摘要
目的对婴幼儿哮喘和肺炎患儿行支气管舒张剂吸入前后潮气呼吸容积曲线检测,探讨各肺功能参数改变特点,为临床医师诊断婴幼儿哮喘提供客观依据。方法选择婴幼儿哮喘患儿105例,肺炎患儿26例。使用Jaeger公司Masterscreen Paed型肺功能仪,镇静后行支气管舒张剂吸入前后潮气呼吸容积曲线检测。根据婴幼儿患儿基础肺功能测定结果分轻度通气障碍组(达峰时间比≥15%,59例)和重度通气障碍组(达峰时间比<15%,46例)进行比较。结果1.肺炎患儿予支气管舒张剂后,除潮气量上升(P<0.01),呼吸频率亦增加(P<0.05),其他指标改善均无统计学意义。2.所有哮喘患儿予支气管舒张剂后,其潮气量、吸气时间、达峰容积比上升,改善有统计学意义(P<0.05,0.01)。3.吸呼比、达峰时间较吸入支气管舒张剂后略有升高,但差异均无显著意义(P>0.05),而呼气时间、呼吸频率几乎无变化。轻、重度组比较发现,轻度组支气管舒张试验前后各参数均无显著改善(P>0.05),而重度组患儿除呼吸频率、呼气时间吸入支气管舒张剂前后无明显改善外,其他参数均显著上升(P<0.05),尤以潮气量、达峰时间比、达峰容积比改善最显著。结论婴幼儿哮喘患儿吸入支气管舒张剂前后改变能在一定程度上反映其呼吸道可逆性阻塞特征,尤其在重症喘息患儿的意义更大。使用潮气呼吸模式进行潮气肺功能检测有其局限性,临床医师应结合患儿临床表现进行综合判断。
Objective To evaluate the effect of nebulized bronchodilator on the change of tidal breathing in infants with asthma. This may provide some objective evidence for clinical diagnosis. Methods One hundred and five infants with asthma and 26 cases with pneumonia were involved for the study. Tidal breathing flow - volume was obtained before and 10 - 15 minutes ＇after nebulized bronchodilator was given. According to the basic lung tunction resuhs,59 cases as a mild group [the ratio of time taken to reach peak expiratory flow to total expiratory time （TPTEF/Te） ≥ 15% ], and 46 cases of the infant asthma as a severe group（ TPTEF/Te 〈 15% ） were indentified. Comparison was made between the 2 groups. Results 1. After inhaling bronchodilator, except for an increase of tidal volume per kilogram（VT/kg） （ P〈0.01 ） and respiratory rate （RR） （ P 〈 0.05 ）, there were no significant differences in other indices in children with pneumonia. 2. VT/kg, inspiratory time （Ti）, the ratio of peak expiratory volume to total expiratory volume（VPEF/Ve） significantly increased after bronchodilator inhalation in all intants with asthma （ P 〈0.05,0.01 ）. 3. In comparison,the mild group had no significant change of lung function indices after bronchodilatation （P 〉 0.05 ）. Moreover, in severe group, expect for RR and expiratory time（ Te）, the other indices significantly increased after administration of nebulized brouchodilator（ P 〈 0.05 ） ,especially in the increase of VT/kg,TPTEF/Te and VPEF/Ve. Conclusions The results suggest that the change of lung function after nebulized branchodilator administration in infants with asthma can reflect a reversal of airway obstruction, which is especially prominent in severe group. The test may provide some laboratory reference in the diagnosis of infant asthma. Although there exists certain limitation, diagnosis shall Ire made in combination with the clinical manifestations and consideration.
出处
《实用儿科临床杂志》
CAS
CSCD
北大核心
2007年第19期1475-1476,1480,共3页
Journal of Applied Clinical Pediatrics
