最大呼气峰流速在儿童哮喘中的应用

目的　探讨最大呼气峰流速 (PEFR)在儿童哮喘诊治中的临床应用价值。方法　用呼气峰速仪测定 43例哮喘患儿急性发作期PEFR。测定缓解期PEFR个人最佳值 ,求出个体化PEFR下降率及警戒值 ,观察2 0例规范监测组和 2 3例非规范监测组个体化PEFR下降率与哮喘发作关系。结果　哮喘发作期时PEFR越低 ,临床表现越重。缓解期规范监测组根据个体化PEFR下降率变化指导预防用药 ,哮喘发作人数、次数及发病呈中、重度表现者分别为 15%、2 3 .5%、2 5% ;非规范监测组分别为 43 .5%、75.5%、76.9% ,两组比较均有显著性差异 (P均 <0 .0 1)。结论　PEFR可作为诊断儿童哮喘和病情严重程度分级依据 ,指导治疗。个体化PE FR下降率较PEFR变异率更灵敏反映病情变化 ,可作为哮喘发作警报 ,指导预防用药 ,以减少发作次数及利于肺功能恢复

Application of peak expiratory flow rate in asthmatic children

Objective To study the clinical application of the peak expiratory flow rate( PEFR) in children with asthma.Methods The PEFRs of 43 cases of asthma at the acute stage were measured to guide the clinical grading and therapy by the optimum individual PEFR of the patients at the remission stage, and the descending rate and warning value of individual PEFR were determined to investigate the relationship between the individual PEFR descending rate and the asthma attack conditions in the standard and nonstandard monitoring groups.Results At the asthma attack stage, the clinical symptoms became severe with PEFR declining; at the remission stage, the preventive application of drugs was based on the changes of the individual PEEF descending rate . The case number and frequency of asthma attack and the cases subjected to moderate or severe attacks in the standard group were 15 %,23.5 % and 25 % respectively; while those in the nonstandard group were 43.5 %, 75.5 % and 76.9 % respectively, which showed a significant difference( P <0.01).Conclusions The PEFR could be used as the basis for asthma diagnosis and its severity grading to guide the treatment. The individual PEFR descending rate could reflect the changes of the disease conditions more sensitively than PEFR variation rate and it could be regarded as the warning of asthma attack, which indicates the need of preventive application of drugs beneficial to the decrease of attack times and recovery of pulmonary function.