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通过强迫振荡和体描法特定气道阻力测量有喘息病史的学龄前儿童的肺功能。

Lung function in preschool children with a history of wheezing measured by forced oscillation and plethysmographic specific airway resistance.

机构信息

Infection, Immunity & Environment Theme, Murdoch Children's Research Institute, Melbourne, VIC, Australia.

出版信息

Pediatr Pulmonol. 2010 Nov;45(11):1049-56. doi: 10.1002/ppul.21223.

Abstract

RATIONALE

Wheezing is common in preschool children, but objective evidence for airway obstruction and its reversibility are rarely available in clinical practice. We assessed whether abnormalities of lung function and bronchodilator response can be detected in preschool children using the forced oscillation technique and measurements of specific airway resistance.

METHODS

Fifty-nine children with a history of wheeze and 24 healthy controls aged 3-6 years were recruited. Resistance and reactance at 6 and 8 Hz (Rrs6, Rrs8, Xrs6 and Xrs8, respectively) were measured using the forced oscillation technique and specific airway resistance was measured in a plethysmograph. z-Scores were calculated from published reference data. Tests were repeated 15 min after 400 mcg salbutamol. Bronchodilator response was expressed as the log-transformed ratio of postbronchodilator/prebronchodilator values.

RESULTS

Technically acceptable measurements using the forced oscillation technique were obtained in n = 77 (93%) of children and in n = 56 (68%) using plethysmography. There was no significant difference in baseline lung function or bronchodilator response, assessed by either technique, between those with a history of wheeze and healthy controls.

CONCLUSION

Measurement of lung function is feasible in preschool children, but neither of these techniques was able to identify diminished lung function or reversibility to bronchodilator in children with a history of wheeze.

摘要

原理

喘鸣在学龄前儿童中很常见,但在临床实践中很少能获得气道阻塞及其可逆转性的客观证据。我们评估了使用强迫振荡技术和特定气道阻力测量是否可以在学龄前儿童中检测到肺功能和支气管扩张剂反应的异常。

方法

招募了 59 名有喘息史的儿童和 24 名健康对照者,年龄为 3-6 岁。使用强迫振荡技术测量 6 和 8 Hz 时的阻力和电抗(分别为 Rrs6、Rrs8、Xrs6 和 Xrs8),并在体描仪中测量特定气道阻力。使用发表的参考数据计算 z 分数。沙丁胺醇 400 mcg 吸入 15 分钟后重复测试。支气管扩张剂反应表示为支气管扩张剂后/支气管扩张剂前比值的对数变换。

结果

使用强迫振荡技术获得了 n = 77(93%)名儿童的可接受技术测量值,使用体描仪获得了 n = 56(68%)名儿童的可接受技术测量值。在使用这两种技术评估时,有喘息史的儿童与健康对照组之间的基础肺功能或支气管扩张剂反应均无显著差异。

结论

在学龄前儿童中测量肺功能是可行的,但这两种技术均不能识别有喘息史的儿童肺功能下降或对支气管扩张剂的可逆转性。

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