Department of Medical Physics and Informatics, University of Szeged, Hungary.
Pediatr Pulmonol. 2012 Oct;47(10):956-65. doi: 10.1002/ppul.22551. Epub 2012 Mar 26.
Provocation tests are routinely used to detect airway hyperreactivity (AH) in the diagnosis of asthma. We compared the sensitivities of the forced oscillation technique (FOT) and spirometry in the detection of AH in asthmatic children.
FOT and spirometry were performed in 20 asthmatic children (aged 5-18 years) following aerosolized histamine and methacholine at an interval of 2 weeks. The respiratory system input impedance was measured by FOT; the resistance at 6 Hz (R(6) ), the average resistance between 4 and 24 Hz, the area under the reactance curve (AX) and the resonant frequency were extracted from these recordings. Spirometry was used to obtain forced expiratory volumes and flow parameters.
Following provocation with the two agonists, the FOT detected the airway response as early as spirometry. When the greater variability of the impedance parameters was taken into account, the two methods were observed to have similar sensitivities. Among the lung function parameters studied, AX and R(6) were the most sensitive for the demonstration of AH.
Our findings demonstrate that FOT is as suitable as spirometry for the measurement of bronchoconstriction and thus it may be considered for the detection of AH in asthmatic children. Since its application requires minimal cooperation, this approach imposes less stress and may be particularly favorable in the diagnosis of asthma at a young age.
激发试验通常用于检测气道高反应性(AH),以辅助哮喘的诊断。我们比较了呼吸强迫震荡技术(FOT)和肺量计在检测哮喘儿童气道高反应性中的敏感性。
对 20 名哮喘儿童(5-18 岁)在间隔 2 周后进行雾化组胺和乙酰甲胆碱激发试验,使用 FOT 进行呼吸力学测试,提取呼吸阻抗参数,包括 6Hz 时的气道阻力(R(6))、4-24Hz 时的平均气道阻力、电抗曲线下面积(AX)和共振频率;同时进行肺量计检测,获取用力呼气容积和流量参数。
两种激动剂激发后,FOT 比肺量计更早地检测到气道反应。当考虑到阻抗参数的更大变异性时,两种方法的敏感性相似。在研究的肺功能参数中,AX 和 R(6) 是检测 AH 最敏感的指标。
我们的研究结果表明,FOT 与肺量计一样适用于检测气道收缩,因此可用于检测哮喘儿童的气道高反应性。由于其应用需要最小的配合,这种方法带来的压力较小,可能特别有利于在儿童早期诊断哮喘。