合并哮喘和/或过敏性鼻炎儿童的肺功能表现：PEF25-75%与标准测量方法的比较
2019/03/21
摘要
背景：FEF25-75%是一种肺功能中测量小气道的一种方法，能够预测哮喘和过敏性鼻炎患者气道反应性的存在。我们的目的是寻找FEF25-75%与传统肺功能测量方法（FEV1%及FEV1/FVC）在不同情况下的关系，即哮喘患儿、哮喘合并过敏性鼻炎患儿、过敏性鼻炎患儿即健康儿童。
方法：哮喘患儿116例，哮喘合并过敏性鼻炎患儿75例及健康儿童对照组25例。进行临床测试、肺功能测试及舒张试验。
结果：在哮喘患儿中FEF25-75%和FEV1% (r=0.596, P<0.001)，以及 FEF25-75% 和FEV1/FVC (r=0.740, P<0.001)之间存在相关性。在哮喘合并过敏性鼻炎的患儿中FEF25-75% 和 FEV1% (r=0.633, P=0.001) 以及FEF25-75% 和FEV1/FVC (r=0.539, P=0.005)之间的相关性同样显著。舒张试验前，过敏性鼻炎患儿的FEV1%和FEF25-75%较健康对照组低。舒张试验后，过敏性鼻炎患儿在FEV1%(P<0.001)和FEF25-75%(P<0.001)及(P=0.001)显著增加。在过敏性鼻炎患儿中只有12/75 (16.0%)应用沙美特罗后出现支气管扩张。在FEF25-75% <65%的患儿中，哮喘患儿中FEV1%正常占6/43 (14%)，在哮喘合并过敏性鼻炎患儿中FEV1%正常占3/9 (33%)。
结论：除了FEV1% and FEV1/FVC，FEF25-75%可能是一种可用来评估哮喘合并过敏性鼻炎患儿的早期肺功能参数。
Spirometry in children with asthma and/or allergic rhinitis: comparison of FEF25-75% with the standard measures.
Eke Gungor H, Sahiner UM.
Abstract
BACKGROUND:Forced expiratory flow between 25% and 75% of vital capacity (FEF25-75%), a spirometric measure of small airways, may predict the presence of airway responsiveness both in asthmatics and in allergic rhinitis (AR). We aimed to search the correlation between FEF25-75% and standard measures of spirometry (forced expiratory volume in the first second [FEV1%] and FEV1/FVC [forced vital capacity]) in different clinical conditions, that is in children with asthma, in children with asthma and AR, in children with AR and in healthy children.
METHODS:Children with asthma (N.=116), asthma plus AR (N.=25), AR (N.=75) and healthy controls (N.=52) were evaluated. Clinical examinations, spirometry and bronchodilation tests were performed.
RESULTS:In asthmatics there was a strong correlation between FEF25-75% and FEV1% (r=0.596, P<0.001); and between FEF25-75% and FEV1/FVC (r=0.740, P<0.001). In AR patients correlation between FEF25-75% and FEV1% (r=0.367, P=0.001); and between FEF25-75% and FEV1/FVC (r=0.534, P<0.001) were less prominent compared to asthmatics but they were still significant and strong. In children with both AR and asthma correlation between FEF25-75% and FEV1% (r=0.633, P=0.001) and between FEF25-75% and FEV1/FVC (r=0.539, P=0.005) were again significant. Pre-test FEV1% and FEF25-75% in AR patients were lower than that of the control subjects. After the bronchodilation, percentage change in the FEV1 in AR patients were significantly higher than the control subjects (P=0.010). AR patients showed significant increases in FEV1%, (P<0.001), FEF25-75%, (P<0.001) and (P=0.001) after the bronchodilation test. Within the AR patients, only 12/75 (16.0%) showed bronchodilation with salbutamol. Among the ones with a FEF25-75% <65%, FEV1% was normal in 6/43 (14%) patients in asthmatics, and FEV1% was normal in 3/9 (33%) patients in asthma +AR patients.
CONCLUSIONS:Besides the FEV1% and FEV1/FVC, the FEF25-75% may be a useful and early spirometric parameter to evaluate the children with asthma and or AR.
背景：FEF25-75%是一种肺功能中测量小气道的一种方法，能够预测哮喘和过敏性鼻炎患者气道反应性的存在。我们的目的是寻找FEF25-75%与传统肺功能测量方法（FEV1%及FEV1/FVC）在不同情况下的关系，即哮喘患儿、哮喘合并过敏性鼻炎患儿、过敏性鼻炎患儿即健康儿童。
方法：哮喘患儿116例，哮喘合并过敏性鼻炎患儿75例及健康儿童对照组25例。进行临床测试、肺功能测试及舒张试验。
结果：在哮喘患儿中FEF25-75%和FEV1% (r=0.596, P<0.001)，以及 FEF25-75% 和FEV1/FVC (r=0.740, P<0.001)之间存在相关性。在哮喘合并过敏性鼻炎的患儿中FEF25-75% 和 FEV1% (r=0.633, P=0.001) 以及FEF25-75% 和FEV1/FVC (r=0.539, P=0.005)之间的相关性同样显著。舒张试验前，过敏性鼻炎患儿的FEV1%和FEF25-75%较健康对照组低。舒张试验后，过敏性鼻炎患儿在FEV1%(P<0.001)和FEF25-75%(P<0.001)及(P=0.001)显著增加。在过敏性鼻炎患儿中只有12/75 (16.0%)应用沙美特罗后出现支气管扩张。在FEF25-75% <65%的患儿中，哮喘患儿中FEV1%正常占6/43 (14%)，在哮喘合并过敏性鼻炎患儿中FEV1%正常占3/9 (33%)。
结论：除了FEV1% and FEV1/FVC，FEF25-75%可能是一种可用来评估哮喘合并过敏性鼻炎患儿的早期肺功能参数。
（中日友好医院呼吸与危重症医学科 张鑫 摘译 林江涛 审校）
（Minerva Pediatr. 2019 Apr;71(2):103-109. doi: 10.23736/S0026-4946.16.04267-5. Epub 2015 Sep 11.）
（Minerva Pediatr. 2019 Apr;71(2):103-109. doi: 10.23736/S0026-4946.16.04267-5. Epub 2015 Sep 11.）
Spirometry in children with asthma and/or allergic rhinitis: comparison of FEF25-75% with the standard measures.
Eke Gungor H, Sahiner UM.
Abstract
BACKGROUND:Forced expiratory flow between 25% and 75% of vital capacity (FEF25-75%), a spirometric measure of small airways, may predict the presence of airway responsiveness both in asthmatics and in allergic rhinitis (AR). We aimed to search the correlation between FEF25-75% and standard measures of spirometry (forced expiratory volume in the first second [FEV1%] and FEV1/FVC [forced vital capacity]) in different clinical conditions, that is in children with asthma, in children with asthma and AR, in children with AR and in healthy children.
METHODS:Children with asthma (N.=116), asthma plus AR (N.=25), AR (N.=75) and healthy controls (N.=52) were evaluated. Clinical examinations, spirometry and bronchodilation tests were performed.
RESULTS:In asthmatics there was a strong correlation between FEF25-75% and FEV1% (r=0.596, P<0.001); and between FEF25-75% and FEV1/FVC (r=0.740, P<0.001). In AR patients correlation between FEF25-75% and FEV1% (r=0.367, P=0.001); and between FEF25-75% and FEV1/FVC (r=0.534, P<0.001) were less prominent compared to asthmatics but they were still significant and strong. In children with both AR and asthma correlation between FEF25-75% and FEV1% (r=0.633, P=0.001) and between FEF25-75% and FEV1/FVC (r=0.539, P=0.005) were again significant. Pre-test FEV1% and FEF25-75% in AR patients were lower than that of the control subjects. After the bronchodilation, percentage change in the FEV1 in AR patients were significantly higher than the control subjects (P=0.010). AR patients showed significant increases in FEV1%, (P<0.001), FEF25-75%, (P<0.001) and (P=0.001) after the bronchodilation test. Within the AR patients, only 12/75 (16.0%) showed bronchodilation with salbutamol. Among the ones with a FEF25-75% <65%, FEV1% was normal in 6/43 (14%) patients in asthmatics, and FEV1% was normal in 3/9 (33%) patients in asthma +AR patients.
CONCLUSIONS:Besides the FEV1% and FEV1/FVC, the FEF25-75% may be a useful and early spirometric parameter to evaluate the children with asthma and or AR.
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