Department of Pediatrics, All India Institute of Medical Sciences, New Delhi, India.
Department of Pediatrics, All India Institute of Medical Sciences, New Delhi and Computational Biology, IIIT -Delhi, India.
Indian Pediatr. 2020 Feb 15;57(2):119-123.
Impulse oscillometry is an effort-independent technique of assessment of airway resistance and reactance, and can be performed in children unable to complete spirometry.
To evaluate the utility of impulse oscillometry and spirometry for assessing asthma control in children.
Prospective cohort study.
Children aged 5-15 years, with mild to severe persistent asthma.
On each 3-monthly follow-up visit, clinical assessment, classification of control of asthma, impulse oscillometry and spirometry were performed.
Utility of impulse oscillometry parameters [impedance (Z5), resistance (R5), reactance (X5) at 5 Hz, and R5-20 (resistance at 20Hz -5Hz) (% predicted), and area of reactance (AX, actual values)] and FEV1 (% predicted) to discriminate between controlled and uncontrolled asthma was assessed by receiver operating characteristic (ROC) curve. Association of FEV1 and impulse oscillometry parameters over time with controlled asthma was evaluated by generalized estimating equation model.
Number of visits in 256 children [mean (SD) age, 100 (41.6) mo; boys: 198 (77.3%)], where both impulse oscillometry and spirometry were performed was 2616; symptoms were controlled in 48.9% visits. Area under the curve for discrimination between controlled and uncontrolled asthma by FEV1, AX, R5-20, Z5, R5, and X5 were 0.58, 0.55, 0.55, 0.52, 0.52 and 0.52, respectively. FEV1 [OR (95% CI): 1.02 (1.01-1.03)] and AX [OR (95% CI): 0.88 (0.81-0.97)] measured over the duration of follow-up were significantly associated with controlled asthma.
Spirometry and impulse oscillometry parameters are comparable in ascertaining controlled asthma. Impulse oscillometry being less effort-dependent may be performed for monitoring control of childhood asthma, especially in younger children.
脉冲震荡技术是一种无需用力即可评估气道阻力和电抗的技术，可用于无法完成肺功能检查的儿童。
评估脉冲震荡技术和肺功能检查在评估儿童哮喘控制中的作用。
前瞻性队列研究。
年龄在 5-15 岁之间，患有轻度至重度持续性哮喘的儿童。
每 3 个月进行一次随访，进行临床评估、哮喘控制分类、脉冲震荡技术和肺功能检查。
通过受试者工作特征（ROC）曲线评估脉冲震荡技术参数[阻抗（Z5）、阻力（R5）、电抗（X5）在 5Hz 时、R5-20（20Hz 时的阻力-5Hz 时的阻力）（%预计值）和电抗面积（AX，实际值）]和 FEV1（%预计值）在区分控制和未控制的哮喘中的作用。通过广义估计方程模型评估 FEV1 和脉冲震荡技术参数随时间与控制哮喘的关系。
在 256 名儿童[平均（SD）年龄为 100（41.6）个月；男孩：198（77.3%）]中，共进行了 2616 次脉冲震荡技术和肺功能检查，其中 48.9%的就诊时症状得到控制。FEV1、AX、R5-20、Z5、R5 和 X5 区分控制和未控制哮喘的曲线下面积分别为 0.58、0.55、0.55、0.52、0.52 和 0.52。在随访期间测量的 FEV1[比值比（95%CI）：1.02（1.01-1.03）]和 AX[比值比（95%CI）：0.88（0.81-0.97）]与控制哮喘显著相关。
肺功能检查和脉冲震荡技术参数在确定控制哮喘方面具有可比性。由于脉冲震荡技术的依赖性较小，因此可能更适用于监测儿童哮喘的控制情况，尤其是在年龄较小的儿童中。
