两种肺功能检测在哮喘患儿中应用的比较研究

目的　观察流速 容量曲线 (F V)和脉冲振荡 (IOS)检测的相关性和异常检出率符合情况。探讨IOS检测结果判定和临床应用。方法　采用德国Jaeger公司的MastscreenIOS测定仪 ,对 5 0例哮喘患儿进行F V和IOS检测及支气管舒张试验 ,并对两种检测方法各指标进行相关分析及异常符合率比较 ,选择第一秒用力呼气容积 (FEV1)、用力呼气肺活量 (FVC)、5 0 %肺活量最大呼气流量 (MEF50 )、2 5 %肺活量最大呼气流量 (MEF2 5)、呼吸阻抗 (Zrs)、总气道阻力 (R5)、中心气道阻力 (R2 0 )、周边弹性阻力 (X5)、响应频率 (Fres)。结果　支气管舒张试验后FEV1、MEF50 、MEF2 5、FVC较基础有明显的升高 ,而Fres、Zrs、R5、R2 0 、X5均有显著的下降 (P <0 0 0 1) ,表明支气管阻塞症状缓解。且基础和用药后FEV1、MEF50 、MEF2 5、FVC分别与Fres、Zrs、R5、R2 0 、X5均有显著的相关性。当FEV1基本正常 (>80 % ) ,Zrs、R5、X5已有增高 ,提示IOS检测的灵敏度高于FEV1。结论　IOS检测与常规的F V检测有很好的相关性 ,IOS检测操作简单 ,受试者不必做特殊的呼吸动作 ,尤其适合于儿童 ,特别是学龄前儿童

Impulse oscillation technique vs flow- volume to assess pulmonary function in children with asthma

Objective By comparison the flow volume (F V) examination and impulse oscillation (IOS) measurement in assessing the pulmonary function, to explore the clinical application of IOS. Methods The first second expired volume (FEV 1 ), Forced vital capacity (FVC), Maximal expiratory flow at 50% of vital capacity (MEF 50 ), maximal expiratory flow at 25% of vital capacity (MEF 25 ), respiratory resistance (Zrs), total airway resistance (R 5 ), central airway resistance (R 20 ), periphery resistance (X 5 ), Frequency of response (Fres) were measured by IOS and F V methods. The consistency of the results from both methods was analyzed and compared. Results Both basal and bronchodilator challenging FEV 1, MEF 25 , MEF 50 and FVC correlated with Fres, Zrs and R 5 , R 20 and X 5 significantly. R 5 and X 5 had already increased before FEV 1 reached to the level of more than 80%, which indicated that IOS was more sensitive than FEV 1 in assessing the pulmonary function. Conclusion IOS technique correlated fairly with F V detection. We concluded that IOS measurement, which was simple to be operated, should be applied clinically in children, especially in preschool children.