| 廉建丽,李继玲,陈俊松.小气道功能指标在儿童哮喘病情严重程度评估及临床诊断中的应用[J].安徽医药,2019,23(6):1101-1104. |
| 小气道功能指标在儿童哮喘病情严重程度评估及临床诊断中的应用 |
| Application of small airway function indexes in assessment of the severity and clinical diagnosis of asthma in children |
| 投稿时间：2017-09-17 |
| DOI： |
| 中文关键词: 小气道功能指标 儿童 哮喘 价值 |
| 英文关键词: Small airway function index Children Asthma Value |
| 基金项目: |
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| 中文摘要: |
| 目的 探讨小气道功能指标在儿童哮喘病情严重程度评估及临床诊断中的应用价值。方法 选取2013年5月至2016年4月于郑州市第二人民医院56例哮喘急性发作期病儿作为哮喘组,并根据哮喘急性发作严重程度分为轻度(21例)、中度(20例)和重度(15例)三个亚组,同时选取同期、年龄相仿及性别相匹配的30例因其他原因引起喘息咳嗽的慢性炎症病儿和32例入院检查健康儿童分别作为非哮喘组和对照组,收集各组儿童一般资料,采用肺功能测定系统检测各组儿童用力肺活量(FVC)、最大呼气流量(PEF)、第1秒用力呼气容积(FEV1)和FEV1/FVC比值、呼出25%肺活量时呼气流速(FEF25%)、呼出50%肺活量时呼气流速(FEF50%)、呼出75%肺活量时呼气流速(FEF75%)、最大中期呼气流速(MMEF)等指标。结果 与对照组比较,非哮喘组和哮喘组病儿FVC、FEV1、PEF、FEF25%、FEF50%、FEF75%和MMEF等指标均显著降低(P<0.05),且哮喘组病儿上述指标显著低于非哮喘组[(1.42±0.36)L比(1.85±0.47)L、(1.25±0.32)L比(1.42±0.41)L、(2.68±0.64)L比(3.25±0.77)L/s、(2.54±0.65)L/s比(3.74±0.68)L/s、(1.58±0.36)L/s比(2.24±0.71)L/s、(0.61±0.37)L/s比(1.02±0.41)L/s、(1.42±0.49)L/s比(1.89±0.68)L/s)](均P<0.05),而三组病儿FEV1/FVC指标差异无统计学意义(P>0.05)。哮喘急性发作期不同程度病儿用力呼出25%肺活量的呼气流量占预计值百分比(FEF25pred%)、用力呼出50%肺活量的呼气流量占预计值百分比(FEF50pred%)、用力呼出75%肺活量的呼气流量占预计值百分比(FEF75pred%)、最大呼气中期流量占预计值的百分比(MMEFpred%)等指标比较差异有统计学意义(P<0.05),且随着病情程度增加,病儿FEF25pred%、FEF50pred%、FEF75pred%、MMEFpred%等指标呈现明显降低趋势(P<0.05),FEF25%和FEF75%指标在不同严重程度哮喘病儿中异常率比较,差异有统计学意义(P<0.05),FEF50%和MMEF指标比较差异无统计学意义(P>0.05),其中FEF25%主要表现为轻度异常,而FEF75%主要表现为重度异常。结论 小气道功能指标在儿童哮喘病情严重程度评估及临床诊断具有重要意义,随着病情加剧,小气道功能指标明显降低,且异常率显著增加。 |
| 英文摘要: |
| Objective To explore the value of small airway function indexes in assessment of the severity and clinical diagnosis of asthma in children.Methods Fifty-six cases of children with acute asthma admitted to Zhengzhou Second People's Hospital from May 2013 to April 2016 were selected as the asthma group and assigned into the mild (n=21),moderate (n=20),and severe (n=15) subgroups according to the severity of acute asthma.And other 30 children with chronic inflammation (wheezing cough) caused by other reasons and with the similar age and gender at the same time period and 32 healthy children admitted to hospital for examination were selected as the non-asthma group and the control group respectively.The general information of all children were collected,and forced vital capacity (FVC),peak expiratory flow (PEF),forced expiratory volume in one second (FEV1) and the ratio of FEV1/FVC,exhaled 25% FVC expiratory flow (FEF25%),exhaled 50% FVC expiratory flow (FEF50%),exhaled 75% FVC expiratory flow (FEF75%),maximal midexpiratory flow rate (MMEF) and other indicators were measured by pulmonary function determination system.Results Compared with control group,the levels of FVC,FEV1,PEF,FEF25%,FEF50%,FEF75% and MMEF in the non-asthma group and the asthma group were significantly decreased (P<0.05),and the above indexes levels in the asthma group were lower than those in the non-asthma group [(1.42±0.36) L vs. (1.85±0.47) L,(1.25±0.32) L vs. (1.42±0.41) L,(2.68±0.64) L/s vs. (3.25±0.77) L/s,(2.54±0.65) L/s vs. (3.74±0.68) L/s,(1.58±0.36) L/s vs.(2.24±0.71) L/s,(0.61±0.37) L/s vs. (1.02±0.41)L/s,(1.42±0.49) L/s vs. (1.89±0.68) L/s)] (all P<0.05),and there was no significant difference in the FEV1/FVC index among the three groups (P>0.05).There were significant differences in the percentage of expiratory exhalation flow of 25% forced vital capacity in predicted value (FEF25pred%),FEF50pred%,FEF75pred% and MMEFpred% of acute asthma children at acute stage with different degrees (P<0.05),and with the increased severity,the FEF25pred%,FEF50pred%,FEF75pred% and MMEFpred% were significantly decreased (P<0.05).And there were significant differences in the abnormal rates of FEF25%,FEF75%(P<0.05).There are no significant differences in the percentage of EFF50% and MMEF(P>0.05) The FEF25% was mainly shown as mild abnormalities,and FEF50% was shown as mild.Conclusion Small airway function indexes have important significance in children's asthma severity assessment and clinical diagnosis.With the exacerbation of the disease,small airway function indexes are significantly reduced and the abnormal rate is significantly increased. |
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