肺功能脉冲震荡参数联合哮喘预测指数在儿童哮喘中的诊断作用

The diagnostic value of pulmonary function impulse shock parameters combined with asthma predictive index in childrenwithasthma

目的 探究肺功能脉冲震荡参数(IOS)联合哮喘预测指数(API)在儿童哮喘中的诊断作用。方法 以在东莞市人民医院接受治疗的200例哮喘患儿作为哮喘组,健康对照组选体检健康的儿童50例,检测受试者API、IOS[震荡频率20 Hz时呼吸道阻力(R20)、肺弹性阻力(X5)、共振频率(Fres)及震荡频率5 Hz时呼吸道阻力(R5)]。结果 API阳性者在哮喘组中有172例,占比86.00%,明显高于对照组的API阳性者6例,占比12.00%(P<0.05);哮喘组患儿R5、R20、Fres均明显高于对照组(P<0.05),X5明显低于对照组(P<0.05)。多因素Logistic回归分析结果显示,R5、X5、R20、Fres以及API均是儿童发生哮喘的危险因素(P<0.05);将哮喘患者R5、X5、R20、Fres以及API各指标作为检验变量进行ROC分析,结果显示,SR5、X5、R20、Fres以及API的AUC分别为0.877,0.915,0.917,0.888,0.872,五项联合对哮喘预测的AUC为0.999,高于各指标单独检测(P<0.05)。结论 儿童哮喘使用IOS与API联合检测敏感性及特异性较高,能够为诊断提供判断依据,具有一定的临床价值。

Objective To investigate the diagnostic role of pulmonary function impulse oscillation parameters(IOS)combined with asthma prediction index(API)in children with asthma.Methods Two hundred children with asthma treated in the people's hospital of Dongguan city were used as the asthma group,and 50 children with healthy control group were selected from physical examination.Subjects were tested for API,IOS[respiratory resistance at oscillation frequency 20 Hz(R20),pulmonary elastic resistance(X5),resonance frequency(Fres)and respiratory resistance at oscillation frequency 5 Hz(R5)].Results API-positive individuals were significantly higher in the asthma group in 172 cases(86.00%)than in the control group in 6 cases(12.00%)of API-positive individuals(P<0.05);children in the asthma group had significantly higher R5,R20 and Fres(P<0.05)and significantly lower X5(P<0.05)than in the control group;multifactorial Logistic regression analysis,the results showed that R5,X5,R20,Fres and API were all risk factors for the development of asthma in children(P<0.05);ROC analysis was performed by using each index of R5,X5,R20,Fres and API in asthma patients as test variables,and the results showed that the AUC of SR5,X5,R20,Fres and API were 0.877,0.915,0.917,0.888,and 0.872,respectively,and the AUC of the combination of the five items for asthma prediction was 0.999,which was higher than that of each index tested separately(P<0.05).Conclusion The combined test of IOS combined with API in children's asthma has higher sensitivity and specificity,which can provide a basis for the diagnosis of asthma in children and has certain application value.