潮气呼吸分析参数结合胸部CT在评价先天性心脏病患儿肺功能中的应用

目的 探讨潮气呼吸分析参数结合胸部CT在评价先天性心脏病患儿肺功能中的临床应用价值.方法 对44例先天性心脏病儿童进行潮气呼吸肺功能测定,并对其中28例进行胸部螺旋CT三维重建气管、支气管树成像(CTB).同时选取普通肺炎患儿64例进行潮气呼吸肺功能测定作为对照,并对其中49例进行胸部CT检查.结果 44例先天性心脏病患儿呼吸频率(RR)增快,吸气时间(TI)缩短,达峰时间比(TPTEF/TE)、到达潮气呼气峰流速时的呼气量(VPTEF)、达峰容积比(VPEF/VE)明显下降(P<0.01),呼气峰流速(PTEF)和75%潮气量时的潮气呼气流速(TEF 75)升高(P<0.05).28例先天性心脏病患儿胸部CT显示肺部感染、气道狭窄、肺气肿和肺不张,患病率明显高于对照组(P<0.05).结论 潮气呼吸参数中TPTEF/TE、VPTEF、VPTEF/VE能反映先天性心脏病阻塞性通气功能障碍,胸部CT能进一步显示通气功能障碍的原因,两种无创技术相结合,能较全面反映先天性心脏病患儿的肺功能状态.

Value and applicability of tidal breathing pattern analysis and chest CT in assessment of pulmonary function in children with congenital heart disease

Objective To evaluate the value and applicality of tidal breathing pattern analysis and chest CT in assessing pulmonary function in children with congenital heart disease. Methods We measured tidal breathing pattern in 44 children with congenital heart disease and conducted three-dimensional spiral CT imaging of tracheobronchography among 28 children. As a contrast, we also measured tidal breathing pattern in 64 children with common pneumonia and conducted threa-dimensional spiral CT imaging of tracheobronehography among 49 children. Results Patients with congenital heart disease showed the increased respiratory rate and decreased inspiratory time. Tidal breathing analysis parameters (TPTEF/TE, VPTEF and VPEF/VE) decreased obviously, but PTEF and TEF 75 increased in 44 children with congenital heart disease. Chest CT confirmed pulmonary infection, airway stenosis, emphysema and atelectasis in patients with congenital heart disease. The incidence rate of pulmonary dysfunction in patients with congenital heart disease was higher than that of control group. Conclusion Tidal breathing analysis parameters (TPTEF/TE,VPTEF and VPTEF/VE) could reflect obstructive ventilation function disorder in children with congenital heart disease. Chest CT could further uncover the etiology of ventilation function disorder. The combination of theses two noninvasive techniques facilitate clinicians to have a better picture of pulmonary function status in children with congenital heart disease.