潮气呼吸肺功能在反复喘息婴幼儿中的应用及临床意义

摘要

目的：探讨不同类型反复喘息婴幼儿潮气呼吸肺功能的变化及临床意义。方法选取2013年10月至2014年2月收治的3岁以下反复喘息患儿80例，根据哮喘预测指数分为阳性组和阴性组，分别在入院时(急性期)、出院时(缓解期)和出院后1周(恢复期)测定其潮气呼吸肺功能，比较两组喘息患儿的达峰时间比(TPTEF/TE)和达峰容积比(VPEF/VE)；并与20例健康儿童对照比较。结果从急性期、缓解期至恢复期，阳性组和阴性组的TPTEF/TE和VPEF/VE均呈上升趋势，不同时期之间的差异均有统计学意义(P均=0.000)。急性期时，TPTEF/TE和VPEF/VE在阳性组和阴性组间的差异无统计学意义(P>0.05)，但均低于对照组，差异有统计学意义(P<0.05)；到缓解期时，阴性组的TPTEF/TE和VPEF/VE均已高于阳性组，但低于对照组，差异有统计学意义(P<0.05)；恢复期时，阴性组和对照组间TPTEF/TE、VPEF/VE的差异无统计学意义(P>0.05)，且均高于阳性组，差异有统计学意义(P<0.05)。结论哮喘预测指数阳性婴幼儿的肺功能损害比哮喘预测指数阴性患儿持续时间长；运用潮气呼吸肺功能为反复喘息婴幼儿预测哮喘提供客观的临床指标。%Obiective To explore the dynamics of tidal breathing pulmonary function in infants with recurrent wheeze and its clinical signiifcance. Methods Eighty (80) infants with recurrent wheeze from October 2013 to February 2014 were enrolled and divided into asthma predictive index positive (n=25) and asthma predictive negative (n=55) groups, and another 20 healthy children were enrolled as control group. Tidal breath pulmonary function at the time of admission (acute phase), leaving hospital (remission phase), and a week after discharge (admission phase) were tested, the ratio of time taken to reach peak expiratory lfow to total expiratory time(TPTEF/TE)and ratio of peak expiratory volume to total expiratory volume(VPEF/VE) between groups were compared. Results From acute phase and remission phase to admission phase, TPTEF/TE, VPEF/VE were elevated in positive group and negative group showing signiifcant statistical difference between phases (P=0.000). In acute phase, TPTEF/TE, VPEF/VE showed no statistical difference (P>0.05) between positive group and negative group, when compared with control group, TPTEF/TE, VPEF/VE were signiifcantly lower in positive and negative groups than that in control group (P<0.05). In remission phase, TPTEF/TE, VPEF/VE in negative group were higher than that in positive group, but significantly lower than that in control group (P<0.05). In admission phase, TPTEF/TE and VPEF/VE in negative group and control group showed no statistical difference (P>0.05), but significantly higher than that in positive group (P<0.05). Conclusions Lung function impairment duration was longer in asthma predictive index positive children than in asthma predictive index negative children. The tidal breathing pulmonary function test can provide objective clinical indicators for infants with recurrent wheeze to predict asthma.