Useful Parameters of Bronchial Hyperresponsiveness Measured with an Impulse Oscillation Technique in Preschool Children
Useful Parameters of Bronchial Hyperresponsiveness Measured with an Impulse Oscillation Technique in Preschool Children
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DOI：
10.3109/02770901003624259
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发表时间：
2010-04-01
影响因子：
1.9
通讯作者：
Han, Man Yong
中科院分区：
文献类型：
--
作者：
Jee, Hye Mi;Kwak, Ji Hee;Han, Man Yong
背景很少有研究关注使用振荡技术进行支气管激发试验，并且在学龄前儿童中进行的试验结果不一致。目标.本研究的目的是探讨激发浓度（PC）的水平是适当的支气管激发试验使用脉冲流速仪系统（IOS）评估哮喘。作者还比较了以不同方式表达的PC的可变诊断临界值。方法.应用IOS对50例学龄前哮喘儿童和41例慢性咳嗽儿童进行乙酰甲胆碱激发试验，同时记录呼吸系统在5 ~ 35 Hz频谱上的平均基线值、阻力（Rrs）、电抗（Xrs）、共振频率（Rf）和电抗面积（AX）。结果通过IOS进行的乙酰甲胆碱激发试验的结果（表示为预测值的百分比变化（Δ %Pred））在两组之间存在显著差异，而表示为实际数据或Z评分的结果则无显著差异。PC80_Xrs5是一个有价值的诊断哮喘的临界值，其敏感性（80.0%）和特异性（82.9%）可接受。Xrs 5的实际值（0.867; p < .001）和预测值（0.877; p < .001）的ROC曲线下面积均大于Rrs 5的ROC曲线下面积（分别为0.746和0.730）。结论.作者认为PC80_Xrs5可能是IOS评估学龄前哮喘儿童支气管激发试验的有用参数。
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. PC80_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 PC80_Xrs5 might be a useful parameter for IOS-assessed bronchial challenge testing in preschool children with asthma.