学龄前儿童采用脉冲振动技术检测支气管高反应性
2010/07/06
摘要
背景：有关采用振动技术进行支气管激发试验的研究较少，并且在学龄前儿童中，该技术取得的测试结果并不一致。
目的：本试验旨在通过脉冲振动系统研究支气管激发试验中的最佳激发浓度（PC）。同时，对采用不同方式表示的不同PC诊断截值进行比较。
方法：应用脉冲振动系统（IOS）对50名学龄前哮喘患儿和41名慢性咳嗽患儿进行乙酰甲胆碱激发试验，同时记录呼吸系统频谱超过5-35Hz的平均基线值、电阻(Rrs)、电抗（Xrs）、共振频率(Rf)及阻抗面积(AX)。
结果：通过脉冲振动系统进行的乙酰甲胆碱激发试验，若将结果表示为预测值的变化百分数，两组结果存在显著差异性；若将结果表示为实际值或Z评分，该值在两组间无差异。PC(80)_Xrs5是一个有价值的诊断截值，其敏感性和特异性分别为80.0%和82.9%。若上述结果为实际值和预测值，Xrs5的ROC曲线下面积（0.867，P<0.001；0.877，P<0.001）分别大于Rrs5曲线下面积（分别为0.746和0.730）。
结论： PC(80)_Xrs5是IOS评估学龄前儿童哮喘患者支气管激发试验的有用参数。
（林江涛 审校）
Jee HM, et al. J Asthma. 2010 Apr;47(3):227-232.
Useful parameters of bronchial hyperresponsiveness measured with an impulse oscillation technique in preschool children.
Jee HM, Kwak JH, Jung da W, Han MY.
Department of Pediatrics, CHA University School of Medicine, Seongnam, Korea.
Abstract
BACKGROUND: There are few studies focused on bronchial challenge testing using the oscillation technique, and results from the test in preschool children have been inconsistent.
OBJECTIVES: The aim of this study was to explore which level of provocative concentration (PC) is appropriate for bronchial challenge testing using the impulse oscillometry system (IOS) for assessing asthma. The authors also compared variable diagnostic cutoff values of PC expressed in different ways.
METHODS: A methacholine challenge test was performed using an IOS and the mean baseline value, resistance (Rrs), reactance (Xrs), resonance frequency (Rf), and area of reactance (AX) of the respiratory system were recorded simultaneously over a frequency spectrum of 5 to 35 Hz in 50 preschool children with asthma and 41 children with chronic cough, serving as controls.
RESULTS: The results of the methacholine challenge test by IOS, expressed as percent changes of the predicted value (Delta%Pred), were significantly different between the two groups, whereas results expressed as actual data or Z-score were not. PC(80)_Xrs5 was a valuable diagnostic cutoff level for asthma with acceptable sensitivity (80.0%) and specificity (82.9%). The areas under the ROC curves of Xrs5 for both actual (0.867; p < .001) and predicted values (0.877; p < .001) were larger than those for Rrs5 (0.746 and 0.730, respectively).
CONCLUSIONS: The authors suggest PC(80)_Xrs5 might be a useful parameter for IOS-assessed bronchial challenge testing in preschool children with asthma.
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