֧��������������0~6���ͯ��Ϣ�Լ�������е�����

目的利用潮气呼吸法进行小年龄儿童的支气管舒张试验,以确立适合0~6岁儿童支气管舒张试验的评定标准。方法2003-06—2004-03就诊于复旦大学附属儿科医院门诊及病房≤6岁的喘息性支气管炎患儿36例,以同期收治的支气管炎患儿25例作为急性支气管炎组,沙丁胺醇和异丙托溴铵两药联合应用作为支气管舒张药物。用潮气呼吸法分析评价支气管炎患儿与喘息性支气管炎患儿吸入两药前后肺功能的变化,以确立小年龄儿童气道高反应性疾病支气管舒张试验的评定标准。结果适合小年龄喘息性支气管炎患儿的支气管舒张试验的评定标准:(1)吸入支气管舒张剂前后,急性支气管炎组呼吸频率(RR)略有改善,喘息性支气管炎组达峰时间比(tPTEF/tE)、达峰容积比(VPEF/VE)明显改善。(2)两组比较达峰时间比(tPTEF/tE)改善率、达峰容积比(VPEF/VE)改善率差异有统计学意义。(3)以达峰时间比(tPTEF/tE)和达峰容积比(VPEF/VE)任意一个改善率≥15%为阳性标准,灵敏度为72·2%,特异度为80·0%。喘息性支气管炎组支气管舒张试验阳性率为72·2%。结论达峰时间比(tPTEF/tE)改善率或达峰容积比(VPEF/VE)改善率≥15%可以作为小年龄儿童支气管舒张试验的评定标准。

Application of bronchodilation test by tidal breathing in 0 ～ 6-year old children with airway hyper-responsive diseases

??AbstractObjectiveTo evaluate the bronchodilation test in tidal breathing of young children with airway hyper??responsive disease,and to establish the diagnostic standard of tidal breathing in young children's bronchodilation test.MethodsSixty??one children who saw doctor (because of coughing) at the Children s Hospital of Fudan University,aged 4~72 months.They were classified into two groups??one group was coughing with wheeze(n=36),one group was just coughing(n=25).Each group received salbutamol and ipratropium bromide.Tidal breathing flow??volume loop and parameters were obtained before and after aerosol inhalation to evaluate the effects of drugs.We evaluated the change of two groups of tidal breathing flow??volume loops and parameters.Results(1) After inhaling the drugs,there were significant recovery (increase) in tPTEF/tE and VPEF/VE in wheezying bronchitis group.(2)There were significant differences in the change of tPTEF/tE and VPEF/VE between two groups.(3)If we used tPTEF/tE rises??15% or VPEF/VE rises??15% as the diagnostic standard,the best combination of sensitivity and specificity was achieved.The sensitivity was 72.2%;the specificity was 80%.The positive rate of wheezy group was 72.2%.ConclusionWe suggest that tPTEF/tE rise??15% or VPEF/VE rise??15% to be the diagnostic standard in younger children??s bronchodilation test by tidal breathing.