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目的探究儿童哮喘的呼吸阻抗特点及其临床意义。方法对2005年7月至2006年6月就诊于天津儿童医院的80例哮喘患儿、同期于天津儿童医院保健门诊体检的112名健康儿童及天津胸科医院呼吸科的62例成人哮喘患者应用脉冲振荡法(IOS)测定呼吸阻抗,部分患者作常规通气肺功能检测。对其组间指标进行统计学处理。结果 IOS测定显示儿童哮喘组气道总阻力5Hz时气道黏性阻力(R5)明显增高[(142.19±36.40)%],中心气道阻力(20Hz时气道黏性阻力(R20)正常[(88.53±17.83)%]。成人哮喘组R5、R20均增高,分别为(190.03±49.97)%、(152.53±39.11)%。两组电抗值X5和共振频率Fres均有不同程度减低和后移,Fres变化更显著。常规通气肺功能检查成人组FVC、FEV1/FVC实测值占预计值百分比分别为(81.19±15.42)%、(55.57±12.93)%,儿童组分别为(79.12±18.65)%、(64.81±9.78)%。结论儿童与成人哮喘患者呼吸阻抗特点差异存在统计学意义,儿童哮喘病变以小气道为主,吸入药物治疗应尽可能达到小气道水平。
Objective To investigate the characteristics of respiratory resistance in children with asthma and its clinical significance. Methods From July 2005 to June 2006, 80 children with asthma admitted to Tianjin Children’s Hospital, 112 healthy children in Tianjin Children’s Hospital during the same period and 62 adults with asthma in Tianjin Breast Hospital were enrolled. Respiratory impedance was measured by pulse oscillation method (IOS), and some patients were tested for routine ventilation pulmonary function. Statistical analysis of the indicators between the two groups. Results The IOS measurement showed that the airway resistance (R5) was significantly increased in children with asthma ([(142.19 ± 36.40)%] and the central airway resistance (normal airway resistance (R20) 88.53 ± 17.83)%], and both R5 and R20 in adult asthma group were (190.03 ± 49.97)% and (152.53 ± 39.11)%, respectively.The reactance X5 and resonance frequency Fres of both groups decreased and retarded to some extent, Fres showed more significant changes.The percentage of predicted values of FVC and FEV1 / FVC in adults with routine ventilation pulmonary function tests were (81.19 ± 15.42)% and (55.57 ± 12.93)%, respectively, and those in children were (79.12 ± 18.65)% and (64.81 ± 9.78)%, respectively.Conclusion There is a significant difference in the characteristics of respiratory resistance between children and adults with asthma, and small asthma in children with asthma and inhalation medication should reach the level of small airway as much as possible.