阻塞性睡眠呼吸暂停低通气综合征婴幼儿肺功能测定的诊断意义

目的观察鼾症患儿的潮气呼吸分析、呼吸力学指标的改变，探讨其对婴幼儿阻塞性睡眠呼吸暂停低通气综合征（OSAHS）的诊断价值。方法鼾症患儿48例按有无扁桃体、腺样体肥大分2组，采用MS-BABY—BODY测定，并与55例正常儿童对照组比较。主要测定指标：达峰容量比（VPTEF／VE）、达峰时间比（tPTEF／tE）、吸气时间与呼气时间比（TI／tE）、吸气时间分数（TI／rtot）、50％潮气量时吸气流量与潮气量比（TIF如／VT）、平均吸气流速（VT／TI）、功能残气量（FRCp）、呼吸道阻力（Reff）。结果Ⅰ、Ⅱ组TI／Tt0t、50％潮气量时呼气流量与吸气流量比（TEF50／TIF50）、FRCp、Reff均较正常对照组增高，VT／TI、TIF50／VT均较正常对照组减低（P均〈0．01）。Ⅰ组部分有呼吸暂停、脉搏血氧饱和度[Sp（O2）]下降、吸气流速减低、吸气环异常等改变。结论肺功能测定反映鼾症患儿的呼吸气流、呼吸力学变化及程度，VPEF／VE、tPTEF／tE、TI／tE、TI／Ttot、VT／TI可作为上呼吸道阻塞的判断指标，结合呼吸暂停及Sp（O2）下降等，对婴幼儿OSAHS诊断及病变程度的判断有重要意义。

Diagnostic Significance of Pulmonary Function Test on Infants with Obstructive Sleep Apnea- Hypopnea Syndrome

Objective To evaluate the effect of pulmonary function test on infants with obstructive sleep apnea-hypopnea syndrome (OSAHS). Methods Forty-eight patients were divided into two groups based on physical examination. Pulmonary function were measured in 48 patients. Age-matched healthy infants were enrolled as controls. The parameters included ratio of volume to PEF to total expiratory volume(VPTEF/VE,tPTEF/tE),inspiratory time/expiratory time(TI/tE),inspiratory time/total respiratory time(TI/Ttot),ratio of 50% of the tital inspiratory flow to tital volume(TIF_ 50 /V_T),mean inspiratory flow(V_T/TI),function capacity(FRCp),resistance effective(Reff).Results TI/Ttot,ratio of 50% of the tital expiratory flow to 50% of the tital inspiratory flow(TEF_ 50 /TIF_ 50 ),FRCp,Reff were significantly higher in patients compared with controls(P<0.01).VT/TI,TIF_ 50 /V_T were significantly decreased in patients compared with controls(P<0.01). Conclusions The changes of breathing airflow and breathing mechanics reflection by pulmonary function test and VPTEF/VE,tPTEF/tE,TI/tE,TI/Ttot, V_T/TI may be used as markers for upper airway obstruction. Pulmonary function test can play an important role in diagnosis of OSAHS.