哮喘儿童肺通气功能检测的临床分析

摘要

目的：通过监测哮喘儿童急性发作期与缓解期肺通气功能各指标变化情况，了解其在儿童哮喘病情评估及指导治疗中的作用。方法应用德国Jaeger Master Screen肺功能仪对43例5～12岁哮喘急性发作期和经治疗后进入缓解期的哮喘儿童进行肺通气功能检测，包括大气道指标（ FVC、FEVl、FEV1/FVC、PEF）及小气道指标（ FEF25、FEF50、FEF75、MMEF75/25），同时收集哮喘患儿病史资料和治疗情况。结果哮喘急性发作期患儿肺功能指标FVC、FEV1、FEV1/FVC、PEF与缓解期及健康对照组儿童比较，差异有统计学意义（ P＜0.01）；哮喘缓解期患儿的FVC、FEV1、PEF与健康对照组比较，差异无统计学意义（ P＞0.05）。小气道功能指标FEF25、FEF50、FEF75、MMEF75/25在哮喘急性发作期患儿中均明显降低，与缓解期组及健康对照组儿童相比差异有统计学意义（ P＜0.01）；哮喘治疗缓解期组中FEF25、FEF50、FEF75、MMEF75/25仍低于健康对照组，差异有统计学意义（ P＜0.05）。哮喘急性发作期不同严重程度患儿的肺通气功能指标（ FVC％pred、FEV1％pred、PEF％pred、FEF25％pred、FEF50％pred、FEF75％pred、MMEF75/25％pred ）随哮喘严重程度增加各指标越低，差异有统计学意义（ P＜0.05）。结论哮喘急性发作期肺通气功能受损，治疗缓解后小气道肺功能指标仍低于正常。肺通气功能的小气道功能指标在儿童哮喘的病情评估及治疗监测指导中意义更大。%Objective To study the role of parameters of pulmonary ventilation function in assessing asth-matic status and instructing treatment by measuring parameter of pulmonary ventilation function in children with asth -ma in acute exacerbation and remission .Methods Forty three(5 to 12 years old) children with asthma both in acute exacerbation and in remission after treatment were studied .Pulmonary ventilation function parameters including large-airway pulmonary function values ( FVC, FEV1, FEV1/FVC, PEF) and small-airway pulmonary function measure-ments(FEF25, FEF50, FEF75, MMEF75/25) in all subjects were measured in stage of asthma attack and in remis-sion after treatment respectively by using Jaeger Master Screen diffusion determinator .Also the date of medical history and treatment of asthmatic children was collected at the same time .Results There were statistically significant that pulmonary ventilation function parameters FVC , FEV1, FEV1/FVC, PEF of asthmatic children in acute exacerbation were decreased as compared to that of those in remission and healthy children group ( P<0.01 ); while pulmonary ventilation function parameters including FVC , FEV1, PEF in remission children after therapy with asthma were nor-mal comparing to those of healthy children group (P>0.05).The small airway function parameters FEF25, FEF50, FEF75, MMEF75/25 in children with acute asthma were obviously decreased , which be significantly different from that of those in remission and healthy children (P<0.01);the parameters of FEF25, FEF50, FEF75, MMEF75/25 in asthmatic children of catabasis were lower significantly than that of those in healthy children ( P<0.05 ) .The lower each index of pulmonary ventilation function parameters ( FVC%pred, FEV1% pred, PEF%pred, FEF25%pred, FEF50%pred, FEF75%pred, MMEF75/25%pred) and the more severe in episode in asthmatic children , there were significant difference ( P<0.05 ) .Conclusion There was likely to that the parameters of pulmonary ventilation func-tion in asthmatic children of acute exacerbation were impaired .The parameters of small airway function were still de-creased in asthmatic children in remission after therapy , while that small-airway pulmonary ventilation function pa-rameters were more importance in assessing the state of asthma which could instruct treatment for asthma in children .