婴幼儿呼吸道合胞病毒肺炎潮气呼吸肺功能变化

Change of tidal breathing lung function of infants with respiratory syncytial virus pneumonia

目的探究婴幼儿呼吸道合胞病毒(RSV)肺炎呼出气一氧化氮(FeNO)及潮气呼吸肺功能变化.方法选取2016年8月-2018年8月在湖北省妇幼保健院接受治疗的88例婴幼儿RSV肺炎为病例组;另选同龄健康婴幼儿88名为对照组.检测病例组治疗前后及对照组婴幼儿FeNO水平、潮气呼吸流速-容量(Tidal breath flow-volume,TBFV)环形态及各项指标变化,分析FeNO水平及潮气呼吸肺功能指标与婴幼儿RSV肺炎的相关性.结果病例组治疗前FeNO水平高于对照组,治疗后低于治疗前(均P<0.05).病例组治疗前每千克体质量潮气量(Vt/kg)、吸气时间(T1)、达峰时间比(TPEF/T2)、达峰容积比(VPEF/V2)均低于对照组(P<0.05),呼吸频率(RR)、呼气峰值流速(PEF)、呼气流速(TEF)50%及TEF75%均高于对照组(P<0.05).病例组治疗后TPEF/T2、VPEF/V2、PEF高于对照组(P<0.05).与对照组比较,病例组治疗前TBFV环变窄,降支斜率增大,出现凹陷;治疗后病例组TBFV环形状与对照组类似.FeNO及各项潮气呼吸肺功能指标与婴幼儿RSV肺炎相关(P<0.05).结论婴幼儿RSV肺炎治疗后FeNO水平降低,潮气呼吸肺功能明显改善;FeNO水平及潮气呼吸肺功能与婴幼儿RSV肺炎发生及发展密切相关,可作为临床评估婴幼儿RSV肺炎炎症状态及肺功能损伤程度的可靠指标之一.

OBJECTIVE To explore the changes of fractional exhaled nitric oxide(FeNO)and tidal breath pulmonary function of infants with respiratory syncytial virus(RSV)pneumonia.METHODS Totally 88infants with RSV pneumonia who were treated in the Maternal and Child Health Hospital of Hubei Province from Aug 2016to Aug 2018were assigned as the case group,and 88healthy infants at the same age were set as the control group.The FeNO,tidal breath flow-volume(TBFV)ring morphology and various indicators of the case group and the control group were detected,and the correlation between the FeNO level,tidal breathing lung function indexes and the RSV pneumonia was observed.RESULTS The FeNO level of the case group was significantly higher than that of the case group before the treatment,and it was significantly lower after the treatment than before the treatment(all P<0.05).The tidal volume per kilogram of body mass(Vt/kg),inspiratory time(T1),time to peak ratio(TPEF/T2)and peak volume ratio(VPEF/V2)of the case group were significantly lower than those of the control group before the treatment(P<0.05);the respiratory frequency(RR),peak expiratory flow rate(PEF),expiratory flow rate(TEF)50%and TEF75%of the case group were significantly higher than those of the control group(P<0.05).The TPEF/T2and VPEF/V2and PEF of the case group were significantly higher than those of the control group after the treatment(P<0.05).As compared with the control group,the case group showed the nar-rowed TBFV,increased slope of the descending branch and depression before the treatment;the shape of TBFV loop of the case group was similar to that of the control group after the treatment.The RSV pneumonia in the infants was associated with the FeNO and tidal breath pulmonary function indexes(P<0.05).CONCLUSION The FeNO level of the infants with RSV pneumonia declines after the treatment,and the tidal breath pulmonary function is remarkably improved.The emergence and progression of RSV pneumonia are closely associated with the FeNO level and tidal breathing lung function,which can be served as one of the reliable indexes for clinical assessment of the state of RSV pneumonia and severity of damage of lung function of the infants.