71例儿童非典型哮喘肺功能改变及意义

目的 探讨非典型哮喘患儿肺功能改变及不同肺功能指标评价该类患儿支气管舒张试验阳性率的差异.方法 对71例非典型哮喘患儿进行常规肺通气功能检测,后进行支气管舒张试验,观察患儿气道指标变化情况.结果 71例非典型哮喘患儿大气道指标第1秒用力呼气容积、第1秒用力呼气容积占用力肺活量的百分比基本正常,而反映小气道功能指标用力呼气25％肺活量的瞬间流量、用力呼气50％肺活量的瞬间流量、用力呼气75％肺活量的瞬间流量、用力呼气25％～75％肺活量的瞬间流量均有不同程度的下降,且主要为中、重度损害.以第1秒用力呼气容积作为评价指标,支气管舒张试验阳性例数为34例,阳性率为47.9％（34/71）,而以用力呼气25％～75％肺活量的瞬间流量作为评价指标,支气管舒张试验阳性例数为49例,阳性率为69.0％（49/71）,两种评价指标阳性率比较差异有统计学意义（x2=8.086,P=0.004）.结论 非典型哮喘患儿肺功能改变主要以小气道为主,且主要为中、重度损害,评价该类患儿支气管舒张试验阳性情况时,用力呼气25％～75％肺活量的瞬间流量可以辅助第1秒用力呼气容积,降低误诊率和漏诊率.

The change and significance of lung function in 71 children with atypical asthma

Objective To investigate the change of lung function in children with atypical asthma and different lung function index to evaluate the difference of bronchial dilation test positive rate.Methods Seventy-one cases of atypical asthma children routine monitoring lung function,underwent bronchial dilation test,the airway index changes were observed.Results Seventy-one cases of atypical asthma children with big airways function index of forced expiratory volume in first second FEV1,percentage of FEV1 to forced vital capacity （FVC） were basic normal,and the reaction of small airways function index of forced expiratory flow at 25% of FVC,forced expiratory flow at 50% of FVC,forced expiratory flow at 75% of FVC,forced expiratory flow at 25%-75% of FVC were decreased in different degrees,and mainly for medium and severe damage.FEV1 as evaluation index,the positive rate of bronchial dilation test diastolic was 47.9% （34/71）,and forced expiratory flow rate at 25%-75% in FVC as evaluation index,the positive rate of bronchial dilation test was 69.0% （49/71）,there was significant difference （x2 =8.086,P =0.004）.Conclusions Lung function changes in atypical asthma children are mainly on small airways,and mainly for medium and severe damage,the bronchial dilation test positive rate in such children using the evaluation,forced expiratory flow rate at 25%-75% in FVC can assist FEV1,decrease the rate of misdiagnosis and missed diagnosis.