喘息患儿潮气呼吸肺功能改变的特征

目的观察婴幼儿哮喘和毛细支气管炎患儿的潮气呼吸流速-容量曲线测定结果，探讨不同喘息患儿潮气呼吸肺功能改变的特征，为临床诊断提供依据。方法选择婴幼儿哮喘患儿63例，毛细支气管炎（毛支）患儿52例及正常对照组婴幼儿51例，于镇静后进行潮气呼吸流速容量曲线测定（TBFV），主要参数有：每公斤体重潮气量（VT／kg）、呼吸频率（RR）、吸气时间（Ti）、呼气时间（Te）、吸呼比（Ti／Te）、达峰时间比（TPTEF／Te）、达峰容积比（VPEF／Ve）；并对哮喘患儿经正规治疗1～3个月后的缓解期、毛细支气管炎患儿住院治疗5～9d病情恢复后进行复查，观察其改善情况。结果哮喘组的潮气量与对照组比较差异无显著性，其他各指标差异均有显著性（P〈0．01），而毛支组与对照组相比，除吸呼比差异无显著性外，其他各指标差异均有显著性（P〈0．01），其VT／kg、Ti、Te、TPTEF／Te和VPEF／Ve明显降低、RR增加。哮喘组与毛支组比较发现，毛支组的RR较哮喘组明显增快；而哮喘组的潮气量高于毛支组，更接近于正常，其呼气时间较毛支组更长，吸呼比、达峰时间比和达峰容积比较毛支组降低更明显，两组间差异有显著性。毛支组经5～9d住院治疗后，VT／kg、RR明显改善，而哮喘组患儿1～3个月治疗缓解期后复查TPTEF／Te和VPEF／Ve显著上升。但两组的TPTEF／Te和VPEF／Ve与对照组比较仍存在很大差距，未能恢复至正常水平。结论潮气呼吸肺功能测定能够反映出婴幼儿哮喘、毛细支气管炎的病理生理特征，可成为呼吸道疾病临床诊断及病情评估的重要补充。

Dynamic changing characteristics of tidal flow-volume (TFV) in different wheezing infants

Objective To observe the results of tidal flow-volume measurement in infants with common wheezing diseases-asthma and bronchiolitis and discuss the changing characteristics of these measurements in these wheezing condition to provide the evidence for clinical diagnosis. Methods Sixty-three infants with asthma, 52 with bronchiolitis were studied with 51 normal infants as controls. Tidal flow volumes (TFV) were measured after the patients were sedated. The following indices were recorded: tidal volume per kilogram (VT/kg), respiratory rate (RR), inspiratory time (Ti), expiratory time (Te), Ti/Te, the ratio of time taken to reach peak expiratory flow to total expiratory time (TPEF/Te), the ratio of peak expiratory volume to total expiratory volume (VPEF/Ve). After regular treatment for infants with asthma for 1 to 3 months and 5-9 days hospitalization treatment for the bronchiolitic patients, these indices of pulmonary function were rechecked and the changes were recorded. Results VT/kg was not significantly different between asthmatic and normal infants, but the other indices were significantly different between them (P<0.01). Moreover, except for Ti/Te, the other indices were also significant difference between bronchiolitic and normal infants (P<0.01), including reduced VT/kg, Ti, Te, TPTEF/Te, VPEF/Ve and increased RR. Children with bronchiolitis had significantly higher RR than those in controls and asthmatic group. In comparison with the children with bronchiolitis, children with asthma had higher VT/kg and longer expiratory time. Similarly, the Ti/Te, TPTEF/Te, VPTEF/Ve were significantly lower than those with bronchiolitis with significant difference between these two groups of children after treatment. After hospitalized treatment for 5 to 9 days,VT/kg and RR were significantly improved in bronchiolitic children. After treatment, the TPTEF/Te, VPEF/Ve in asthmatic group improved. However, the TPEF/Te and VPEF/Ve were still lower than those in healthy infants. Conclusions The results suggested that TFV could be used to reveal the characteristics of infants with asthma and bronchiolitis and used as an important supplement index for evaluating the severity of these diseases and clinical diagnosis of respiratory diseases.