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    • 肺功能脉冲震荡法判断儿童哮喘控制水平监测的敏感性

    ,,刘峰,姚劲

    Journal of Nanjing Medicial University（2018）

    Cited 1|Views16
    Abstract
    目的:探讨哮喘肺功能脉冲震荡法(IOS)在判断儿童哮喘控制水平中的临床意义.方法:将45例入组时均达到哮喘完全控制标准的患儿,按维持治疗6个月内有无哮喘再发情况,分为哮喘再发组和完全控制组.记录维持治疗初期运动前、后进行肺通气功能检查及通过脉冲震荡法测总呼吸阻抗(Z5)、外加频率为5 Hz、20 Hz时的气道阻力(R5、R20);5 Hz时的呼吸电抗差(⊿X5)、共振频率(Fres)等监测指标.分析两组患儿各项指标有无差异性,并寻找最佳诊断指标和诊断临界值.结果:两组患儿在运动激发实验前后通气功能无差异.哮喘再发组⊿X5及Fres在运动激发实验后升高,差异有统计学意义(P＜0.05).以运动实验后Fres的升高比率预测哮喘再发,ROC曲线下面积为0.827,临界值16.87％,敏感性0.611,特异性0.963.结论:肺功能脉冲震荡法在判断儿童哮喘控制水平中具有重大意义,且运动实验后Fres的升高比率,有助于监测哮喘是否完全控制.
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    【要点】：研究探讨了脉冲震荡法在评估儿童哮喘控制水平中的临床意义，发现运动后共振频率（Fres）的变化能有效预测哮喘再发，具有较高的特异性和敏感性。
    

    【方法】：通过将45例达到完全控制标准的哮喘患儿分为两组，一组哮喘再发，一组完全控制，对比两组在运动前后肺通气功能和脉冲震荡法测定的各项指标。
    

    【实验】：实验对两组患儿进行了运动前后的肺通气功能和脉冲震荡法的监测，包括总呼吸阻抗（Z5）、气道阻力（R5、R20）、呼吸电抗差（⊿X5）和共振频率（Fres），使用的数据集为患儿自身的监测数据。结果显示，哮喘再发组⊿X5及Fres在运动激发实验后升高，且以Fres的升高比率为指标，预测哮喘再发的ROC曲线下面积为0.827。