脉冲振荡肺功能检查在学龄前儿童哮喘诊断中的价值

Clinical Significance of Impulse Oscillometry Pulmonary Function Test in the Diagnosis of Asthma in Preschool Children

目的 探讨脉冲振荡(IOS)肺功能检查在学龄前儿童哮喘诊断中的价值。方法 将96例学龄前哮喘患儿作为研究组,96例健康儿童作为对照组,比较2组IOS肺功能检查参数[总呼吸黏性阻力(R5)、周边气道黏性阻力(R5-R20)、中心气道黏性阻力(R20)、共振频率(Fres)]、常规肺功能指标[用力肺活量(FVC)、呼气峰流速(PEF)、第1秒用力呼气容积(FEV1)]。将研究组患儿按哮喘急性发作程度分为轻度组、中度组、重度组,比较不同病情程度患儿IOS肺功能检查参数、哮喘控制测试(ACT)评分、常规肺功能指标,分析IOS肺功能检查参数与ACT评分、常规肺功能指标的关系。结果 研究组R5、R5-R20、Fres、R20值均显著高于对照组(P<0.001),FVC、PEF、FEV1值均显著低于对照组(P<0.001)。研究组患儿R5、R5-R20、Fres、R20值随着病情的加重而增加,FVC、PEF、FEV1值及ACT评分随着病情的加重而降低,上述指标不同病情患儿之间比较差异均有统计学意义(P<0.001)。IOS肺功能检查参数与ACT评分、常规肺功能指标均呈显著负相关(P<0.05)。结论 IOS肺功能检查参数随学龄前儿童哮喘发生发展而变化,在学龄前儿童哮喘临床诊断及疗效监测中有较高的应用价值。

Objective To explore the clinical significance of impulse oscillometry(IOS)pulmonary function test in the diagnosis of asthma in preschool children.Methods 96 preschool children with asthma were established as the study group and 96 healthy children were selected as the control group;the IOS pulmonary function test parameters[total respiratory viscous resistance(R5),peripheral airway viscous resistance(R5-R20),central airway viscous resistance(R20),and resonance frequency(Fres)],and conventional pulmonary function indices[forceful lung volume(FVC),peak expiratory flow rate(PEF),exertional expiratory volume in the first second(FEV1)]were compared between the two groups.The children in the study group were divided into mild,moderate and severe groups according to the degree of acute asthma exacerbation;the IOS pulmonary function test parameters,asthma control test(ACT)scores,and conventional lung function indexes of the children with different degrees of asthma were compared;the relationship between the IOS pulmonary function test parameters and ACT scores and conventional lung function indexes was analyzed.Results R5,R5-R20,Fres,and R20 of the study group were significantly higher than those of the control group(P<0.001);FVC,PEF,and FEV1 were significantly lower than those of the control group(P<0.001).R5,R5-R20,Fres and R20 of the study group increased with the aggravation of asthma,whereas FVC,PEF,FEV1 and ACT scores decreased with the aggravation of the disease;the differences of the above indexes were statistically significant when compared between the children with different degrees of asthma(P<0.001).The parameters of the IOS pulmonary function tests suggested a significant negative correlation with the ACT scores and the conventional pulmonary function indexes(P<0.05).Conclusion The parameters of IOS pulmonary function test might change with the development of asthma in preschool children,and its application might be clinically significant in the diagnosis and efficacy monitoring of asthma in preschool children.