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目的探讨肺功能变化在间质性肺炎婴幼儿临床病情评估中的价值。方法对57例间质性肺炎婴幼儿(肺炎组)进行肺功能测定,并与40例健康婴幼儿(健康对照组)肺功能指标进行对照,观察间质性肺炎婴幼儿潮气流速-容量环的形态及各项指标的变化。回顾性调查间质性肺炎婴幼儿临床病情评分及住院天数,与肺功能各主要参数进行相关性分析。结果与健康对照组比较,肺炎组患儿急性期的潮气流速-容量环曲线形态显得瘦长,且呼气下降支斜率增大,高峰提前,降支呈波谷样向容量轴凹陷。肺炎组患儿呼吸频率、潮气呼气峰流速、潮气呼气峰流速与呼出75%潮气量时的呼气流速的比值(PF/V25)、呼吸系统阻力均较健康对照组升高(Pa<0.01);呼气达峰时间比、呼气达峰容积比、每千克体质量潮气量,吸气时间和呼气时间的比值、潮气呼气中期流速和吸气中期流速的比值,每千克体质量顺应性(Crs/kg)均较健康对照组降低(Pa<0.001)。相关性分析显示PF/V25与临床病情评分、住院天数呈正相关(r=0.532、0.265,Pa<0.05);Crs/kg与临床病情评分呈负相关(r=-0.269,P<0.05)。结论间质性肺炎婴幼儿急性期肺功能主要表现为大、小呼吸道阻塞性通气功能障碍及限制性通气功能障碍,肺功能检查可为该病临床病情及预后提供客观评估的依据。
Objective To investigate the value of lung function changes in the evaluation of clinical conditions of infants with interstitial pneumonia. Methods Pulmonary function tests were performed in 57 infants with pneumonia (pneumonia group) and 57 healthy infants (healthy control group). The pulmonary function of infants and young children with interstitial pneumonia Morphology and changes in various indicators. Retrospective investigation of interstitial pneumonia in infants and young children clinical score and length of stay, and the main parameters of lung function correlation analysis. Results Compared with the healthy control group, the morphology of the tidal flow velocity-volume curve in the acute stage of children with pneumonia was slender and the slope of the descending branch of pneumonia was increased and the peak was earlier than that of the healthy control group. The descending branch showed trough-like depression to the capacity shaft. The respiratory rate, the peak expiratory flow rate, the peak expiratory flow rate and the expiratory flow rate (PF / V25) and respiratory resistance in the pneumonia group were higher than those in the healthy control group (Pa < 0.01); the peak expiratory time, peak expiratory volume ratio, the body mass per kilogram of tidal volume, inspiratory time and expiratory time ratio, mid-term expiratory flow and mid-inspiratory flow velocity ratio, per kilogram body Quality compliance (Crs / kg) was lower than the healthy control group (Pa <0.001). Correlation analysis showed that there was a positive correlation between PF / V25 score and clinical days (r = 0.532,0.265, Pa <0.05). Crs / kg was negatively correlated with clinical score (r = -0.269, P <0.05). Conclusion Pulmonary function in infants and young children with interstitial pneumonia is mainly manifested as large and small airway obstructive ventilatory dysfunction and restrictive ventilatory dysfunction. Pulmonary function tests may provide an objective assessment for the clinical condition and prognosis of the disease.