Lee Eun, Yoon Jisun, Cho Hyun-Ju, Hong Soo-Jong, Yu Jinho
Department of Pediatrics, Inje University Haeundae Paik Hospital, Busan, Korea.
Department of Pediatrics, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea.
Acta Paediatr. 2017 Jan;106(1):81-86. doi: 10.1111/apa.13632.
We investigated airway function in preschoolers with postinfectious bronchiolitis obliterans (PIBO) using impulse oscillometry (IOS).
This study enrolled 182 children aged three to five years: 12 with PIBO, 135 with asthma and 35 nonatopic controls. Respiratory resistance and reactance were assessed using IOS.
The percentage predicted (% predicted) of prebronchodilator respiratory resistance at 5 Hz was significantly higher in children with PIBO (177.9 ± 118.4%) than the asthma (126.1 ± 30.5%, p = 0.013) or control (121.1 ± 21.8%, p = 0.014) groups. After bronchodilator use, children with PIBO did not reach the values of Rrs5% predicted in the asthma and control groups. Respiratory reactance (Xrs5% predicted) in children with PIBO (337.1 ± 478.5%) was significantly higher than both asthma (130.0 ± 80.0%, p = 0.004) and control (105.1 ± 30.8%, p < 0.001) groups before bronchodilator use and significantly higher than the two groups after bronchodilator use (p = 0.010 and p = 0.004, respectively). The changes in Rrs5 and Xrs5 were not significantly different between the children with PIBO and asthma.
Measuring Rrs5 and Xrs5 before and after bronchodilator use may help to discriminate PIBO from asthma in children aged three to five years with chronic or recurrent respiratory symptoms.
我们使用脉冲振荡法(IOS)研究感染后闭塞性细支气管炎(PIBO)学龄前儿童的气道功能。
本研究纳入了182名3至5岁的儿童:12名患有PIBO,135名患有哮喘,35名非特应性对照。使用IOS评估呼吸阻力和电抗。
PIBO患儿在5Hz时支气管扩张剂使用前呼吸阻力的预测百分比(%预测值)(177.9±118.4%)显著高于哮喘组(126.1±30.5%,p = 0.013)或对照组(121.1±21.8%,p = 0.014)。使用支气管扩张剂后,PIBO患儿未达到哮喘组和对照组Rrs5%预测值。PIBO患儿在使用支气管扩张剂前的呼吸电抗(Xrs5%预测值)(337.1±478.5%)显著高于哮喘组(130.0±80.0%,p = 0.004)和对照组(105.1±30.8%,p < 0.001),且使用支气管扩张剂后也显著高于两组(分别为p = 0.010和p = 0.004)。PIBO患儿和哮喘患儿之间Rrs5和Xrs5的变化无显著差异。
在使用支气管扩张剂前后测量Rrs5和Xrs5可能有助于鉴别3至5岁有慢性或反复呼吸道症状儿童的PIBO和哮喘。