目的 探讨脉冲振荡(impulse oscillometry，IOS)肺功能检测在儿童支气管舒张试验中的诊断价值，确定脉冲振荡肺功能各指标舒张试验的阳性标准。方法 本研究选取2021年1月-2022年8月在四川大学华西第二医院就诊的86例儿童为研究对象，年龄在4～14岁。其中，哮喘门诊就诊患儿为哮喘组(51例)，健康体检儿童为对照组(35例)。两组患者均在吸入沙丁胺醇前后进行常规肺通气功能测定和IOS肺功能检测，以第一秒用力呼气容积(forced expiratory volume in one second，FEV1)≥12％作为标准，比较两组受试者在支气管舒张试验前后IOS各参数的差异，确定IOS舒张试验的阳性标准。结果 舒张试验前，哮喘组肺通气功能测定指标FEV1/FVC、FEV1 为(82。64±7。53)和(78。64±16。49)，对照组为(99。27±6。16)和(98。19±9。02)，吸入沙丁胺醇后哮喘组FEV1改善率≥12％，而对照组＜12％。支气管舒张试验后，哮喘组和对照组IOS肺功能各参数均有不同程度改善。ROC结果显示，IOS各指标中，振荡频率为5Hz时的呼吸总阻抗(Z5)、周边弹性阻力(X5)、气道黏性阻力(R5)等指标对于支气管舒张试验阳性有较好的诊断价值。以Z5下降≥13。91％、X5下降≥14。78％、R5下降≥14。96％为脉冲振荡肺功能支气管舒张试验阳性的分界点，敏感性和特异性较高。结论 支气管舒张试验后，Z5下降≥13。91％、X5下降≥14。78％、R5下降≥14。96％可以判断支气管舒张试验阳性。
Diagnostic Threshold Exploration of Impulse Oscillometry Pulmonary Function in Pediatric Bronchodilation Test
Objective To explore diagnostic value of impulse oscillometry(IOS)pulmonary function in pediatric bronchodilation test,and determine positive criteria for various indicators of impulse oscillometry pulmonary function dilation test.Methods The paper chose 86 subjects,including 51 cases in asthma group and 35 cases in control group,carried ou routine lung ventilation function and IOS lung function test before and after inhaling salbutamol.Difference in IOS parameters was compared between two groups before and after bronchodilation test with standard of force expiratory volume in one second(FEV1)＞12％,to determine positive standard for IOS dilation test.Results Lung ventilation function measurement indicators FEV1/FVC and FEV1 were 82.64±7.53 and 78.64±16.49 in asthma group,and 99.27±6.16 and 98.19±9.02 in control group.After inhaling salbutamol,improvement rate of FEV1 in asthma group was＞12％,while it was＜12％in control group.After bronchodilation test,both asthma group and control group showed varying degrees of improvement of IOS lung function parameters.The ROC results showed among various indicators of IOS,total respiratory impedance(Z5)at an oscillation frequency of 5Hz,peripheral elastic resistance(X5),and airway viscous resistance(R5)at an oscillation frequency of 5Hz had good diagnostic value for positive bronchodilation test.Cut-off points of Z5 decrease≥ 13.91％,X5 decrease≥ 14.78％,and R5 decrease≥ 14.96％for positive pulse oscillation pulmonary function bronchodilation test could achieve high sensitivity and specificity.Conclusion After bronchodilation test,Z5 decrease≥ 13.91％,X5 decrease≥ 14.78％,and R5 decrease≥ 14.96％can indicate positive bronchodilation test.
Impulse oscillometry pulmonary functionChildrenBronchial asthmaBronchodilation test
万方数据
维普
