哮喘患儿组胺诱发气道阻塞时哮鸣音的特征
Characteristics of wheeze during histamine-induced airways obstruction in children with asthma.
作者信息
Rietveld S, Dooijes E H, Rijssenbeek-Nouwens L H, Smit F, Prins P J, Kolk A M, Everaerd W A
机构信息
Department of Clinical Psychology, Faculty of Psychology, The Netherlands.
出版信息
Thorax. 1995 Feb;50(2):143-8. doi: 10.1136/thx.50.2.143.
BACKGROUND
An automated system has been developed for the detection of sound patterns suggestive of airways obstruction in long term recordings. The first step, presented here, was tracheal sound recording during histamine-induced airways obstruction.
METHODS
The tracheal sounds of 29 children aged 8-19 years with asthma were recorded during airways obstruction caused by histamine inhalation using a system for continuous respiratory telemetry and computer analysis. Sound patterns were analysed, classified, and related to airways obstruction measured by lung function tests based on the forced expiratory volume in one second (FEV1).
RESULTS
Five sound patterns were identified, one dominant sensitive and four specific to a fall in FEV1 of > 20%. The presence of at least one of three specific sound patterns during unforced respiration predicted a fall in FEV1 of > 20% in 87.5% of the subjects. The inspiratory and expiratory sound patterns were almost equally informative of airways obstruction.
CONCLUSIONS
Wheezes can be differentiated with more precision than is currently accepted. Tracheal sound patterns are sensitive and specific predictors of histamine-induced airways obstruction. These patterns are neither invariably nor proportionally related to the results of lung function testing. However, they can be used for detection of airways obstruction on the basis of their presence or absence.
背景
已开发出一种自动化系统，用于在长期记录中检测提示气道阻塞的声音模式。本文介绍的第一步是在组胺诱导的气道阻塞期间进行气管声音记录。
方法
使用连续呼吸遥测和计算机分析系统，在29名8至19岁哮喘儿童吸入组胺引起气道阻塞期间记录气管声音。对声音模式进行分析、分类，并与基于一秒用力呼气量（FEV1）的肺功能测试所测量的气道阻塞情况相关联。
结果
识别出五种声音模式，一种为主导敏感模式，四种为FEV1下降>20%时特有的模式。在自主呼吸期间至少出现三种特定声音模式之一，可预测87.5%的受试者FEV1下降>20%。吸气和呼气声音模式对气道阻塞的信息量几乎相同。
结论
哮鸣音可被更精确地区分，其精确程度超过目前公认的水平。气管声音模式是组胺诱导的气道阻塞的敏感且特异的预测指标。这些模式与肺功能测试结果既不是始终相关，也不是成比例相关。然而，它们可根据其是否存在用于检测气道阻塞。
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