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哮喘患儿吸入乙酰甲胆碱时呼吸音频谱的变化。

Changes in the breath sound spectrum during methacholine inhalation in children with asthma.

机构信息

Department of Pediatrics, Tokai University School of Medicine, Isehara, Japan.

Department of Basic Clinical Science and Public Health, Tokai University School of Medicine, Isehara, Japan.

出版信息

Respirology. 2018 Feb;23(2):168-175. doi: 10.1111/resp.13177. Epub 2017 Sep 27.

Abstract

BACKGROUND AND OBJECTIVE

An effort-independent breath sound analysis is expected to be a safe and simple method for clinical assessment of changes in airway function. The effects of bronchoconstriction and bronchodilation on novel breath sound parameters in asthmatic children were investigated.

METHODS

The study population included 49 children with atopic asthma (male = 33; mean age: 10.2 years). We evaluated breath sound parameters of the highest frequency of the power spectrum (HFp), frequency limiting 50% and 99% of the power spectrum (F and F ) and roll-off from 600 Hz to the HFp (Slope). We also assessed new parameters obtained using the ratios of sound spectrum parameters (spectrum curve indices), such as the ratio of the third and fourth power area to the total power area (P /P and P /P ), the ratio of the third and fourth areas to the total area under the curve (A /A and B /A ) and the ratio of power and frequency at 75% of HFp and 50% of HFp (RPF and RPF ). This was measured before and after methacholine inhalation challenge and after β agonist inhalation.

RESULTS

The parameters, F and F , showed no changes after methacholine inhalation. Conversely, the A /A (12.5-10.0%, P < 0.001), B /A (7.6-5.5%, P < 0.001), RPF (6.7-4.0 dBm/Hz, P < 0.001) and RPF (5.8-4.3 dBm/Hz, P < 0.001) were significantly decreased. These values returned to the original level after β agonist inhalation.

CONCLUSION

Spectrum curve indices indicate bronchoconstriction and bronchodilation. These parameters may play a role in the assessment of airway narrowing in asthmatic children.

摘要

背景与目的

用力无关的呼吸音分析有望成为一种安全、简单的临床气道功能评估方法。本研究旨在探讨支气管收缩和支气管扩张对哮喘儿童新型呼吸音参数的影响。

方法

本研究纳入 49 例特应性哮喘患儿(男 33 例;平均年龄:10.2 岁)。我们评估了呼吸音最高频率功率谱(HFp)、功率谱 50%和 99%频率限制(F 和 F )以及 600Hz 到 HFp 衰减(Slope)等参数。同时,我们还评估了利用声谱参数比值获得的新参数,如第三和第四功率区与总功率区比值(P /P 和 P /P )、第三和第四区与总曲线下面积比值(A /A 和 B /A )以及 HFp 功率和频率的 75%与 50%比值(RPF 和 RPF )。该研究在乙酰甲胆碱吸入激发前、后以及β激动剂吸入后进行。

结果

乙酰甲胆碱吸入后,参数 F 和 F 没有变化。相反,A /A(12.5-10.0%,P<0.001)、B /A(7.6-5.5%,P<0.001)、RPF(6.7-4.0dBm/Hz,P<0.001)和 RPF(5.8-4.3dBm/Hz,P<0.001)显著降低。β激动剂吸入后,这些值恢复到原始水平。

结论

频谱曲线指数可反映支气管收缩和支气管扩张,这些参数可能在评估哮喘儿童气道狭窄中发挥作用。

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