Kim Hyeong Yoon, Shin Yun Ho, Jung Da Woon, Jee Hye Mi, Park Hye Won, Han Man Yong
Department of Pediatrics, CHA University School of Medicine, Seongnam, Korea.
Respirology. 2009 Sep;14(7):1035-41. doi: 10.1111/j.1440-1843.2009.01605.x.
Currently there are few data available regarding the use of impulse oscillometry parameters to assess airflow obstruction during standardized methacholine challenge testing.
Methacholine challenge tests were performed using impulse oscillometry and conventional spirometry in 64 healthy and 39 asthmatic children, in order to determine airway resistance (R) and reactance (X) at frequencies of 5-35 Hz, as well as FEV(1).
Baseline R and X were significantly different between the healthy and asthmatic children, with the most discriminating parameter being resistance at 5 Hz (R5). In asthmatic children BHR was well demonstrated by FEV(1), X5 and X10, but not by R5. However, when the actual R5 values obtained in this study were compared with the predicted values, there appeared to be differences in the lung function measures that corresponded to varying methacholine concentrations. In addition, the PC20_FEV(1) and PC70_X5 were significantly more sensitive than other parameters for methacholine challenge testing.
Measuring resistance at 5 Hz using impulse oscillometry facilitates significant differentiation of baseline lung function between asthmatic and healthy children. Additionally, X may be a suitable replacement for PC20 in methacholine challenge testing.
目前,关于在标准化乙酰甲胆碱激发试验中使用脉冲振荡法参数评估气流阻塞的可用数据较少。
对64名健康儿童和39名哮喘儿童进行了乙酰甲胆碱激发试验,采用脉冲振荡法和传统肺量计,以确定5 - 35赫兹频率下的气道阻力(R)和电抗(X),以及第一秒用力呼气容积(FEV₁)。
健康儿童和哮喘儿童的基线R和X存在显著差异,最具鉴别力的参数是5赫兹时的阻力(R5)。在哮喘儿童中,FEV₁、X5和X10能很好地显示气道高反应性(BHR),但R5不能。然而,当将本研究中获得的实际R5值与预测值进行比较时,肺功能测量结果似乎因乙酰甲胆碱浓度不同而存在差异。此外,PC20_FEV₁和PC70_X5在乙酰甲胆碱激发试验中比其他参数显著更敏感。
使用脉冲振荡法测量5赫兹时的阻力有助于显著区分哮喘儿童和健康儿童的基线肺功能。此外,在乙酰甲胆碱激发试验中,X可能是PC20的合适替代指标。