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强迫振荡技术在儿童支气管哮喘诊断中的应用价值

The Usefulness of the Forced Oscillation Technique in the Diagnosis of Bronchial Asthma in Children.

作者信息

Starczewska-Dymek L, Bozek A, Jakalski M

机构信息

Medical Center, Strzelce Opolskie, Poland.

Clinical Department of Internal Disease, Dermatology and Allergology in Zabrze, Medical University of Silesia, Katowice, Poland.

出版信息

Can Respir J. 2018 Jul 24;2018:7519592. doi: 10.1155/2018/7519592. eCollection 2018.

Abstract

The forced oscillation technique (FOT) requires minimal patient cooperation and is useful for children. However, comprehensive values of respiratory impedance at baseline and after the reversibility test have not been definitively confirmed. The aim of this study was to evaluate the basic parameters of FOT reactance (Xrs) and resistance (Rrs) in groups of healthy children and children with controlled and uncontrolled asthma. The second aim was the assessment of the reversibility bronchial test using the forced oscillation method in children with bronchial asthma. . One hundred and six children aged from 2 to 6 years diagnosed with early-onset controlled or uncontrolled asthma and healthy controls were included in this single-center, prospective, randomized study. All asthmatic patients and healthy controls underwent basic FOT as one measurement according to the recommendation of Resmon Pro FOT. The reversibility test was then performed 15 min after the administration of 200 mcg salbutamol by MDI in all patients. . Basic Rrs showed significantly higher mean values in patients with uncontrolled asthma compared to patients with controlled asthma, which were in turn higher than the values for patients in the control group (11.14 ± 1.29 versus 15.71 ± 2.6 versus 9.21 ± 0.98, resp.; < 0.05). The data analysis showed similar relationships in terms of the Xrs between the studied groups (-4.76 ± 1.19 versus -7.31 ± 2.33 versus -2.11 ± 0.48, resp.; < 0.05). According to the changes in the Rrs values, 35 (66%) positive bronchial reversibility tests were obtained in 53 subjects with controlled asthma and in 39 (74%) subjects with uncontrolled asthma. . Rrs and Xrs obtained by FOT well-discriminate patients with asthma from healthy children. A bronchial reversibility test involving the use of FOT is valuable for the diagnosis of bronchial asthma.

摘要

强迫振荡技术(FOT)所需的患者配合极少,对儿童很有用。然而,基线时和可逆性试验后的呼吸阻抗综合值尚未得到确切证实。本研究的目的是评估健康儿童组以及患有可控和不可控哮喘儿童组中FOT电抗(Xrs)和电阻(Rrs)的基本参数。第二个目的是在患有支气管哮喘的儿童中使用强迫振荡法评估支气管可逆性试验。在这项单中心、前瞻性、随机研究中纳入了106名年龄在2至6岁之间、被诊断为早发性可控或不可控哮喘的儿童以及健康对照。根据Resmon Pro FOT的建议,所有哮喘患者和健康对照都进行了一次基本FOT测量。然后,所有患者在通过定量吸入器(MDI)吸入200微克沙丁胺醇15分钟后进行可逆性试验。与可控哮喘患者相比,不可控哮喘患者的基本Rrs平均值显著更高,而可控哮喘患者的该值又高于对照组患者的值(分别为11.14±1.29、15.71±2.6和9.21±0.98;P<0.05)。数据分析显示,研究组之间在Xrs方面也有类似关系(分别为-4.76±1.19、-7.31±2.33和-2.11±0.48;P<0.05)。根据Rrs值的变化,53名可控哮喘患者中有35名(66%)支气管可逆性试验呈阳性,39名不可控哮喘患者中有39名(74%)呈阳性。通过FOT获得的Rrs和Xrs能够很好地区分哮喘患者和健康儿童。涉及使用FOT的支气管可逆性试验对支气管哮喘的诊断很有价值。

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