Expiratory flow limitation in infants with bronchopulmonary dysplasia

We evaluated lung function in 20 infants with bronchopulmonary dysplasia (BPD) during the first year of life. Compared with a group of age- and size-matched controls, the infants with BPD had a significantly (P less than 0.005) lower functional residual capacity (FRC; 25 +/- 4 vs 18 +/- 6 ml/kg) at less than 10 1/2 months after conception, but no significant difference during the remainder of the first year. The partial expiratory flow volume curves in the infants with BPD were markedly concave, with tidal breathing approaching expiratory flow limitation. The infants with BPD had significantly (P less than 0.01) lower absolute and size-corrected flows than did control infants, and 50% of the infants with BPD required rehospitalization because of acute respiratory distress associated with a lower respiratory tract illness. In addition, the slope of the linear regression of maximal expiratory flow at FRC (in milliliters per second) vs length (in centimeters) was significantly lower (P less than 0.001) for the infants with BPD than for normal control infants (2.25 vs 4.52), indicating poor growth of the airways. Oxygen saturation (SaO2 was negatively correlated with maximal expiratory flow at FRC, indicating that measurement of SaO2 alone may not be sufficient in the evaluation of lung function in infants with BPD. We conclude that, although infants with BPD improve clinically during the first year of life, they have abnormal functional airway growth; the decreased expiratory flow reserve helps to explain their high risk for acute respiratory distress during lower respiratory tract illness.     

极低出生体重儿支气管肺发育不良潮气呼吸肺功能临床观察

目的 研究极低出生体重儿支气管肺发育不良(bronchopulmonary dysplasi,BPD)潮气呼吸肺功能的改变.方法 选取在温州市儿童医院住院的262例极低出生体重儿作为研究对象,在出院前1周内和纠正胎龄6~8个月时做潮气呼吸肺功能检测.根据临床诊断,分为BPD组(65例)和非BPD组(197例),BPD组根据严重程度分为轻度BPD组(31例)、中度BPD组(20例)和重度BPD组(14例),比较不同组患儿的肺功能指标.结果 出院前1周内测量潮气呼吸肺功能显示,BPD组患儿呼吸频率较非BPD组均增快(P均＜0.05);呼气峰流速,75%、50%、25%潮气量时的呼气流速比较,均为重度BPD组高于其余组(P均＜0.05),轻度BPD组低于非BPD组(P均＜0.05);达峰时间比、达峰容积比BPD组较非BPD组均降低,BPD程度越严重,下降越明显(P均＜0.05);各组间潮气量比较差异无统计学意义(P＞0.05).矫正胎龄6~8个月时行潮气呼吸肺功能检查,呼气峰流速,75%、50%、25%潮气量时的呼气流速比较,提示重度BPD组仍较其余组均高(P均＜0.05),达峰时间比、达峰容积比仍低于其余组(P均＜0.05),而其余各组间比较各指标差异均无统计学意义(P＞0.05).结论 出院前1周内BPD患儿有不同程度的肺功能损伤,但随日龄增大(矫正胎龄6~8个月时),部分肺功能指标逐渐改善,但早期重度小气道阻塞性病变仍较严重,因此,积极预防、治疗BPD对呼吸道疾病的防治有重要意义.     

支气管肺发育不良早产儿体积描记肺功能的动态观察

目的 探讨支气管肺发育不良（BPD）对早产儿肺功能的影响。方法 根据是否发生BPD及BPD程度将72名早产儿分为3组：非BPD组（n=44）、轻度BPD组（n=15）、中度BPD组（n=13），采用体积描记术测定各组生后7 d、14 d及28 d的肺功能。结果 3组早产儿公斤体重潮气量（TV/kg）、功能残气量（FRC）、达峰时间比（% T-PF）、达峰容积比（% V-PF）在生后7 d、14 d及28 d均逐渐升高，而公斤体重气道阻力（Reff/kg）及呼吸频率（RR）则逐渐下降（P < 0.05）；轻度及中度BPD组在生后7 d、14 d、28 d的TV/kg、FRC、% T-PF、% V-PF均低于非BPD组，而Reff/kg及RR则高于非BPD组（P < 0.05）；中度BPD组在生后7 d的气道阻力（Reff）、Reff/kg、公斤体重功能残气量（FRC/kg）高于轻度BPD组（P < 0.05）。结论 BPD患儿存在一定程度的肺功能受损；体积描记肺功能监测有助于评估BPD患儿在新生儿期的肺发育。     

肥胖对不同年龄段哮喘患儿肺功能的影响

目的研究肥胖对不同年龄段初诊哮喘患儿肺功能的影响。方法 294名初诊哮喘患儿按年龄分为学龄前期组(6岁)及学龄期组(6~12.5岁),并根据不同体重指数(BMI)分为体重正常哮喘组、超重哮喘组及肥胖哮喘组,检测患儿肺功能,包括大气道通气功能指标[用力肺活量(FVC)、第1秒用力呼气量(FEV1)]和小气道通气功能指标[用力呼气25%、50%及75%流量的实测值占预计值的百分比,即MEF25%、MEF50%、MEF75%]。结果在校正了性别及BMI分组因素后,学龄期组FEV1%、MEF25%、MEF50%低于学龄前期组(P0.05)。两年龄组正常体重患儿间比较,学龄期组基础肺功能FEV1%、MEF25%、MEF50%低于学龄前期组(P0.05);两年龄组超重患儿间比较,学龄期组FVC%及MEF50%低于学龄前期组;两年龄组肥胖患儿间比较,肺功能各指标差异均无统计学意义。学龄前期肥胖组FVC%、FEV1%及MEF75%均低于体重正常组,而学龄期肥胖组仅FVC%和FEV1%与体重正常组间差异有统计学意义(P0.05)。结论肥胖对哮喘患儿基础肺功能的影响存在年龄差异,于学龄前期更明显。     

Proximal airway function 8 to 16 years after laryngomalacia: follow-up using flow-volume loop studies

Twenty children who had endoscopically confirmed laryngomalacia were reviewed at 8 to 16 years of age. All had developed stridor in the first 6 weeks of life; stridor had stopped or largely resolved by age 4 years. Proximal airway function was assessed by expiratory and inspiratory flow volume loops and compared with control values. These children as a group had variable extrathoracic obstruction to inspiratory airflow, as indicated by a significantly low maximal inspiratory flow at 50% of vital capacity and a high mean ratio of maximal expiratory to maximal inspiratory flow at 50% vital capacity. Although limitation to inspiratory airflow was detectable in later childhood, it was not associated with troublesome symptoms. Significant stridor always resolved by 4 years of age, but some children experienced minor stridor under stress in later childhood.     

支气管肺发育不良早产儿1岁和2岁时体积描记肺功能的随访研究

目的 探讨支气管肺发育不良 (BPD)早产儿的远期肺功能。 方法 以2012年1月至2013年12月在复旦大学附属儿科医院新生儿病房住院的胎龄≤ 32周、出生体重≤ 1 500 g的BPD早产儿为BPD组,以同期住院非BPD早产儿按1∶1匹配为对照组,于纠正年龄1岁和2岁时召回随访,行体积描记（体描）肺功能检测,分析早产儿BPD及不同严重度BPD在纠正年龄1岁和2岁时肺功能状况。 结果 149例BPD早产儿和与之匹配的149例非BPD早产儿进入文本分析,1岁和2岁时召回随访,BPD组37例（轻中度22例,重度15例）和25例（轻中度15例,重度10例）,非BPD组33例和10例。在纠正年龄1岁及2岁时,BPD组公斤体重残气量（FRCp/kg）、达峰时间比（TPTEF/TE）、达峰容积比（VPTEF/VE）、肺内剩余25%潮气量时潮气呼气流速（TEF25）显著低于非BPD组,公斤体重有效气道阻力（Reff/kg）显著高于非BPD组。在纠正年龄1岁时,重度BPD亚组FRCp/kg 、TPTEF/TE显著低于轻中度BPD亚组, Reff/kg显著高于轻中度BPD亚组;在纠正年龄2岁时,重度BPD亚组VPTEF/VE显著低于轻中度BPD亚组,Reff/kg显著高于轻中度BPD亚组。 结论 BPD早产儿存在功能残气量降低及小气道阻塞,以重度BPD患儿更为明显。     

新生儿机械通气后远期肺功能随访

目的　了解新生儿机械通气对远期肺功能及反复呼吸道疾病影响。方法　新生儿期用呼吸机治疗16例患儿 ,8年后对其进行随访 ,并作肺功能检测。结果　 5 0 %患儿有反复呼吸道疾病症状 ,75 %患儿肺功能异常 ,其中残气量 /肺总量 (RV/TLC)为 5 6 .2 5 %、肺活量 2 5 %时最大呼气流量 (Vmax 2 5 )为 4 3.7%、特殊呼吸道阻力 (sRaw)及特殊呼吸道传导 (sGaw)均为 5 0 %。吸气峰压 (PIP) >2 5cmH2 O组用力肺活量中期平均呼气流速 (FEF 2 5 %～ 75 % )及 5 0 %用力肺活量时的最大呼气流速 (Vmax 5 0 )低于PIP <2 5cmH2 O组。呼气末正压 (PEEP)≤ 4cmH2 O组sRaw >4cmH2 O组。结论　新生儿机械通气可影响远期肺功能。较高PIP或过低PEEP可引起肺损伤 ,从而引起呼吸道阻力增加 ,呼吸道高反应。而儿童期反复呼吸道疾病可能与肺损伤后支气管反应性增高有关     

Cardiovascular findings in very low birthweight schoolchildren with and without bronchopulmonary dysplasia

BACKGROUND: With the introduction of new therapies in peri- and neonatology, the clinical picture of bronchopulmonary dysplasia (BPD) seems to alter. The consequences of this "new BPD" are of interest. AIM: To evaluate cardiovascular findings during the surfactant era in very low birthweight (VLBW, birth weight < 1500 g) schoolchildren with and without BPD. METHODS: At 7-8 years of age, 34 VLBW children with BPD born in one hospital underwent blood pressure (BP) measurement, electrocardiography (ECG), two-dimensional Doppler and M-mode echocardiography, flow-volume spirometry and whole-body plethysmography. The age- and sex-matched control groups comprised 34 VLBW children without BPD (no-BPD group) and 34 term children (term group). RESULTS: The mean(SD) diastolic BP was significantly higher in the no-BPD than in the BPD group (65(9) vs. 59(8) mm Hg, p < 0.05). No clinically significant tricuspid regurgitations were found. The groups did not differ with respect to right ventricular systolic time intervals corrected for heart rate. The results of all M-mode measurements were within normal range. Compared to term controls, the BPD cases had lower mean(SD) forced expiratory flow in 1 s (90(14)% vs. 99(11)% of ref., p < 0.05) and more often high ratio of residual volume to total lung capacity (15(52%) vs. 4(13%), p < 0.01). No clinically significant correlations were found between current lung function and echocardiographic findings. CONCLUSION: In the surfactant era, school-aged VLBW survivors with and without BPD do not seem to evince indirect signs of elevated pulmonary pressure. The increased pulmonary vascular resistance associated with BPD appears to resolve with time more rapidly than abnormalities in respiratory function.     

Exercise performance in very low birth weight children at the age of 7–12 years

Fifteen very low birth weight children, 9 appropriate for gestational age (AGA, mean birth weight 1302 ± 164 g) and 6 small for gestational age children (SGA, mean birth weight 1263±117 g), were studied at the age of 7–12 years, and compared to a group of 26 healthy, age-, sex-, and height-matched children born at term. None of the VLBW children had developed chronic bronchopulmonary disease. Pulmonary function tests and progressive exercise tests on a treadmill were performed. Forced vital capacity, forced expiratory volume at 1 s and forced expiratory flow between 25% and 75% of vital capacity were normal for all subjects. No differences were found in maximum oxygen consumption, anaerobic threshold and maximal heart rate between the AGA and SGA children and the respective controls. Both in the AGA and SGA subgroups, the pre-exercise oxygen uptake results were comparable to those of the controls. In the SGA subgroup the energy cost of running was significantly higher with respect to the controls, while no difference was found between the AGA and the control children. In conclusion, children with birth weight less than 1501 g have normal values of aerobic fitness. In SGA children the efficiency of running is slightly reduced.     

哮喘和咳嗽变异性哮喘儿童肺常规通气功能的比较

目的：比较哮喘与咳嗽变异性哮喘（CVA）患儿肺常规通气功能的变化。方法：选择2010年 5月至2011年5月确诊为哮喘或CVA的患儿140例,分为哮喘急性发作组（发作组,50例）、哮喘缓解组（缓解组,50例）和CVA组（40例）;同期正常健康体检儿童30例作为对照组。测定4组儿童用力肺活量(FVC)、一秒钟用力呼气容积(FEV1)、最大呼气峰流速(PEF)、用力呼气25%流速(FEF25)、用力呼气50%流速(FEF50)、用力呼气75%流速(FEF75)、最大呼气中期流速(MMEF75/25)等7项肺功能指标。结果：发作组患儿各项肺功能指标如大气道指标FVC、FEV1、PEF、FEF25及小气道指标FEF50、FEF75、MMEF75/25的实际值/预计值平均水平均<80%,且以FEF50、FEF75、MMEF75/25等小气道指标下降为著。CVA组患儿小气道指标FEF75、MMEF75/25实际值/预计值的平均水平<80%。发作组各项肺常规通气功能指标均低于对照组;缓解组、CVA组FVC、FEV1、FEF25及 MMEF75/25实际值/预计值的平均水平低于对照组;发作组各项肺功能指标均明显低于缓解组和CVA组;CVA组与缓解组各项肺功能指标差异均无统计学意义。结论：哮喘急性发作期患儿存在大小气道功能障碍,以小气道功能障碍为主;CVA患儿以小气道功能轻微障碍为主,与哮喘缓解期相似。     

达良好控制哮喘患儿停用低剂量吸入性糖皮质激素的临床随访研究

目的 通过随访达良好控制哮喘患儿停用低剂量吸入性糖皮质激素（ICS）后哮喘急性发作情况,以及实验室指标的动态变化,以期为哮喘患儿的长期控制最佳方案提供依据。方法 根据家长意愿,将63例达到良好控制的哮喘患儿分为ICS治疗组（n=35）和停药组（n=28）,进行18个月随访,每3个月进行评估,观察哮喘急性发作情况,并动态监测两组患儿肺功能和呼出气一氧化氮（FeNO）浓度,以及儿童哮喘控制测试（C-ACT）评分等指标进行分析。结果 随访第3、6、9、12个月时,FeNO在两组间比较差异无统计学意义（P > 0.05）;但在随访第15、18个月时,停药组FeNO显著高于治疗组（P < 0.05）。6次随访时点内C-ACT在两组间比较差异无统计学意义（P > 0.05）。随访第3、6、9、12个月时,第1秒用力呼气容积占预计值的百分比（FEV1%）、第1秒用力呼气量占用力肺活量比值（FEV1/FVC%）、最大呼气中期流速占预计值百分比（MMEF%）、最大呼气50%肺活量的瞬间流速（MEF50%）等指标在两组间比较差异无统计学意义（P > 0.05）;但在随访第15、18个月时,治疗组MMEF%、MEF50%显著高于停药组（P < 0.05）。治疗组随访期间有3例（9%）患儿哮喘发作,停药组有8例（29%）患儿哮喘发作,停药组哮喘复发率高于治疗组（P=0.0495）。结论 持续吸入低剂量ICS可维持哮喘患儿肺功能稳定,减少哮喘发作。     

肺炎支原体肺炎婴幼儿肺功能的变化

目的 探讨肺炎支原体肺炎（MPP）婴幼儿肺功能的变化特点。方法 选取2014年1月至2018年6月诊断为MPP的0~36月龄住院患儿196例为研究对象,同期非肺炎支原体感染引起的0~36月龄肺炎患儿208例为对照（非MPP组）。回顾性分析患儿临床资料,比较两组患儿入院次日和出院当日肺功能结果,并随访MPP患儿出院后2周和出院后4周的肺功能。结果 与非MPP组相比,MPP组入院次日和出院当日肺功能检测显示,达峰时间比（TPTEF/TE）、达峰容积比（VPTEF/VE）、吸呼比及呼出75%潮气量时呼气流量显著下降（P < 0.05）;潮气峰流量与呼出75%潮气量时呼气流量比、呼吸频率、有效气道阻力和公斤功能残气量均显著升高（P < 0.05）。与肺功能参数正常参考值比较,MPP和非MPP两组患儿入院次日VPTEF/VE和TPTEF/TE均有所下降;出院当日MPP组患儿VPTEF/VE和TPTEF/TE仍有所下降,而非MPP组患儿已达正常水平。与出院当日比较,MPP组患儿出院后2周及4周VPTEF/VE和TPTEF/TE均升高（P < 0.05）,但出院后4周时TPTEF/TE仍未达到正常水平。结论 急性期MPP和非MPP婴幼儿均存在阻塞性通气功能障碍,而MPP患儿的小气道阻塞更加严重,且改善缓慢,恢复期仍存在一定程度气流受限。     

支气管肺发育不良患儿婴儿期下呼吸道感染的临床特征及病原学分析

目的 分析支气管肺发育不良(bronchopulmonary dysplasia,BPD)患儿婴儿期内因下呼吸道感染再入院的临床特征及病原体特点。方法 选取2020年1月—2022年12月青岛市妇女儿童医院收治的因下呼吸道感染住院的BPD早产儿128例进行回顾性分析,并选择同期住院的同等例数的非BPD早产儿为对照,比较2组患儿的一般资料、临床特征、肺功能指标及呼吸道病原学结果。结果 与非BPD组相比,BPD组患儿胎龄、体重小,更容易出现气促、喘息及发绀,喘息缓解时间长(P<0.05)。肺功能检查方面,与非BPD组相比,BPD组患儿每公斤体重潮气量、达峰时间比、达峰容积比、25%潮气量呼气流量、50%潮气量呼气流量、75%潮气量呼气流量均降低,而呼吸频率增快(P<0.05)。BPD组患儿肺炎克雷伯菌、鲍曼不动杆菌等革兰氏阴性杆菌检出率高于非BPD组(P<0.05)。结论 BPD患儿婴儿期下呼吸道感染后需更关注气促、喘息及发绀等临床特征,肺功能表现为阻塞性改变及小气道功能障碍,呼吸道病原更易检出肺炎克雷伯菌、鲍曼不动杆菌等革兰氏阴性杆菌。[中国当代儿科杂志,2023,25...     

121例支气管肺发育不良患儿2岁内再入院的临床分析

目的总结支气管肺发育不良(BPD)患儿2岁内再入院的临床情况。方法回顾性分析121例BPD患儿2岁内242例次因反复下呼吸道感染再入院的临床资料。结果 242例次再入院BPD患儿中,115例次(47.5%)有喘息;1~2岁患儿喘息发生率高于1岁内患儿(P0.05)。193例次行胸部影像学检查,结果示囊泡影31例次(16.1%)。肺功能检查结果示BPD患儿的每公斤体重潮气量(TV/kg)、达峰时间比(TPEF/TE)、达峰容积比(VPEF/VE)、50%潮气量时的呼气流速(TEF50)、75%潮气量时的呼气流速(TEF75)均低于无呼吸道疾病的对照组,而呼吸频率高于对照组(P0.05)。28例行支气管镜检查,气道发育异常21例(75%)。242例次均吸入糖皮质激素,无治疗相关不良反应发生;6例次静脉使用人脐血间充质干细胞(hUCB-MSCs),无不良反应发生,其中1例治疗后顺利脱氧。结论因下呼吸道感染再入院BPD患儿喘息发生率随年龄增长而增高,其肺功能以小气道阻塞、低肺容量时呼气流速降低和呼吸频率增快为主要表现,多伴有气道发育异常。吸入糖皮质激素可用于BPD再入院患儿急性期抑制炎症反应;hUCB-MSCs输注后短期安全可行,并提示可能对BPD恢复有一定益处。     

Respiratory outcome in school-aged, very-low-birth-weight children in the surfactant era

AIM: To assess respiratory outcome and its predictors during the surfactant era in very-low-birth-weight (VLBW, birth weight <1500g) schoolchildren with and without bronchopulmonary dysplasia (BPD). METHODS: At 7-8 years of age, 34 VLBW children with BPD diagnosed at a postnatal age of 28 d underwent flow-volume spirometry, metacholine challenge, bronchodilatation test, whole body plethysmography and diffusion capacity measurement. Fourteen of them had not recovered from BPD by a corrected gestational age of 36 wk (sBPD subgroup). The age- and sex-matched control groups comprised 34 VLBW cases without BPD and 34 term children. RESULTS: Current respiratory symptoms in contact with cold air and/or upon exercise were reported in one-third of the VLBW children. Only half of the symptomatic VLBW cases without BPD had inhaled medications. Compared with term controls, the BPD cases had lower forced expiratory volume in 1 s (FEV1), higher ratio of residual volume to total lung capacity and higher airway resistance. Lower FEV1 and specific conductance were found in the sBPD subgroup compared to both control groups. Additionally, their vital capacity was lower than in term controls. A higher rate of bronchial hyper-reactivity and lower diffusion capacity of the lungs were detected in VLBW as against term cases. Low birth weight, long duration of oxygen therapy, low socio-economic status and exposure to animal dander emerged as predictors of poorer respiratory outcome. CONCLUSION: In the surfactant era, birth weight, neonatal respiratory morbidity, as well as later environmental factors appear to affect the respiratory outcome of VLBW children. However, careful pulmonary follow-up of all VLBW children seems to be indicated regardless of the severity of neonatal respiratory problems.     

不同体重指数的哮喘患儿规范化激素治疗后肺功能变化

目的：研究不同体重指数（BMI）的哮喘患儿经吸入糖皮质激素（ICS）治疗后肺功能的改善情况。方法：157例哮喘患儿根据BMI分为肥胖组（46例）、超重组（50例）和体重正常组（61例）,检测所有患儿治疗前及规范化ICS治疗1年后,大气道通气功能指标1秒用力呼气容积（FEV1）、用力肺活量（FVC）及小气道通气功能指标用力呼气25%流量（MEF25）、用力呼气50%流量（MEF50）。结果：治疗前各组患儿行肺功能激发试验,雾化吸入乙酰甲胆碱后肥胖组FVC%、FEV1%、MEF25%及MEF50%下降率均明显高于体重正常组（均P<0.01）;雾化吸入沙丁胺醇后肥胖组FEV1%、MEF25%和MEF50%以及超重组MEF25%和MEF50%改善率均明显低于体重正常组（均P<0.05）。ICS治疗1年后,与治疗前相比,体重正常组FVC%、FEV1%均明显升高,而肥胖组和超重组仅FVC%升高。结论：肥胖能够增加哮喘患儿对乙酰甲胆碱敏感性,而抑制对沙丁胺醇反应性;规律ICS治疗能改善正常体重哮喘患儿大气道通气功能,对小气道通气功能影响较小;肥胖能够抑制ICS对哮喘患儿肺功能的改善作用。     

肺功能检查及呼出气一氧化氮在儿童支气管哮喘规范化管理中的应用

目的探讨肺功能与呼出气一氧化氮(FeNO)在儿童支气管哮喘规范化治疗过程中的变化及意义。方法选取254例初诊、急性发作期的支气管哮喘患儿作为研究对象,按照有无合并过敏性鼻炎分为合并鼻炎组与未合并鼻炎组,并以62例健康儿童作为对照组。哮喘患儿均给予规范化治疗,于治疗初始以及治疗3、6、9、12个月复查肺功能及FeNO水平;对照组测定一次肺功能和FeNO。结果规范治疗1年中第1秒用力呼气容积(FEV1)、最高呼气流速(PEF)、最大呼气中段流量(MMEF),以及最大呼气25%、50%及75%肺活量的瞬间流速(MEF25、MEF50、MEF75)均逐渐升高,FeNO水平逐渐降低(P0.05)。治疗6个月后PEF、FEV1等大气道功能指标基本恢复;9个月后MMEF、MEF25、MEF50、MEF75等小气道功能指标基本恢复;1年后大小气道功能指标与对照组的差异均无统计学意义(P0.05),而FeNO水平仍高于对照组(P0.05)。治疗初始及3个月时,合并鼻炎组的哮喘患儿FeNO均高于未合并鼻炎组(P0.05)。治疗初始FeNO水平与肺功能各项指标均存在负相关(P0.05)。结论哮喘儿童的规范化治疗过程中,肺功能参数逐渐升高,FeNO水平逐渐下降,大气道功能的恢复早于小气道功能,另外也要注意鼻炎对气道反应性的影响。     

Chronic lung disease of prematurity and respiratory outcome at eight years of age

AIM: The study aimed to determine the respiratory outcome of children who had chronic lung disease of prematurity (CLD) compared with a preterm control group of children at school age. METHODS: Fifty-two preterm infants with CLD born between 26 and 33 weeks gestation were assessed regarding respiratory illness with 47 having lung function testing. Information regarding respiratory illness was obtained from 52 children in the birthweight-matched control group of whom 45 had lung function testing. The results were compared between the CLD and control groups. RESULTS: There was no difference in respiratory symptomatology between CLD groups and control preterm infants. On lung function testing, a significantly lower mean forced expiratory flow at 25-75% of vital capacity was identified compared with the preterm controls (P=0.024). This significant difference did not persist after bronchodilator therapy. There was no evidence of increased air trapping or bronchial hyper-reactivity in the CLD children compared with the controls. CONCLUSION: Lung function in CLD children is largely normal in comparison with preterm controls, apart from some evidence of reversible small airway obstruction. Respiratory symptomatology is not increased in chronic disease children in comparison with control preterm children.     

两种肺功能检测在哮喘患儿中应用的比较研究

目的　观察流速 容量曲线 (F V)和脉冲振荡 (IOS)检测的相关性和异常检出率符合情况。探讨IOS检测结果判定和临床应用。方法　采用德国Jaeger公司的MastscreenIOS测定仪 ,对 5 0例哮喘患儿进行F V和IOS检测及支气管舒张试验 ,并对两种检测方法各指标进行相关分析及异常符合率比较 ,选择第一秒用力呼气容积 (FEV1)、用力呼气肺活量 (FVC)、5 0 %肺活量最大呼气流量 (MEF50 )、2 5 %肺活量最大呼气流量 (MEF2 5)、呼吸阻抗 (Zrs)、总气道阻力 (R5)、中心气道阻力 (R2 0 )、周边弹性阻力 (X5)、响应频率 (Fres)。结果　支气管舒张试验后FEV1、MEF50 、MEF2 5、FVC较基础有明显的升高 ,而Fres、Zrs、R5、R2 0 、X5均有显著的下降 (P <0 0 0 1) ,表明支气管阻塞症状缓解。且基础和用药后FEV1、MEF50 、MEF2 5、FVC分别与Fres、Zrs、R5、R2 0 、X5均有显著的相关性。当FEV1基本正常 (>80 % ) ,Zrs、R5、X5已有增高 ,提示IOS检测的灵敏度高于FEV1。结论　IOS检测与常规的F V检测有很好的相关性 ,IOS检测操作简单 ,受试者不必做特殊的呼吸动作 ,尤其适合于儿童 ,特别是学龄前儿童     

百日咳样咳嗽婴幼儿的肺功能特点

目的 探讨不同病原体感染的百日咳样咳嗽患儿的肺功能特点。方法 收集95例百日咳样咳嗽住院婴幼儿病原学及潮气呼吸肺功能检测资料,并与67例健康婴幼儿（正常对照组）潮气呼吸肺功能检测资料比较。百日咳样咳嗽患儿按病原体种类不同分为百日咳组（17例）、病毒感染组（23例）、结核感染组（6例）、支原体感染组（9例）、其他细菌感染组（8例）以及病原体未明组（32例）。结果 95例百日咳样咳嗽患儿中,轻度阻塞性通气功能障碍15例（16%）,中度阻塞性通气功能障碍30例（32%）,重度阻塞性通气功能障碍22例（23%）。与正常对照组相比,百日咳样咳嗽患儿吸呼比（tI/tE）、达峰时间比（tPF% tE）和达峰容积比（vPF% vE）均显著降低（均P < 0.05）。结核感染组和支原体感染组潮气量均显著低于正常对照组（均P < 0.05）。除结核感染组外,各病原体感染组tPF% tE和vPF% vE显著低于正常对照组（均P < 0.05）。百日咳组tPF% tE和vPF% vE显著低于其他病原体感染组（均P < 0.05）。结论 百日咳样咳嗽患儿肺功能多有异常;百日咳杆菌感染的患儿肺功能损害最重;潮气呼吸肺功能测试可为百日咳样咳嗽患儿病原体分析提供一定的参考依据。