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目的研究呼吸音量化分析在儿童哮喘的临床应用情况,以期探寻更有效的辅助临床诊断的方法。方法选取2012年9月至2014年8月在北京中医药大学东直门医院儿科门诊就诊的177例哮喘患儿及30例小儿保健按摩的正常儿童为研究对象,急性发作期患儿60例,缓解期患儿117例。采用3MTM Littmann~3200电子听诊器记录哮喘患儿发作期、缓解期与正常儿童呼吸音情况,通过蓝牙传输至电脑,采用配套的Zargis~Cardioscan TM软件,提取呼吸音相关数据,对比分析哮喘患儿发作期及缓解期与正常儿童呼吸音的差异情况。应用SPSS 16.0软件进行t检验。结果急性发作期和缓解期患儿的呼吸音强度[分别为(82.24±4.68)、(76.84±3.64)d B]和总有效功率[分别为(-20.94±3.50)、(-17.84±3.14)d B]均明显高于正常儿童[分别为(72.12±2.81)、(-24.35±2.94)d B],差异均有统计学意义(t值分别为10.896、6.619、4.863和10.252,P<0.01)。除25 Hz外,哮喘发作期患儿各频率呼吸音振幅均低于正常儿童,差异均有统计学意义(P<0.05,P<0.01)。在75 Hz以内和500、650 Hz频率段,哮喘缓解期儿童呼吸音振幅高于正常儿童,差异均有统计学意义(P<0.05,P<0.01)。结论呼吸音量化分析可以更直观地描述哮喘患儿气管痉挛程度及变化,做为辅助临床诊断的有效方法值得推广。
Objective To study the clinical application of quantitative analysis of respiratory volume in children with asthma, in order to find out more effective methods to assist the clinical diagnosis. Methods Seventy-seven children with asthma and 30 normal children with pediatric massage were selected from Pediatric Outpatient Department, Dongzhimen Hospital, Beijing University of Chinese Medicine from September 2012 to August 2014. Sixty children with acute exacerbation, 117 cases of children. The 3MTM Littmann ~ 3200 electronic stethoscope was used to record the breath sounds of children with asthma during the remission, the remission and the normal children. The breath sounds were transmitted to the computers via Bluetooth. The related Zargis ~ Catardoscan TM software was used to extract the breath sound data. Children’s attack and remission and normal children’s breathing sound differences. Apply SPSS 16.0 software t test. Results The intensity of breath sounds in acute and remission children were (82.24 ± 4.68) and (76.84 ± 3.64) d B, respectively, and the total effective power were -20.94 ± 3.50 and 17.84 ± 3.14, respectively d B] were significantly higher than those in normal children [(72.12 ± 2.81) and (-24.35 ± 2.94) d B], respectively (all t = 10.896, 6.619, 4.863 and 10.252, respectively, P <0.01 ). Except for 25 Hz, the amplitude of respiratory sounds was lower in children with asthma attack than in normal children (P <0.05, P <0.01). Within the frequency range of 75 Hz and 500,650 Hz, the amplitude of respiratory sounds of children with asthma during remission was higher than that of normal children (P <0.05, P <0.01). Conclusions Quantification of respiratory volume can be more direct description of the extent and changes of tracheal spasm in children with asthma, which is worthy of promotion as an effective method to assist clinical diagnosis.