%after 2 months of treatment,and(85.26±4.48),(84.15±3.32),(82.03±4.55),(80.90±2.44),(81.30±3.60)%after 3 months of treatment.After 3 months of treatment,the PEFT,FEV1 T,FEF25 T,FEF50%and FEF75%was higher than those before treatment and after 1 and 2 months of treatment,and their difference was statistically significant(P<0.05).After 2 months of treatment,the PEF%,FEV1%,FEF25%,FEF50%and FEF75%was higher than those before treatment and after 1 month of treatment,and their difference was statistically significant(P<0.05).After 1 month of treatment,the PEF%,FEV1%,FEF25%,FEF50%and FEF75%was higher than those before treatment,and the difference was statistically significant(P<0.05).After 3 months of treatment,the PEF%abnormal rate,FEV1%abnormal rate,FEF25%abnormal rate,FEF50%abnormal rate,FEF75%abnormal rate was lower than those before treatment and after 1 and 2 months of treatment,and the difference was statistically significant(P<0.05).After 2 months of treatment,the PEF%abnormal rate and FEV1%abnormal rate was lower than those before treatment and after 1 month of treatment,and the difference was statistically significant(P<0.05).There was no statistically significant difference in FEF25%abnormal rate,FEF50%abnormal rate and FEF75%abnormal rate after 2 months of treatment,compared with those 1 month after treatment(P>0.05).After 1 month of treatment,the PEF%abnormal rate and FEV1%abnormal rate was lower than those before treatment,and their difference was statistically significant(P<0.05).There was no statistically significant difference in FEF25%abnormal rate,FEF50%abnormal rate and FEF75%abnormal rate after 1 month of treatment,compared with those before treatment(P>0.05).Conclusion For children with bronchial asthma,pulmonary function monitoring can dynamically observe children’s airway function recovery,so as to provides an important reference for the development of clinical treatment plan.