婴幼儿支气管哮喘和闭塞性细支气管炎患儿肺功能比较

目的比较婴幼儿支气管哮喘和闭塞性毛细支气管炎(BO)患儿肺功能差异。方法选择57例婴幼儿支气管哮喘和47例BO患儿,应用Master Screen Paed型肺功能仪测定潮气呼吸流量容积曲线,分析参数包括呼吸频率(RR)、每千克体质量潮气量(VT/kg)、吸呼比(TI/TE)、达峰时间比(TPTEF/TE)、达峰容积比(VPEF/VE)、呼吸气中期流速比值(TEF50/TIF50)。单阻断法测定每千克体质量呼吸系统顺应性(CrsSO/kg)和呼吸系统阻力(Rrs)。结果支气管哮喘和BO患儿VT/kg差异无统计学意义(P>0.05);BO患儿RR、Rrs显著高于支气管哮喘患儿,差异有统计学意义(P均<0.05);BO患儿TI/TE、TPTEF/TE、VPEF/VE、TEF50/TIF50、CrsSO/kg显著低于支气管哮喘患儿,差异有统计学意义(P均<0.05)。结论与婴幼儿支气管哮喘比较,BO患儿呼吸系统阻力显著增高,小气道阻塞程度显著加重,呼吸系统顺应性相对减低,应用婴幼儿肺功能评估可在一定程度上为鉴别婴幼儿支气管哮喘和BO提供帮助。

Comparison of pulmonary function between bronchial asthma and bronchiolitis obliterans in infants

Objective To compare the results of pulmonary function test between bronchia asthma and bronchio-litis obliterans(BO)in infants.Methods Fifty-seven infants with bronchial asthma and 47 infants with BO aged from 0 to 3 years old were selected.Their tidal breathing flow-volume curves were tested by Master Screen Paed and the parameters were recorded including respiratory rate(RR),tidal volume over body weight(VT/kg),ratio of inspiratory time to expiratory time(TI/TE),ratio of time to reach tidal peak flow to total expiratory time(TPTEF/TE),ratio of volume at tidal peak flow to total tidal volume(VPEF/VE).Pulmonary compliance(CrsSO/kg)and airway resistance(Rrs)were examined by the single occlusion technique.Results There was no significant difference in VT/kg between asthma group and BO(P < 0.05).RR and Rrs of BO group were significantly higher than that of asthma group(P < 0.05).The levels of TI/TE,TPTEF/TE,VPEF/VE,TEF50/TIF50 and CrsSO/kg in BO group were significantly lower than those in asthma group respectively(P < 0.05).Conclusions In infants with BO,compare with infants with asthma,the resistance of respiratory system and the degree of small airway obstruction increase,but the respiratory system compliance decreases.The evaluation of lung function can provide certain help to differentiate BO and asthma in infants.