肺功能检查和静脉血过敏原检测在3岁以内哮喘预测指数阳性患儿中的应用价值

Values of pulmonary function and venous blood allergen in asthma prediction index positive children with age≤3 years old

目的评价肺功能检查和静脉血过敏原检测在3岁以内哮喘预测指数阳性患儿中的应用价值。方法连续选择2016年6月-2018年2月在该院诊断为哮喘预测指数阳性的3岁以内患儿60例,阴性患儿60例,采用婴幼儿潮气呼吸肺功能检测达峰时间比(Tpef/Te)、达峰容积比(Vpet/VTex)、潮气量(VT/kg)、呼吸频率(F)、吸呼比(Ti/Te)、呼出50%潮气容积的呼吸流速比(TEF50/TIF50),支气管舒张试验阳性率;吸入过敏原和食入过敏原的阳性率;分别以肺功能、静脉血过敏原和两者联合作为诊断哮喘预测指数阳性患儿的指标,采用受试者工作曲线(ROC)分析诊断灵敏度和特异度。结果阳性组肺功能指标中Tpef/Te和Vpet/VTex降低,VT/kg减小,TEF50/TIF50降低,支气管舒张试验阳性率增加,差异有统计学意义(P<0. 05)。阳性组吸入和食入过敏原的阳性率均明显高于阴性组(P<0. 05)。ROC分析得出:肺功能诊断哮喘预测指数阳性的灵敏度为85. 6%,特异度为88. 9%,准确性(曲线下面积AUC值)为0. 826;过敏原诊断的灵敏度为82. 3%,特异度为86. 6%,准确性为0. 806;联合诊断的灵敏度为89. 5%,特异度为92. 3%,准确性为0. 865。结论肺功能检查和静脉血过敏原检测对评估3岁以内哮喘预测指数阳性患儿具有较好的应用价值。

Objective to study values of pulmonary function and venous blood allergen in asthma prediction index positive children with age≤3 years old.Methods A total of 60 consecutives as asthma prediction index positive and other 60 of negative children with age≤3 years old from June 2016 to February 2018 were enrolled,then to compare differences of tidal breathing lung function in infants including Tpef/Te,Vpet/VTex,VT/kg,F,Ti/Te,TEF50/TIF50 and positive rate of bronchial dilation test;the positive rates of inhaled and ingested allergens;to analyze sensitivity and specificity of diagnosing asthma prediction index positive by receiver operating curve(ROC)with single pulmonary function,single allergen and combined with them respectively.Results The Tpef/Te,Vpet/VTex,VT/kg and TEF50/TIF50 in asthma prediction index positive group were all significantly lower,while positive rate of bronchial dilation test was more than negative group(P<0.05).What’s more,the positive rates of inhaled and ingested allergens in positive group were both higher,too(P<0.05).The sensitivity of single pulmonary function was 85.6%,specificity 88.9%,accuracy with area under the curve(AUC)0.826 by ROC analysis,they were 82.3%,86.6%and 0.806 of single allergen,they were 89.5%,92.3%and 0.865 of combination.Conclusion It is better value of combination with pulmonary function and Venous blood allergen for asthma prediction index positive children with age≤3 years old.