中国实用儿科杂志

中国实用儿科杂志

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潮气呼吸肺功能与呼出气一氧化氮检测对2~5岁哮喘患儿临床价值研究

  

  1. 第四军医大学西京医院儿科, 陕西  西安  710032
  • 出版日期:2018-03-06 发布日期:2018-03-13

Clinical value of the test of tidal breathing lung function and exhaled nitric oxide in asthmatic children aged 2 to 5

  1. Department of Pediatrics，Xijing Hospital of Fourth Military Medical University，Xi’an  710032，China
  • Online:2018-03-06 Published:2018-03-13

摘要：

目的　探讨潮气呼吸肺功能检测及呼出气一氧化氮（FeNO）检测在2～5岁儿童哮喘中的临床价值。方法　选择2012年1月至2015年6月在第四军医大学西京医院儿科首次诊治的216例哮喘儿童为哮喘组，以同期128例正常儿童为对照组。分别测定哮喘患儿急性期及缓解期潮气呼吸肺功能与FeNO水平，并与对照组进行比较。比较支气管舒张试验前后肺功能变化。分析FeNO水平与肺功能参数之间的相关性。结果　哮喘急性期的达峰时间比（TPEF/TE）、达峰容积比（VPEF/VE）均明显低于哮喘缓解期和对照组（均P＜0.05）。哮喘缓解期的TPEF/TE、VPEF/VE有所恢复，但仍低于对照组（P＜0.05）。哮喘组急性期支气管舒张试验后TPEF/TE、VPEF/VE 较试验前明显改善（P＜0.05）。以TPEF/TE、VPEF/VE 任意一个改善率≥15%为舒张试验阳性，阳性率69.90%。哮喘组急性期及缓解期的FeNO ［（35.50±14.13）×10-9，（28.16±5.52）×10-9］均高于对照组（12.77±7.00）×10-9（P＜0.05），且急性期FeNO 水平高于缓解期（P＜0.05）。哮喘组急性期及缓解期TPEF/TE、VPEF/VE均与FeNO无相关性。结论　FeNO、肺功能检测及支气管舒张试验互为补充，共同应用可有助于低龄儿童哮喘管理。

关键词: 潮气呼吸, 肺功能, 呼出气一氧化氮, 儿童, 哮喘

Abstract:

Objective　To study the clinical value of the test of tidal breathing lung function and exhaled nitric oxide in asthmatic children aged 2 to 5. Methods　216 children with asthma treated from January 2012 to June 2015 in the Pediatric Department of Xijing Hospital of Fourth Military Medical University were listed in asthma group，and 128 normal children in the same period were selected as control group. Tidal breathing lung function and exhaled nitric oxide at the acute and remission stages of asthma were tested respectively，and compared with control group. Tidal breathing lung function were compared before and after bronchial dilation test. Correlation between exhaled nitric oxide level and tidal breath lung function parameters was analyzed. Results　The ratio of time to peak tidal expiratory flow to total expiratory time（TPEF/TE） and ratio of volume to peak expiratory flow to total expiratory volume（VPEF/VE） in acute stage of asthma group were significantly lower than those of the asthma group in the remission stage and the control group（P＜0.05）. TPEF/TE and VPEF/VE had significantly improved in asthma group in remission stage，but were still significantly lower than those of the control group（P＜0.05）. TPEF/TE and VPEF/VE had significantly improved after bronchial dilation test in the acute stage of asthma group（P＜0.05）. Taking an improvement rate of ≥15% either for TPEF/TE or for VPEF/VE as an indicator of positive bronchial dilation test，thus the positive rate was 69.90%. The levels of FeNO in acute and remission stages of asthma group［（35.50±14.13）×10-9，（28.16±5.52）×10-9］ were significantly higher than those of the control group［（12.77±7.00）×10-9（P＜0.05）］，and the levels of FeNO in acute stage of asthma group were significantly higher than those of asthma group in remission stage（P＜0.05）. FeNO levels were not correlated with TPTEF/TE and VPEF/VE in acute or in remission stages of asthma group. Conclusion　Tidal breathing lung function，exhaled nitric oxide test and bronchial dilation test are complementary；combined applications can effectively improve the diagnosis and treatment in early childhood asthma.

Key words: tidal breathing, lung function, exhaled nitric oxide, child, asthma