摘要
目的探讨潮气肺功能联合血清25(OH)D水平检测早期诊断儿童哮喘的临床价值。方法选取2018年1月至2020年6月在杨凌示范区医院就诊的75例哮喘患儿作为哮喘组,其中急性发作期40例,缓解期35例,另取同期、同年龄段肺炎患儿75例作为对照组。比较两组之间、哮喘组急性发作期与缓解期患儿之间潮气呼吸肺功能[每公斤体质量潮气量(VT)、达到呼气峰流速的时间与呼气时间的比值即达峰时间比(TPTEF/TE)、达到呼气峰流速时呼出的容积与呼气容积比值即达峰容积比(VPTEF/VE)]及血清25(OH)D水平,并采用受试者工作曲线(ROC)分析潮气呼吸肺功能各项指标、血清25(OH)D水平单独及联合对儿童哮喘早期诊断、急性发作期与缓解期的诊断价值。结果哮喘组和对照组患儿的VT[(5.92±1.34)mL/kg vs(6.45±1.26)mL/kg]、TPTEF/TE[(24.35±3.89)%vs(25.69±3.74)%]、VPTEF/VE[(27.87±3.74)%vs(29.06±3.55)%]、血清25(OH)D[(21.34±6.45)nmol/L vs(33.36±8.49)nmol/L]比较,哮喘组明显低于对照组,差异均有统计学意义(P<0.05);哮喘组急性发作期和缓解期患儿的VT[(5.32±1.25)mL/kg vs(6.52±1.62)mL/kg]、TPTEF/TE[(23.28±3.65)%vs(25.42±4.26)%]、VPTEE/VF[(26.95±3.88)%vs(28.79±3.16)%]、血清25(OH)D[(19.90±5.52)nmol/L vs(22.78±7.12)nmol]比较,急性发作期患儿明显低于缓解期,差异均有统计学意义(P<0.05);ROC曲线分析结果显示,潮气呼吸肺功能指标、血清25(OH)D水平联合对儿童哮喘的早期诊断价值高于各项指标单一检测,差异均有统计学意义(P<0.05);ROC曲线分析结果显示,潮气呼吸肺功能指标、血清25(OH)D水平联合对儿童哮喘急性发作期与缓解期诊断价值高于各项指标单一检测,差异均有统计学意义(P<0.05)。结论潮气肺功能联合血清25(OH)D水平检测能将各自优势互补,有效提高儿童哮喘早期诊断准确性,并有利于判别儿童哮喘严重程度。
Objective To analyze and explore the clinical value of tidal breathing pulmonary function combined with serum 25-hydroxyvitamin D(25(OH)D)in early diagnosis of pediatric asthma.Methods A total of 75 children with asthma treated in Yangling Demonstration Zone Hospital from January 2018 to June 2020 were selected as the observation group,including 40 cases in acute episode and 35 cases in remission stage,and 75 children with pneumonia of the same age were selected as the control group.The tidal respiratory pulmonary function and serum 25(OH)D level were compared between the two groups and between acute attack and remission stage in the observation group.The value of combined diagnosis or separate diagnosis of each index of tidal respiratory pulmonary function and serum 25(OH)D level in the early diagnosis,acute attack and remission stage of childhood asthma was analyzed.Results The tidal volume per kilogram of body weight(VT),time to peak expiratory flow/expiratory time(TPTEF/TE),volume to peak expiratory flow/expiratory volume(VPTEF/VE),and the level of serum 25(OH)D in the asthma group were(5.92±1.34)mL/kg,(24.35±3.89)%,(27.87±3.74)%,(21.34±6.45)nmol/L,respectively,which were significantly lower than corresponding(6.45±1.26)mL/kg,(25.69±3.74)%,(29.06±3.55)%,(33.36±8.49)nmol/L in the control group(all P<0.05).The levels of VT,TPTEF/TE,VPTEE/VF,and serum 25(OH)D of the asthma group in acute attack stage were(5.32±1.25)mL/kg,(23.28±3.65)%,(26.95±3.88)%,(19.90±5.52)nmol/L,respectively,which were significantly lower than corresponding(6.52±1.62)mL/kg,(25.42±4.26)%,(28.79±3.16)%,(22.78±7.12)nmol/L in the remission stage(all P<0.05).The results of ROC analysis showed that the early diagnostic value of tidal respiratory pulmonary function index and serum 25(OH)D in children with asthma was higher than that of single detection(all P<005);the results of ROC analysis showed that the diagnostic value of tidal respiratory pulmonary function index and serum 25(OH)D in children with asthma in acute attack and remission stage was higher than that of single detection(all P<0.05).Conclusion The tidal breathing pulmonary function combined with serum 25(OH)D can complement each other to effectively improve the accuracy of early diagnosis of asthma in children and help to judge the severity of asthma in children.
作者
陈燕鸽
张峰
黄莹
CHEN Yan-ge;ZHANG Feng;HUANG Ying(The Second Ward of Department of Pediatrics,Yangling Demonstration Zone Hospital,Yangling 712100,Shaanxi,CHINA;Department of Pediatrics,Xi'an Jiren Hospital,Xi'an 710032,Shaanxi,CHINA)
出处
《海南医学》
CAS
2021年第15期1975-1978,共4页
Hainan Medical Journal
关键词
儿童哮喘
急性发作期
缓解期
潮气肺功能
血清25(OH)D
早期诊断
Pediatric asthma
Acute attack stage
Remission stage
Tidal breathing pulmonary function
Serum 25-hydroxyvitamin D(25(OH)D)
Early diagnosis
