Beydon Nicole, Amsallem Francis, Bellet Michèle, Boule Michèle, Chaussain Michèle, Denjean André, Matran Régis, Wuyam Bernard, Alberti Corinne, Gaultier Claude
Physiology Department, Robert Debré Teaching Hospital, Paris, France.
Am J Respir Crit Care Med. 2002 May 15;165(10):1388-94. doi: 10.1164/rccm.2011082.
The interrupter technique estimates flow resistance. It entails occlusion of the airways during tidal breathing while flow and mouth pressure are recorded. This noninvasive technique is easy to use in young children. The aim of the present study was to measure inspiratory and expiratory interrupter resistance (Rint(insp), Rint(exp)) before and after bronchodilator administration in young healthy white children. We designed a multicenter study using a standardized procedure for Rint measurements. Centers in five French cities studied 91 children (48 boys and 43 girls; height, 92 to 129 cm; mean age 5.3 +/- 1.4 years). Mean values were not significantly different for Rint(insp) and Rint(exp) (0.78 +/- 0.21 versus 0.78 +/- 0.20 KPa x L(-1) x second). However, the difference between Rint(insp) and Rint(exp) decreased significantly with age and being positive before 5 years and negative later on (p < 0.02). Rint(insp) and Rint(exp) decreased significantly with height (Rint(insp) [KPa x L(-1) x second] = 2.289 - 1.37. 10(-2) x H [cm], Rint(exp) [KPa. L(-1) x second] = 2.021 - 1.12.10(-2) x H [cm]; p < 0.001). Bronchodilator (salbutamol) administration significantly decreased Rint(insp) and Rint(exp) (p < 0.001). Bronchodilator-induced changes (% of predicted values) in mean Rint(insp) and mean Rint(exp) were -15% (95% confidence interval, -46 to +15%) and -12% (95% confidence interval, -46 to +22%), respectively. Sex did not affect pre- or postbronchodilator values. Data from the present study may prove useful for testing lung function in young children with respiratory disorders who failed to cooperate with forced expiratory maneuvers.
阻断法可估算气流阻力。该方法是在潮气呼吸时阻断气道,同时记录气流和口腔压力。这种非侵入性技术在幼儿中易于使用。本研究的目的是测量健康白人幼儿在使用支气管扩张剂前后的吸气和呼气阻断阻力(Rint(insp),Rint(exp))。我们设计了一项多中心研究,采用标准化程序测量Rint。法国五个城市的研究中心对91名儿童(48名男孩和43名女孩;身高92至129厘米;平均年龄5.3±1.4岁)进行了研究。Rint(insp)和Rint(exp)的平均值无显著差异(分别为0.78±0.21与0.78±0.20千帕×升⁻¹×秒)。然而,Rint(insp)与Rint(exp)之间的差异随年龄显著减小,5岁前为正值,之后为负值(p<0.02)。Rint(insp)和Rint(exp)随身高显著降低(Rint(insp) [千帕×升⁻¹×秒]=2.289 - 1.37×10⁻²×身高[厘米],Rint(exp) [千帕×升⁻¹×秒]=2.021 - 1.12×10⁻²×身高[厘米];p<0.001)。使用支气管扩张剂(沙丁胺醇)后,Rint(insp)和Rint(exp)显著降低(p<0.001)。支气管扩张剂引起的平均Rint(insp)和平均Rint(exp)变化(预测值的百分比)分别为-15%(95%置信区间,-46至+15%)和-12%(95%置信区间,-46至+22%)。性别不影响使用支气管扩张剂前后的值。本研究的数据可能有助于测试那些无法配合用力呼气动作的患有呼吸系统疾病的幼儿的肺功能。