中国全科医学 ›› 2021, Vol. 24 ›› Issue (5): 551-554.DOI: 10.12114/j.issn.1007-9572.2020.00.429

• 专题研究 • 上一篇    下一篇

呼出气一氧化氮和潮气呼吸肺功能检测在毛细支气管炎中的应用价值

张盛鑫,袁林*,卓志强,李明珍,童秀斌   

  1. 361006福建省厦门市儿童医院 复旦大学附属儿科医院厦门分院三病区
    *通信作者:袁林,副主任医师;E-mail:yuanlin9716@sina.com
  • 出版日期:2021-02-15 发布日期:2021-02-15
  • 基金资助:
    基金项目:厦门市科技局科技惠民项目(3502Z20164069);厦门市儿童医院骨干人才培育项目(CHP-2019-BT-B003);厦门市儿童医院青年科研项目-膈肌超声对预测机械通气撤机结果的价值研究(CHP-2019-YRF-0009)

Clinical Value of Fractional Exhaled Nitric Oxide and Lung Function by Tidal Breathing in Children with Bronchiolitis 

ZHANG Shengxin,YUAN Lin*,ZHUO Zhiqiang,LI Mingzhen,TONG Xiubin   

  1. Ward 3,Xiamen Children's Hospital/Children's Hospital of Fudan University Xiamen Branch,Fujian 361006,China
    *Corresponding author:YUAN Lin,Associate chief physician;E-mail:yuanlin9716@sina.com
  • Published:2021-02-15 Online:2021-02-15

摘要: 背景 毛细支气管炎(简称毛支)是婴幼儿常见的下呼吸道疾病,如控制不佳相当一部分患儿将发展为支气管哮喘,因此,毛支患儿进行呼出气一氧化氮(FeNO)和潮气呼吸肺功能检测对于疾病的诊治疗效以及预后评估均有重要意义,但目前有关毛支患儿的FeNO和潮气呼吸肺功能的研究较少。目的 探讨FeNO和潮气呼吸肺功能检测在毛支中的应用价值。方法 采用便利抽样法选择厦门市儿童医院三病区2018年1—9月收治的38例首次诊断毛支的患儿(观察组)及同期厦门市儿童医院儿保中心体检的17例健康婴幼儿(对照组)为研究对象。分别在观察组急性期(治疗前)、恢复期(规范治疗1~2周后,出院前)及对照组进行FeNO和潮气呼吸肺功能检查,记录FeNO、潮气量(VT)、呼吸频率(RR)、吸呼比(Ti/Te)、达峰时间比(TPTEF/TE)、达峰容积比(VPEF/VE)等指标,并比较不同组及同组不同时期的差异。结果 观察组急性期及恢复期FeNO与对照组比较,差异均无统计学意义(P>0.05);观察组急性期FeNO与恢复期比较,差异无统计学意义(P>0.05)。观察组急性期VT、Ti/Te、TPTEF/TE、VPEF/VE低于对照组,RR高于对照组(P<0.05);观察组恢复期PTEF/TE和VPEF/VE高于急性期、低于对照组,RR低于急性期、高于对照组(P<0.05)。结论 潮气呼吸肺功能可反映毛支病情进展情况及临床治疗的效果,具有一定的应用价值;首次诊断毛支患儿治疗前、后以及健康儿童的FeNO无差异,因此FeNO在毛支中的应用价值有限。

关键词: 支气管炎, 毛细支气管炎, 呼出气一氧化氮, 潮气呼吸肺功能, 婴儿

Abstract: Background Bronchiolitis is a common lower respiratory disease in children,which may develop into asthma with a relatively high probability when it is poorly controlled.So detecting fractional exhaled nitric oxide(FeNO)and lung function by tidal breathing is of great significance in diagnosing,treating,and evaluating prognosis of bronchiolitis in children.Objective To explore the clinical value of FeNO and tidal breathing lung function in children with bronchiolitis.Methods A case control study was conducted in Xiamen Children's Hospital during January 2018 to September 2018 among a random sample of 45 children,including 38 with first diagnosed bronchiolitis(observation group)from Ward 3,and 17 healthy examinees(control group)from the Pediatric Healthcare Department.FeNO and lung function by tidal breathing were tested in the observation group during both acute and convalescent phases of bronchiolitis(before treatment,and before hospital discharge after one or two weeks of standardized treatment)and in the control group,with parameters of FeNO,tidal volume(VT),respiratory rate(RR),inspiratory-to-expiratory time ratio(Ti/Te),ratio of time to reach peak tidal expiratory flow to total expiratory time(TPTEF/TE),and ratio of volume to peak expiratory flow to total expiratory volume(VPEF/VE)were recorded and their interphase and intergroup differences were analyzed.Results In the observation group,there was no significant difference in the average FeNO level between acute and convalescent phases (P>0.05).The ratio of TPTEF/TE and ratio of VPEF/VE increased and RR decreased in the convalescent phase compared with the acute phase(P<0.05).The average FeNO level in the observation group during the acute or convalescent phase was similar to that of the control group(P>0.05).Compared with the control group,the observation group showed lower average VT,ratio of Ti/Te,ratio of TPTEF/TE,and ratio of VPEF/VE,and higher RR in the acute phase of bronchiolitis(P<0.05).In the convalescent phase,the observation group still showed lower ratio of TPEF/TE and ratio of VPEF/VE,and higher RR than the control group(P<0.05).Conclusion Lung function by tidal breathing may reflect the progression of disease and clinical treatment efficacy,which has certain application value.The FeNO level showed insignificant differences between the acute and convalescent phases of bronchiolitis,and between the suffered children and the healthy children,so the application value of FeNO is limited.

Key words: Bronchitis, Bronchiolitis, Fractional exhaled nitric oxide, Tidal breathing lung function, Infant