Department of Pediatrics, Severance Hospital, Institute of Allergy, Brain Korea 21 PLUS Project for Medical Science, Yonsei University College of Medicine, Seoul, Korea.
Department of Pediatrics, Hanyang University College of Medicine, Seoul, Korea.
Pediatr Pulmonol. 2019 Feb;54(2):117-124. doi: 10.1002/ppul.24201. Epub 2018 Dec 10.
Impulse oscillometry (IOS) measures respiratory resistance and reactance during tidal breaths and is a convenient tool for evaluation of lung function. Respiratory resistance and reactance can be measured separately during inspiration and expiration (inspiratory-expiratory analysis).
We investigated the differences in inspiratory-expiratory measurements obtained using IOS between children with and without asthma.
We analyzed 819 subjects aged 4-18 years, including asthmatic children (n = 600) and controls (n = 219). Asthma was diagnosed in accordance with the American Thoracic Society/European Respiratory Society guideline. Spirometry and IOS were performed in all subjects.
In whole-breath analysis, the asthma group had higher resistance at 5 Hz (R5) and reactance area (AX) and lower reactance at 5 Hz (X5) than the control groups. In inspiratory-expiratory analysis, the asthma group showed increased expiratory R5 and AX and decreased expiratory X5 when compared with the control group. The absolute changes in R5, X5, and AX values between inspiration and expiration were greater in children with asthma than those in controls (0.138 ± 0.195 vs 0.102 ± 0.162, P = 0.014; -0.106 ± 0.200 vs -0.086 ± 0.434, P < 0.001 and 0.460 ± 11.63 vs 0.398 ± 2.88, P = 0.002, respectively).
Inspiratory-expiratory IOS analysis differentiated asthmatic children from control subjects, reflecting airway narrowing on expiration in pediatric asthma. The changes in R5, X5, and AX between inspiration and expiration can be a useful index for diagnosis of asthma in children without assessment of the response to a bronchodilator.
脉冲振荡法（IOS）可在潮气呼吸时测量呼吸阻力和电抗，是评估肺功能的便捷工具。呼吸阻力和电抗可在吸气和呼气时分别测量（吸气-呼气分析）。
我们研究了 IOS 吸气-呼气测量值在哮喘患儿和非哮喘患儿之间的差异。
我们分析了 819 名 4-18 岁的受试者，包括哮喘患儿（n=600）和对照组（n=219）。哮喘诊断符合美国胸科学会/欧洲呼吸学会指南。所有受试者均行肺量计检查和 IOS 检查。
在全呼吸分析中，哮喘组的 5Hz 阻力（R5）和电抗面积（AX）较高，5Hz 电抗（X5）较低。在吸气-呼气分析中，哮喘组与对照组相比，呼气 R5 和 AX 增加，呼气 X5 降低。与对照组相比，哮喘患儿吸气和呼气时 R5、X5 和 AX 值的绝对值变化更大（0.138±0.195 比 0.102±0.162，P=0.014；-0.106±0.200 比-0.086±0.434，P<0.001 和 0.460±11.63 比 0.398±2.88，P=0.002）。
IOS 吸气-呼气分析可区分哮喘患儿和对照受试者，反映儿童哮喘呼气时气道狭窄。吸气和呼气时 R5、X5 和 AX 的变化可作为儿童哮喘诊断的有用指标，无需评估对支气管扩张剂的反应。
