潮气呼吸肺功能联合支气管舒张试验在学龄前儿童哮喘诊断中的应用

Application of tidal breathing pulmonary function examination combined with bronchodilation test in diagnosis of asthma in preschool children

摘要

目的 探究在学龄前哮喘患儿诊断中,潮气呼吸肺功能以及支气管舒张试验的应用价值。方法 纳入2023年1月至2024年1月于佛山市南海区妇幼保健院收治的100例学龄前哮喘患儿为研究对象,依据病情进展分为研究A组(急性发作期)与研究B组(慢性持续期),各50例,另选50例体检健康儿童作为对照组.所有患儿均进行潮气呼吸肺功能检测及支气管舒张试验.比较三组的潮气呼吸肺功能指标以及研究A/B组的支气管舒张阳性率.采用受试者工作特性曲线(ROC)对潮气呼吸肺功能指标进行学龄前哮喘患儿诊断的预测价值评估,分析应用潮气呼吸肺功能以及支气管舒张试验联合检测对学龄前哮喘患儿的诊断效能。结果 三组的每千克体重潮气量(VT/kg)、达峰时间比(TPTEF/TE)、达峰容积比(VPEF/VE)以及吸呼比(Ti/Te)比较,均为研究A组＜研究B组＜对照组(F＝54.592、79.267、103.714、148.701,P＜0.05).100例哮喘患儿的支气管舒张试验总阳性率为44％,其中研究A组的阳性率为62％、研究B组为26％,研究A组的支气管舒张试验阳性率高于研究B组(χ²＝13.149,P＜0.05).ROC显示,VPEF/VE、VT/kg、Ti/Te、TPTEF/TE以及四者联合检测学龄前哮喘的曲线下面积(AUC)分别为0.711、0.736、0.725、0.720以及0.895.潮气呼吸肺功能指标与支气管舒张试验联合对学龄前哮喘诊断的敏感性、特异性及准确性均高于单独检验(P＜0.05)。结论 潮气呼吸肺功能及支气管舒张试验联合检测在学龄前哮喘患儿中诊断效能较好,具备较高应用价值.

Abstract

Objective To explore application values of bronchodilation test (BDT) and tidal breathing flow volume curve (TBFV) in diagnosis of asthma in preschool children. Methods A total of 100 preschool children with asthma who admitted to Nanhai District Maternity and Child Health Hospital of Foshan City from January 2023 to January 2024 were selected as study subjects.According to disease progression,they were divided into study group A (acute attack stage,n＝50) and study group B (chronic persistent stage,n＝50).Another 50 healthy children who received regular physical examination were selected as control group.All the children received tidal breathing pulmonary function examination and BDT.The pulmonary function indexes of the children in the three groups and the positive rate of BDT between group A and group B were compared.Receiver operating characteristic (ROC) curve was used to evaluate diagnostic value of tidal breathing pulmonary function indexes for asthma in preschool children.The diagnostic efficacy of the combination of tidal breathing pulmonary function examination and BDT for asthma in preschool children was analyzed. Results The tidal volume per kilogram body weight (VT/kg),the peak-to-volume ratio [the time necessary to reach the peak expiratory flow in tidal breathing over the total expiratory time (TPTEF/TE)],peak-to-volume ratio [the volume necessary to reach the peak expiratory flow in tidal breathing over the total expiratory volume (VPEF/VE)] and the ratio of inspiration time over expiration time (Ti/Te) of the children were compared among the three groups,and the results shown that those in the study group A ＜study group B ＜control group (F＝54.592,79.267,103.714 and 148.701 respectively,all P＜0.05).The total positive rate of BDT in 100 children with asthma was 44％,and the positive rate in the study group A was 62％ and that in the study group B was 26％,showing that the positive rate in the study group A was higher than that in the study group B (χ²＝13.149,P＜0.05).ROC curve analysis showed that the areas under the curves (AUCs) of VPEF/VE,VT/kg,Ti/Te,TPTEF/TE and the combination of the four indexes above for diagnosing asthma in preschool children were 0.711,0.736,0.725,0.720 and 0.895 respectively.The sensitivity,specificity and accuracy of the combination of tidal breathing pulmonary function indexes and BDT for preschool asthma were higher than those of each single test (all P＜0.05). Conclusion In diagnosis of asthma in preschool children,the combination of tidal breathing pulmonary function and BDT has better diagnostic efficacy and high application value.

关键词

学龄前儿童 / 哮喘 / 潮气呼吸肺功能 / 支气管舒张试验 / 应用价值

Key words

asthma / tidal breathing pulmonary function / application value / bronchodilation test

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基金资助

佛山市科技局课题(2220001004625)