Kano S, Nishima S
Department of Pediatrics, National Minami-Fukuoka Chest Hospital.
Arerugi. 1997 Dec;46(12):1265-72.
We evaluated the relationship between PEF and SpO2 on 126 acute asthma attacks of 52 asthmatic children (25 males, 27 females, age 6-17 yrs-old) whose PEF and SpO2 being measured either before or after inhalation of beta-agonist at out-patient clinic. In the whole age group over 6 yrs-old, values of %PEF were proportional to individual SpO2 (n = 76, R = 0.472, p < 0.001). However, the relationship between %PEF and SpO2 in the present study was different from that of the guideline proposed by WHO (Global Initiative for asthma, GINA), showing that the value of SpO2 corresponding to %PEF was higher in the present study than in GINA. Regarding the difference in age group, significant relationship between %PEF and SpO2 was observed in both lower (6-9 yrs-old) and middle age group (10-12 yrs-old) but not in older age group (over 12 yrs-old). Also, there was a significant relationship between %PEF and SpO2 in cases whose pulmonary function during stable condition showed no-obstructive change (FEV1.0% > 80%), but not in cases with obstructive change. On the other hand, averaged values of %PEF, SpO2, heart rate (HR), respiratory rate (RR) before inhalation of beta-agonist at out-patient clinic in cases with or without admission were 32.3% vs 50.0%, 93.0%, vs 95.0%, 115 bpm vs 100 bpm, and 27/min vs 25/min respectively, those difference being statistically significant. Although measurement of SpO2 is thought to be a useful index for assessing severity of childhood asthma exacerbation, clinician should recognize that value of SpO2 could be greater than 91% even though % predicted PEF is less than 60%. Especially in older age group, obstructive change during stable condition may disturb the relation of SpO2 to %PEF. In such cases, not only SpO2 but also PEF, which is objective index of airway obstruction, should be taken into account for assessing severity of exacerbation.
我们评估了52名哮喘儿童（25名男性，27名女性，年龄6 - 17岁）的126次急性哮喘发作中，呼气峰流速（PEF）与血氧饱和度（SpO2）之间的关系。这些儿童在门诊吸入β - 激动剂之前或之后测量了PEF和SpO2。在整个6岁以上的年龄组中，PEF百分比值与个体SpO2成正比（n = 76，R = 0.472，p < 0.001）。然而，本研究中PEF百分比与SpO2之间的关系与世界卫生组织（全球哮喘防治创议，GINA）提出的指南不同，表明本研究中与PEF百分比相对应的SpO2值高于GINA中的值。关于年龄组差异，在低龄组（6 - 9岁）和中年组（10 - 12岁）中均观察到PEF百分比与SpO2之间存在显著关系，但在高龄组（12岁以上）中未观察到。此外，在稳定状态下肺功能无阻塞性改变（第一秒用力呼气容积百分比（FEV1.0%）> 80%）的病例中，PEF百分比与SpO2之间存在显著关系，但在有阻塞性改变的病例中则不存在。另一方面，在门诊吸入β - 激动剂之前，入院和未入院病例的PEF百分比、SpO2、心率（HR）、呼吸频率（RR）的平均值分别为32.3%对50.0%、93.0%对95.0%、115次/分钟对100次/分钟、27次/分钟对25次/分钟，这些差异具有统计学意义。虽然SpO2的测量被认为是评估儿童哮喘急性发作严重程度的有用指标，但临床医生应认识到，即使预计PEF百分比低于60%，SpO2值也可能大于91%。特别是在高龄组中，稳定状态下的阻塞性改变可能会干扰SpO2与PEF百分比之间的关系。在这种情况下，评估急性发作的严重程度时，不仅应考虑SpO2，还应考虑作为气道阻塞客观指标的PEF。
