目的:探究脉冲震荡肺功能(IOS)检测振荡频率5 Hz时气道黏性阻力(R5)等参数及最大呼气流量-容积曲线(MEFV)与3~5岁小儿慢性咳嗽病情严重程度的关系分析。方法:选择2017年3月~2018年3月于本院进行诊断或治疗的慢性咳嗽患儿80例作为研究组,同时选择在本院进行体检的健康儿50例作为对照组,使用儿童哮喘控制测试(C-ACT)评价患儿的疾病严重程度。两组进行MEFV检测指标包括第一秒用力呼气容积与用力肺活量之比(FEV1/FVC)和呼气峰流速(PEF)。通过IOS检测R5、共振频率(Fres)和振荡频率5 Hz时电抗值(X5)。ACT评分与MEFV、IOS指标的关系采用 Pearson 相关分析。采用受试者工作特征(ROC)曲线评价MEFV、IOS指标对慢性咳嗽的诊断价值。结果:重度组的C-ACT评分显著低于对照组(P<0.05),轻度组和重度组FEV1 /FVC和PEF均低于对照组,并且重度组低于轻度组(P<0.05)。轻度组和重度组患者的Fres、R5和X5均显著高于对照组,且重度组高于轻度组(P<0.05)。FEV1/FVC和PEF与C-ACT评分呈正相关关系(P<0.05),而Fres、R5和X5与C-ACT评分呈负相关关系(P<0.05)。Fres、R5和X5与FEV1/FVC和PEF分别呈现显著的负相关关系(P<0.05)。R5ROC值为0.938,其次为Fres,为0.917。IOS诊断指标的价值均高于MEFV。结论:小儿慢性咳嗽FEV1/FVC和PEF降低而Fres、R5和X5升高,其中Fres、R5和X5与咳嗽症状严重程度具有较高的相关性,并且ROC分析结果也显示R5对3~5岁儿童慢性咳嗽具有最高的诊断价值。
Objective: To investigate the relationship between the parameters of pulse oscillating lung function (IOS), airway viscosity resistance (R5), and maximum expiratory flow-volume curve (MEFV), and the severity of chronic cough in children aged 3 to 5 years. Methods: Eighty children with chronic cough who were diagnosed or treated in our hospital from March 2017 to March 2018 were selected as the study group, and 50 healthy children who underwent physical examination in our hospital were selected as the control group. The child's asthma control test (C-ACT) was used to assess the severity of the disease in the child. MEFV test scores in the two groups included the ratio of forced expiratory volume to forced vital capacity in the first second (FEV1/FVC) and peak expiratory flow (PEF). The reactance value (X5) at R5, the resonance frequency (Fres), and the oscillation frequency of 5 Hz was detected by IOS. The relationship between ACT scores and MEFV and IOS indicators was analyzed by Pearson correlation. The receiver operating characteristic (ROC) curve was used to evaluate the diagnostic value of MEFV and IOS indicators for chronic cough. Results: The C-ACT score of the severe group was significantly lower than that of the control group (P<0.05). FEV1/ FVC and PEF were lower in the mild and severe groups than in the control group. The severe group was lower than the mild group (P<0.05). Fres, R5 and X5 in the mild and severe groups were significantly higher than the control group, and the severe group was higher than the mild group (P<0.05). FEV1/ FVC and PEF were positively correlated with C-ACT score (P<0.05). There was a negative correlation between Fres, R5 and X5 and C-ACT score (P<0.05). Fres, R5 and X5 showed significant negative correlations with FEV1/FVC and PEF, respectively (P<0.05). R5 has a self-high ROC value of 0.938, followed by Fres, which is 0.917. And the value of IOS diagnostic indicators are higher than MEFV indicators. Conclusion: In children with chronic cough, FEV1/ FVC and PEF decreased while Fres, R5 and X5 increased, and Fres, R5 and X5 had a higher correlation with the severity of cough symptoms, and ROC analysis also showed that R5 was for children aged 3 to 5 years. Chronic cough has the highest diagnostic value.