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目的探讨脉冲振荡肺功能在儿童支气管哮喘(哮喘)中的临床意义。方法选取哮喘患儿60例。其中急性发作期36例(急性发作组),临床缓解期24例(临床缓解组),健康儿童20例(健康对照组)。采用Master Screen脉冲振荡肺功能仪分别检测3组肺功能情况。结果哮喘急性发作组患儿振荡频率5 Hz、20 Hz时呼吸道阻力(R5、R20)(单位:Kap.L-1.s-1)、振荡频率在5 Hz、20 Hz时呼吸道阻力之差(R5-R20)为周围呼吸道阻力、肺弹性阻力(X5)的负值、呼吸阻抗(Zrs)及共振频率(Fres)[分别为(1.28±0.31)、(0.85±0.13)、(0.43±0.23)、(-0.59±0.19)、(1.42±0.37)Kap.L-1.s-1和(25.32±3.00)Hz]均较临床缓解组[分别为(0.81±0.11)、(0.56±0.24)、(0.23±0.99)、(-0.27±0.08)、(0.86±0.11)Kap.L-1.s-1和(20.41±1.98)Hz]、健康对照组[分别为(0.63±0.03)、(0.48±0.23)、(0.27±0.11)、(-0.23±0.05)、(0.52±0.21)Kap.L-1.s-1和(14.30±0.85)Hz]高(Pa<0.001)。临床缓解组患儿R5、Zrs、Fres较健康对照组仍高(t=6.79、6.80、12.83,Pa<0.001)。而R20、R5-R20、X5差异无统计学意义(t=1.14、1.33、1.79,Pa>0.05)。结论脉冲振荡肺功能可提供哮喘发作及缓解的各项客观指标,并可作为哮喘患儿肺功能检测及治疗监测的方法。
Objective To investigate the clinical significance of pulsatile pulmonary function in children with bronchial asthma (asthma). Methods Sixty children with asthma were selected. Among them, 36 cases were acute exacerbation (acute attack), 24 were clinical remission (remission) and 20 were healthy children (healthy control). The Master Screen pulse oscillation pulmonary function test were used to detect the lung function of the three groups. Results The respiratory resistance (R5, R20) (unit: Kap.L-1.s-1) at 20 Hz and the respiratory rate at 5 Hz and 20 Hz R5-R20) were the respiratory resistance, the negative values of X5, Zrs and Fres [(1.28 ± 0.31), (0.85 ± 0.13) and (0.43 ± 0.23) resp. , (-0.59 ± 0.19), (1.42 ± 0.37) Kap.L-1.s-1 and (25.32 ± 3.00) Hz, respectively, were significantly lower than those in the clinical remission group (0.81 ± 0.11 and 0.56 ± 0.24, (0.23 ± 0.99), (-0.227 ± 0.08), (0.86 ± 0.11) Kap.L-1.s-1 and (20.41 ± 1.98) Hz respectively in healthy controls [ ± 0.23), (0.27 ± 0.11), (-0.223 ± 0.05), (0.52 ± 0.21) Kap.L-1.s-1 and (14.30 ± 0.85) Hz], respectively. R5, Zrs, Fres in children with remission were still higher than those in healthy controls (t = 6.79,6.80,12.83, Pa <0.001). There was no significant difference between R20, R5-R20 and X5 (t = 1.14,1.33,1.79, Pa> 0.05). Conclusion Pulsed oscillation pulmonary function can provide various objective indicators of asthma attack and remission, and can be used as a method of lung function test and treatment monitoring in children with asthma.