黄小英　张松丽　赵萍　刘国清　罗惠琴　何爱华

体积描记法在婴幼儿急性下呼吸道感染中的应用价值评估

黄小英张松丽赵萍刘国清罗惠琴何爱华

【摘要】目的使用体积描记法对婴幼儿急性下呼吸道感染(ALRI)肺功能相关变化和预后进行评估，探讨体描应用于婴幼儿ALRI中的意义。方法选取2012年2月至2013年6月收治的ALRI患儿共计430例，根据患儿情况分成喘息组180例，非喘息组250例，并设置呼吸功能正常儿童共110例作为对照组，使用体描仪对FRC，Raw以及潮气呼吸参数进行测定，分析比较各组FRC、Raw等体描特征性项目和潮气呼吸项目之间的差异与相关性。结果喘息组TPTEF/TE、FRCp中位数、FRCp/kg、sReff、Reff及Reff/kg明显高于其他2组(P＜0.05)，VPTEF/VE低于其他2 组(P＜0.05)。FRCP、FRCP/kg、sReff、Reff及Reff/kg与TPTEF/TE，IVPTEF/VE呈负相关(P＜0.05)。同急性期相比，喘息组患儿恢复期的TPTEF/TE、VPTEF/VE无显著改善(P＞0.05)，FRCP、FRCP/kg、sReff、Reff、Reff/kg等体描特有指标下降明显，差异均有统计学意义(P＜0.05)。结论体描在测定ALRI患儿肺功能方面可行性较强，能有效反应ALRI的呼吸功能变化，值得临床推广应用。

【关键词】呼吸功能试验;体积描记术;呼吸道感染

【中图分类号】R 725.62

【文献标识码】A

【文章编号】1002－7386(2015)16－2408－04

doi:10.3969/j.issn.1002－7386.2015.16.002

【Abstract】Objective To evaluate the changes of lung function related to infantile acute lower respiratory infection(ALRI)and patient’s prognosis bymeans of plethysmography，and to explore the application value of plethysmography in infantile acute lower respiratory infection.Methods Four hundred and thirty infants with ALRI who were admitted into our hospital from February 2012 to June 2013 were enrolled in the study.The patients were divided into two groups: gasping group(n =180)and non-gasping group(n =250)，besides，110 healthy infants were served as control group.The FRC，Raw andmoisture respiratory parameters of all the subjects were detected by plethysmography，and the correlation between plethysmographic parameters including FRC，Raw andmoisture respiratory parameters was analyzed and compared.Results The TPTEF/TE，median FRCp，FRCp，FRCp/kg，sReff，Reff and Reff/kg in gasping group were significantly higher than those in the other two groups(P＜0.05)，however，VPTEF/VE was significantly lower than that in the other two groups(P＜0.05).The FRCP，FRCP/kg，sReff，Reff，Reff/kg were negatively correlated to TPTEF/TE and IVPTEF/VE.As compared with those in gasping group at acute period，the TPTEF/TE and VPTEF/VE were not obviously improved in gasping group at recovery period(P＞0.05)，but FRCP，FRCP/kg，sReff，Reff，Reff/kg were significantly decreased(P＜0.05).Conclusion Plethysmography is greatly feasible inmeasuring lung function of infants with ALRI，which can effectively reflect the changes of respiratory function of patients with ALRI，therefore，it is worthy of clinical spreading application.

收稿日期:(2015－02－18)

作者单位: 516000广东省惠州市第一人民医院儿科(黄小英、张松丽、赵萍)，肺功能科高压氧(刘国清)，儿保科(罗惠琴);广东省惠州市中医医院儿科(何爱华)

Application value of plethysmography in infantile acute lower respiratory infection

HUANG Xiaoying，ZHANG Songli，ZHAO Ping，et al.Department of Pediatrics，The First Hospital of Huizhou City，Guangdong，Huizhou 516000，China

【Key words】respiratory function test; volume trace technique; respiratory tract infection

急性下呼吸道感染(acute lower respiratory infection，ALRI)是造成婴幼儿死亡重要因素，其中肺炎以18.3%的比例高居时间范围年龄低于5岁的儿童的死亡原因首位［1］，而婴幼儿发生ALRI造成喘息也与哮喘发生存在一定关系，据统计哮喘患儿约有30%于婴儿时期有细支气管炎病史［2］。……