Lebecque P, Stănescu D
Pediatric Pulmonology Division, Cliniques Universitaires Saint-Luc, Brussels, Belgium.
Eur Respir J. 1997 Apr;10(4):891-5.
Measurement of the total resistance of the respiratory system (Rrs) is an attractive alternative to measurement of forced expiratory volume in one second (FEV1) in young children because it requires minimal co-operation. The purpose of this study was to assess the ability of the forced oscillation technique (FOT) to detect airway obstruction in asthmatic children and in patients with cystic fibrosis (CF). Spirometry and Rrs were recorded in 45 asthmatic children (32 males and 13 females) and in 45 patients with CF (28 males and 17 females). Rrs was measured at 10 Hz with the Siregnost FD5 (Siemens, Germany). The asthmatic children were slightly younger than the patients with CF (10+/-3 vs 14+/-7 yrs), and had milder airway obstruction (FEV1 80+/-19 vs 66+/-27% of predicted). Rrs was significantly higher in the asthmatic children (6.6+/-1.7 cmH2O x L(-1) x s) than in the patients with CF (4.8+/-1.4 cmH2O x L(-1) x s). A normal FEV1 (> or = mean -2SD) was associated with a normal Rrs (< or = mean +2SD) in 17 of the 45 asthmatic children and in 13 of the 45 CF patients. By contrast, a low FEV1 (< mean -2SD) was associated with an increased Rrs (> mean +2SD) in 21 of the 45 asthmatic children, but in only 3 of the 45 CF patients. Thus, FEV1 and Rrs yielded concordant information in asthmatic children much more often (38 out of 45) than in CF patients (16 out of 45) (p < 0.001). In CF, Rrs failed to detect even severe airways obstruction. These findings might be accounted for by the inability of Rrs to reflect peripheral obstruction. We conclude that total respiratory resistance is suitable to assess airways obstruction in asthmatic children but not in cystic fibrosis patients.
测量呼吸系统总阻力（Rrs）对于幼儿来说是一种有吸引力的替代一秒用力呼气量（FEV1）测量的方法，因为它所需的配合最少。本研究的目的是评估强迫振荡技术（FOT）检测哮喘儿童和囊性纤维化（CF）患者气道阻塞的能力。对45名哮喘儿童（32名男性和13名女性）和45名CF患者（28名男性和17名女性）进行了肺量测定和Rrs记录。使用Siregnost FD5（德国西门子公司）在10赫兹下测量Rrs。哮喘儿童比CF患者略年轻（10±3岁对14±7岁），气道阻塞程度较轻（FEV1为预测值的80±19%对66±27%）。哮喘儿童的Rrs（6.6±1.7厘米水柱×升-1×秒）显著高于CF患者（4.8±1.4厘米水柱×升-1×秒）。45名哮喘儿童中有17名以及45名CF患者中有13名，FEV1正常（≥平均值-2标准差）与Rrs正常（≤平均值+2标准差）相关。相比之下，45名哮喘儿童中有21名FEV1低（<平均值-2标准差）与Rrs升高（>平均值+2标准差）相关，但45名CF患者中只有3名如此。因此，FEV1和Rrs在哮喘儿童中得出一致信息的情况（45例中有38例）比在CF患者中（45例中有16例）更为常见（p<0.001）。在CF中，即使是严重的气道阻塞，Rrs也未能检测出来。这些发现可能是由于Rrs无法反映外周阻塞所致。我们得出结论，总呼吸阻力适用于评估哮喘儿童的气道阻塞，但不适用于囊性纤维化患者。
