目的 探讨沧州地区农村不同类型毛细支气管炎(简称毛支)后反复喘息患儿潮气呼吸肺功能变化及临床意义。方法 选取3岁以下沧州地区农村毛支后反复喘息患儿102例为研究对象,依据哮喘预测指数分为阳性组45例和阴性组57例。另选30例健康婴幼儿为对照组。分阶段于喘息发作急性期、缓解期和恢复期(喘息缓解3个月后)对两组患儿进行潮气呼吸肺功能检测,比较参数达峰时间比TPTEF/TE和达峰容积比VPEF/VE的变化,并与健康对照组对比。结果 在喘息急性期阳性组、阴性组的TPTEF/TE、VPEF/V、VT、Ti、Te差异均无统计学意义(P>0.05),但与对照组比较,两组患儿TPTEF/TE、VPEF/V均明显降低(P<0.01)。在缓解期阳性组、阴性组的TPTEF/TE、VPEF/VE比急性期均升高,仍低于对照组,且阴性组高于阳性组,差异均有统计学意义(P<0.05)。在恢复期阳性组的TPTEF/TE、VPEF/VE较缓解期升高,但仍明显低于对照组,差异有统计学意义(P<0.01),而阴性组与对照组差异已无统计学意义(P>0.05)。结论 沧州地区农村毛细支气管炎后反复喘息患儿,阳性组喘息缓解3个月后仍持续存在肺功能损害,较阴性组肺功能损害持续时间长,恢复慢,潮气呼吸肺功能检测可为早期识别哮喘并制定规范的治疗方案防治哮喘的发生提供一些临床参考。

Objective To explore the changes and the clinical significance of tidal breathing lung function in infants with recurrent wheezing after bronchiolitis in Cangzhou rural area. Methods One hundred and two infants with recurrent wheezing after bronchiolitis were enrolled.According to asthma predictive index,the infants were divided into positive group (n=45) and negative group (n=57) as observation group,and another 30 healthy children were enrolled as control group.Tidal breathing lung function of acute stage (on admission),remission stage and recovery stage (3 months after discharge from hospital) were tested,the ratio of time taken to reach peak expiratory flow to total expiratory time( TPTEF/TE) and the ratio of peak expiratory volume to total expiratory volume( VPEF/VE) were compared among three groups. Results In acute stage,TPTEF/TE,VPEF/VE,VT,Ti,Te showed no significant statistical differences (P>0.05) between positive group and negative group,but TPTEF/TE and VPEF/VE were significantly decreased,compared with control group (P<0.01).In remission stage,TPTEF/TE,VPEF/VE in positive group and negative group were higher than those in acute stage,but significantly lower than those in control group (P<0.05).In recovery stage,TPTEF/TE,VPEF/VE in positive group were lower than those in control group (P<0.01).While the difference between negative group and control group showed no statistical significance (P>0.05). Conclusions Among the infants with recurrent wheezing after bronchiolitis in Cangzhou rural area,the lung function damage duration is longer in asthma predictive index positive group than in the negative group,and still existed 3 months after discharge from hospital.Tidal breathing lung function test can provide some clinical reference for early recognition of asthma and can be helpful in developing standard treatment plans for the prevention and treatment of asthma.