摘要
目的探讨广州地区1-3岁健康幼儿肺功能状况。方法将120名1-3岁健康幼儿分成1-2岁组-和3岁组。用美国森迪公司2600型婴幼儿肺功能仪测定肺功能值，包括用潮气流速-容量（TBFV）环部分替代最大呼气流速容量曲线检测出的潮气量（TV）和反映大、小气道功能的指标；利用被动流速容量技术测定呼吸系统静态顺应性（Crs）、总气道阻力（Rrs）；用开放式氮冲洗法测定功能残气量（FRC）。结果1-3岁健康幼儿各项肺功能测定值男、女间差异均无统计学意义（P均〉0．05）。1-2岁组和-3岁组呼吸频率差异无统计学意义（27vs26，t=1．512，P〉0．01）。-3岁组TV水平显著高于1-2岁组（0．123vs0．091，t=8．587，P〈0．01），但经体重校正后，差异无统计学意义（0．0091vs0．0086，t=1．959，P〉0．01）。-3岁组潮气呼气峰流速（PTEF）水平显著高于1-2岁组（0．159vs0．135，t=3．787，P〈0．01）。所测定的TBFV环是不典型椭圆形。呼气时间／总呼吸时间（Ti／Tt）、到达潮气呼气峰流速时的呼出气量／潮气量（％V-PF）、呼出75％潮气量时的呼气流速／潮气呼气峰流速（25／PF）和潮气呼气中期流速／潮气吸气中期流速（ME／MI）等指标，两组间差异均无统计学意义（P均〉0．05），而l一2岁组潮气呼气峰流速／潮气量（PF／Ve）水平显著高于-3岁组（1．257vs1.095，t=2．098，P〈0．05）。1-2岁组Rrs水平显著高于-3岁组（2．697vs2．071，t=3．761，P〈0．01）；-3岁组Crs水平显著高于1-2岁组（0．352vs0．254，t=4．297，P〈0．01），但经体重校正后，差异无统计学意义（0．026vs0．024，t=1．051，P〉0．01）；-3岁组FRC水平显著高于1-2岁组（0．271vs0．211，t=8．468，P〈0．01），但经体重校正后，差异无统计学意义（0．0198vs0．0198，t=0．000，P〉0．01）。由此可见，TV、FRC、Crs和PTEF随年龄增大而增大，尤与体重密切相关，两组间差异有统计学意义（P〈0．01），而反映大、小气道功能的所有指标相对稳定。结论用TBFV环部分替代最大呼气流速容量曲线可反映大、小气道功能情况，其各项指标相对稳定，可作为观察呼吸系统疾患时肺功能变化情况较理想的指标。健康幼儿TV、FRC、Crs和PTEF与体重呈正相关，符合幼儿生长发育的规律，1～3岁幼儿体重发育较为明显。
Objective To explore the development of pulmonary function of normal toddlers between 1 and 3 years old. Methods Totally 120 normal toddlers were divided into 2 groups according to their age , i.e. , 1 - 2 years old , - 3 years old. Pediatric pulmonary function laboratory type 2600 （Sensor Medics Corporation, USA ） was used to detect tidal flow volume curve, which can partially replace the maximum expiratory flow volume curve. Parameters showing small airway function were the ratio of the volume to reach peak tidal expiratory flow to total expiratory volume, the ratio of tidal expiratory flow at 25% remaining expiration to peak expiratory flow, and ratio of inspiratory time to total respiratory time. Parameters showing large airway function were the ratio of mid-tidal expiratory flow to mid-tidal inspiratory flow. Passive expiratory flow volume technique was used to examine respiratory system static compliance and total airway resistance. Open nitrogen washout method was used to measure functional residual volume. Results No significant difference was found between male and female toddlers （P 〉 0. 05 ）. Between the two groups, the difference of respiratory rate was not significant （27 vs 26, t = 1.512, P 〉 0. 01 ）. The values of tidal volumes in the - 3 years group were notably higher than in the 1 - 2 years group （ 0. 123 vs 0. 091, t = 8. 587, P 〈 0. 01 ）, but the values of tidal volumes per kilogram body weight were not significantly different （0. 009 1 vs 0. 008 6, t = 1. 959, P 〉 0. 01 ）. The peak tidal expiratory flow in the eider group was similarly distinctly higher than that in the other group. The measured tidal breathing flow volume loops were both displayed uncharacteristic ellipse. The ratioes of inspiratory time to total respiratory time, the volume to reach peak tidal expiratory flow to total expiratory volume, tidal expiratory flow at 25% remaining expiration to peak expiratory flow and mid-tidal expiratory flow to mid-tidal inspiratory flow were not significantly different between two groups （ P 〉 0. 05 ）. But the ratio of peak tidal flow to tidal volume （ 1.095 vs 1. 257, t = 2. 098, P 〈 0. 05 ） and the respiratory system resistances （2.07l vs 2. 697, t = 3.761, P 〈 0. 01 ） were evidently lower in the elder group than in the younger. The respiratory system compliances （0. 352 vs 0. 254, t = 4. 297, P 〈 0. 01 ） and functional residual capacities （0. 271 vs 0. 211, t = 8. 468, P 〈 0. 01 ） were significantly higher in the elder group than that in the younger, but the values per kilogram body weight were not significantly different （ P 〉0. 01 ）. It was shown that the values of tidal volume, peak tidal expiratory flow, respiratory system static compliance, residual volume were significantly different （P 〈0.01 ）, between two groups. The values of each parameter mentioned above were increased with age, and were positively correlated with body weight （ r = 0. 457,0. 849,0. 572,0. 319 ）. Conclusions Tidal breathing flow volume loop could show functions of small and large airways and partially replace the maximum expiratory flow loop. The parameters were stable in toddlers and could be used as reasonable index to evaluate the pulmonary function changes in pulmonary diseases. The ventilatory function, residual volume, respiratory system static compliance and peak tidal flow were increased with the age, which coincides with the rule of development of toddlers.
出处
《中国循证儿科杂志》
CSCD
2007年第1期21-26,共6页
Chinese Journal of Evidence Based Pediatrics
关键词
幼儿
呼吸功能试验
潮气流速-容量环
被动流速容量技术
开放式氮冲洗法
Toddlers
Respiratory function tests
Tidal breathing flow volume curve
Passive expiratory flow volume technique
Open nitrogen washout method
作者简介
通讯作者邓力，E-mail：drdengli@21cn．com
