Service d'Explorations Fonctionnelles Pédiatriques, Hôpital d'enfants, Vandoeuvre F-54500, France.
Pediatr Res. 2010 Dec;68(6):537-41. doi: 10.1203/PDR.0b013e3181f851d2.
Forced expiratory volume in 1 s (FEV1) detection of exercise-induced bronchoconstriction (EIB) to identify asthma has good specificity but rather low sensitivity. The aim was to test whether sensitivity may be improved by measuring respiratory resistance (Rrs) by the forced oscillation technique (FOT). Forty-seven asthmatic and 50 control children (5-12 y) were studied before and after running 6 min on a treadmill. Rrs in inspiration (Rrsi) and expiration (Rrse), FEV1 and Rrsi response to a deep inhalation (DI) were measured before and after exercise. In asthmatics versus controls, exercise induced significantly larger increases in Rrsi (p < 0.001) and larger decreases in FEV1 (p = 0.004). Asthmatics but not controls showed more bronchodilation by DI after exercise (p = 0.02). At specificity >0.90, sensitivity was 0.53 with 25% increase Rrsi and 0.45 with 27% increase Rrse or 5% decrease FEV1. It is concluded that the FOT improves sensitivity of exercise challenge, and the Rrsi response to DI may prove useful in identifying the mechanism of airway obstruction.
1 秒用力呼气容积(FEV1)检测运动诱发的支气管收缩(EIB)以识别哮喘具有很好的特异性,但敏感性相当低。目的是通过用力振荡技术(FOT)测量呼吸阻力(Rrs)来测试敏感性是否可以提高。在跑步机上跑步 6 分钟前后,对 47 名哮喘患儿和 50 名对照儿童(5-12 岁)进行了研究。在运动前后测量了吸气阻力(Rrsi)和呼气阻力(Rrse)、FEV1 和深吸气(DI)引起的 Rrsi 反应。与对照组相比,哮喘患儿运动后 Rrsi 增加显著(p<0.001),FEV1 下降显著(p=0.004)。仅哮喘患儿在运动后 DI 引起的支气管扩张更明显(p=0.02)。特异性>0.90 时,敏感性为 0.53,以 Rrsi 增加 25%为界;0.45,以 Rrse 增加 27%或 FEV1 减少 5%为界。结论是,FOT 提高了运动挑战的敏感性,并且 DI 引起的 Rrsi 反应可能有助于确定气道阻塞的机制。