脉冲振荡肺功能支气管舒张试验阳性患儿的肺功能特征

目的 探讨脉冲振荡肺功能（IOS）支气管舒张试验阳性患儿的肺功能特征,为临床诊治及IOS测定提供依据.方法 选取进行IOS支气管舒张试验测定的患儿70例,其中支气管舒张试验阳性40例,定为阳性组,支气管舒张试验阴性30例,定为阴性组,对两组患儿的主要肺功能参数呼吸总阻抗（Z5）、气道总黏性阻力（R5）、周边气道弹性阻力（X5）、周边气道黏性阻力（Rp）进行分析.结果 阳性组Z5、R5、X5分别为（123.45±24.75）％、（120.09±25.40）％、（138.62±33.48）％,均高于阴性组的（103.89±16.30）％、（102.67±18.16）％,（111.85±14.93）％,差异均有统计学意义（P＜0.05）;阳性组Rp≥19.89 cmH2O/（L·s）（1 cmH2O=0.098 kPa）比例为50.00％（20/40）,高于阴性组的23.33％（7/30）,差异有统计学意义（P＜0.05）.结论 IOS支气管舒张试验阳性患儿的气道阻力明显增高,以X5增高最显著;在各项参数≥100％时,尤其是在X5≥100％时,建议行支气管舒张试验,以降低支气管哮喘的漏诊率.

Characteristics of pulmonary function in children patients with positive bronchodilating response using impulse oscillation system

Objective To discuss the characteristics of pulmonary function in children patients with positive bronchodilating response using impulse oscillation system（IOS） and provide the evidence for clinical diagnosis and performing IOS.Methods Seventy children patients with bronchodilating response using IOS were recruited randomly for this study.Forty children patients with positive bronchodilating response were regarded as positive group and the other thirty children patients with negative bronchodilating response were regarded as negative group.The IOS parameters,for example,total respiratory impedance （Z5）,respiratory resistance at 5 Hz（R5）,reactance at 5 Hz（X5）,peripheral respiratory resistance（Rp） in the two groups were analyzed.Results Z5,R5,X5 of the positive group （123.45 ± 24.75）％,（120.09 ± 25.40）％,（138.62 ± 33.48）％] were higher than those of the negative group （103.89 ± 16.30）％,（102.67 ± 18.16）％,（111.85 ± 14.93）％].There were significantly different between the two groups （P ＜ 0.05）.Moreover,Rp ≥ 19.89 cmH2O/ （L·s）（1 cmH2O =0.098 kPa） in the positive group was 50.00％（20/40）,which was higher than that in the negative group23.33％（7/30）].There was significant difference between the two groups（P＜ 0.05）.Conclusions The impedance of children patients with positive bronchodilating response using IOS is significantly increased,especially X5.When IOS parameters ≥ 100％,especially X5 ≥ 100％,which suggest that perform the bronchodilation test in order to decrease the rate of missed diagnosis of asthma.