Abstract:

Objective　To investigate the factors influencing the improvement of tidal lung function bronchodilation test，and to provide evidence for the diagnosis of infant asthma. Methods　Totally 71 infant patients diagnosed with asthma were included from clinic of Children’s Hospital of Capital Institute of Pediatrics and alternativley assigned into two groups，who respectively received bronchodilator via pMDI（pMDI group）or nebulization（nebulization group），and bronchodilation test was performed. The effects of drug delivering methods on the bronchodilation test was compared，and the main observation indexes were respiratory rate（RR），VT/kg，inspiratory time（Ti），expiratory time（Te），Ti/Te，time to peak tidal expiratory flow as a proportion of expiratory time（TPTEF/TE），volume to peak expiratory flow as a proportion of exhaled volume（VPEF/VE） and peak tidal expiratory flow（PTEF）. Further analysis was carried within each group. Results　Twenty patients received bronchodilator via pMDI，and fifty-one patients received bronchodilator via nebulization. After drug delivery，the RR of the children in the pMDI group decreased significantly（P＝0.003），and the Ti increased significantly（P＝0.011）. The VT/kg，Ti，Ti/Te，TPTEF/TE and VPEF/VE increased significantly in nebulization group（all P＜0.05）. In the nebulization group，the improvement rate of TPTEF/TE and VPEF/VE were significantly higher than that of pMDI group（all P＜0.05）. In the pMDI group，the Te，Ti/Te，TPTEF/TE and VPEF/VE significantly improved in patients with severe airway obstruction（all P＜0.05）. The above parameters also improved after bronchodilation test in nebulization group. Compared in difference age groups，TPTEF/TE and VPEF/VE in children over 2 years improved more significantly than those in children under 1 year（all P＜0.05）. Conclusion　The effects of nebulization are better than pMDI in tidal lung function bronchodilation test. The improvement rate of tidal lung function is related to the degree of airway obstruction and the age of patients.

Key words: tidal lung function, infant, bronchodilation test, drug delivery method

摘要：

目的　探讨影响潮气肺功能支气管舒张试验参数改善的因素，为婴幼儿哮喘的诊断提供参考依据。方法　选择2017年3月至2018年6月就诊于首都儿科研究所哮喘门诊、经临床明确诊断为支气管哮喘且处于急性发作期（喘息发作≤7 d）的71例婴幼儿，将患儿依就诊顺序分为气雾剂组20例及雾化组51例，前者采用定量气雾剂给予支气管舒张剂，后者采用雾化吸入给予支气管舒张剂。2组患儿均进行潮气肺功能支气管舒张试验，比较两种给药方式对支气管舒张试验结果的影响，主要观察参数包括呼吸频率、潮气量、吸气时间、呼气时间、吸呼比、达峰时间比、达峰容积比、呼气峰流量；随后进行组内分析，进一步探讨各参数改善率的影响因素。结果　给药后，气雾剂组患儿呼吸频率显著下降（P＝0.003），吸气时间显著延长（P＝0.011）；雾化组患儿潮气量、吸气时间、吸呼比、达峰时间比、达峰容积比显著上升（均P＜0.05）。雾化组患儿吸呼比、达峰容积比上升幅度显著高于气雾剂组（均P＜0.05）。气雾剂组内，与气道轻度阻塞患儿比较，气道重度阻塞患儿给药后，吸呼比、达峰时间比、达峰容积比改善显著（均P＜0.05）；雾化组内，气道重度阻塞患儿给药后，以上参数亦明显改善。雾化组不同年龄组间比较，2岁以上患儿达峰时间比、达峰容积比上升幅度显著高于1岁以下患儿（均P＜0.05）。结论　通过潮气肺功能技术进行支气管舒张试验，雾化吸入给药方式的舒张效果优于定量气雾剂；给药后肺功能参数的改善与气道阻塞程度有关，也与患儿年龄有关。

关键词: 潮气肺功能, 婴幼儿, 支气管舒张试验, 给药方法