Murakami Katsumi, Habukawa Chizu, Kurosawa Hajime, Takemura Tsukasa
Department of Pediatrics, Kinki University Sakai Hospital, 2-7-1 Harayamadai, Minami-ku, Sakai, Osaka 590-0132, Japan.
Department of Pediatrics, Minami Wakayama Medical Center, 27-1 Takinai-machi, Tanabe-shi, Wakayama 646-0015, Japan.
Respir Investig. 2014 Jan;52(1):57-64. doi: 10.1016/j.resinv.2013.07.003. Epub 2013 Sep 24.
Bronchodilator response (BDR) is routinely used in asthma management. A new forced oscillation technique (FOT) is able to quickly measure respiratory system resistance (Rrs) and reactance (Xrs) at each tidal breath phase. The present study evaluated bronchial changes by using the new FOT.
Respiratory resistance and reactance were measured using FOT in 132 children (age, 10.86±4.78 years; M:F=88:44), including asthmatic (n=98) and nonasthmatic children (n=34), pre- and post-bronchodilator inhalation in an asymptomatic state. Whole-breath or within-breath changes in Rrs and Xrs were measured and compared pre- and post-bronchodilator inhalation and between each group. All patients performed spirometry and forced expiratory nitric oxide pre- and post-bronchodilator inhalation.
Spirometric parameters showed significant positive changes at V50 and V25 in both groups; however, these changes were not significantly different between the groups. eNO was significantly higher in the asthmatic group than in the nonasthmatic group; however, there was no significant change pre- and post-inhalation in either group. Rrs in the asthma group was significantly higher in the expiratory phase than in the inspiratory phase. Rrs and Xrs before and after bronchodilator inhalation were significantly different in the asthma group alone, except for the expiratory-inspiratory phase of each of these parameters. Changes in Rrs and Xrs at 5Hz (R5 and X5) in a whole-breath and the inspiratory phase were significantly different between the groups.
Changes in X5 and R5 reflect bronchial reversibility. The new FOT is useful for asthmatic children.
支气管扩张剂反应(BDR)常用于哮喘管理。一种新的强迫振荡技术(FOT)能够在每个潮气呼吸阶段快速测量呼吸系统阻力(Rrs)和电抗(Xrs)。本研究使用新的FOT评估支气管变化。
在132名儿童(年龄10.86±4.78岁;男:女 = 88:44)中使用FOT测量呼吸阻力和电抗,这些儿童包括哮喘患儿(n = 98)和非哮喘患儿(n = 34),在无症状状态下进行支气管扩张剂吸入前后的测量。测量并比较支气管扩张剂吸入前后以及每组之间Rrs和Xrs的全呼吸或呼吸内变化。所有患者在支气管扩张剂吸入前后均进行肺量计检查和呼出一氧化氮检测。
两组的肺量计参数在V50和V25处均显示出显著的正向变化;然而,两组之间的这些变化没有显著差异。哮喘组的呼出一氧化氮水平显著高于非哮喘组;然而,两组吸入前后均无显著变化。哮喘组呼气期的Rrs显著高于吸气期。仅哮喘组支气管扩张剂吸入前后的Rrs和Xrs有显著差异,这些参数的每个呼气 - 吸气期除外。两组之间全呼吸和吸气期5Hz时Rrs和Xrs的变化(R5和X5)有显著差异。
X5和R5的变化反映支气管可逆性。新的FOT对哮喘儿童有用。