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OBJECTIVE: To investigate the factors influencing the improvement of tidal lung function bronchodilation test,and to provide evidence for the diagnosis of infant asthma. METHODS: Totally 71 infant patients diagnosed with asthma were included from clinic of Children's Hospital of Capital Institute of Pediatrics and alternativley assigned into two groups,who respectively received bronchodilator via pM DI(pMDI group)or nebulization(nebulization group),and bronchodilation test was performed. The effects of drug delivering methods on the bronchodilation test was compared,and the main observation indexes were respiratory rate(RR),VT/kg,inspiratory time(Ti),expiratory time(Te),Ti/Te,time to peak tidal expiratory flow as a proportion of expiratory time(TPTEF/TE),volume to peak expiratory flow as a proportion of exhaled volume(VPEF/VE)and peak tidal expiratory flow(PTEF). Further analysis was carried within each group. RESULTS: Twenty patients received bronchodilator via pM DI,and fifty-one patients received bronchodilator via nebulization. After drug delivery,the RR of the children in the pMDI group decreased significantly(P=0.003),and the Ti increased significantly(P=0.011). The VT/kg,Ti,Ti/Te,TPTEF/TE and VPEF/VE increased significantly in nebulization group(all P<0.05). In the nebulization group,the improvement rate of TPTEF/TE and VPEF/VE were significantly higher than that of pMDI group(all P<0.05). In the pMDI group,the Te,Ti/Te,TPTEF/TE and VPEF/VE significantly improved in patients with severe airway obstruction(all P<0.05). The above parameters also improved after bronchodilation test in nebulization group. Compared in difference age groups,TPTEF/TE and VPEF/VE in children over 2 years improved more significantly than those in children under 1 year(all P<0.05). CONCLUSION: The effects of nebulization are better than pMDI in tidal lung function bronchodilation test. The improvement rate of tidal lung function is related to the degree of airway obstruction and the age of patients.
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Objective To explore the main influential factors of bronchodilation test positive results in mechanically ventila-ted patients with chronic obstructive pulmonary disease(COPD).Methods A total of 55 inpatients with acute exacerbation of COPD(AECOPD)receiving the invasive ventilation from June 2015 to March 2016 were collected.The accurate respiratory mechan-ics monitoring was performed before and after using the bronchodilator.The airway resistance reduction over 12% after inhaling bronchodilator served as the judgment criteria,the patients were divided into the bronchodilation test positive or negative groups, then the influential factors were compared and statistical analysis was performed.Results Twenty-nine cases(52.7%)showed the positive reaction and 26 cases(47.2%)were negative.After univariate analysis,results of heart rate,SaO2,fungal infection,horm-onotherapy,CKMB,lactic acid and BNP were brought into the multivariable Logistic regression analysis(P< 0.1).The analysis found that fungal infection was an independent factor affecting the results of the bronchodilation test(P<0.05).Conclusion Fun-gal infection is an independent influential factor of the bronchodilation test positive in COPD patients receiving invasive ventilation.
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Children are prone to develop respiratory diseases during their infancy.As a noninvasive and safe method of detection,infant lung function test combined with bronchodilation test is of great significance to the assessment of lung development and the diagnosis of disease.Infant lung function test can measure the development of lung and airway,help to study the natural course of the disease,judge the location and type of the obstruction,and observe the effects of treatment.The bronchodilation test uses inhalation bronchodilator to relieve bronchial smooth muscle spasm and indicates the reversibility of airflow obstruction.This article reviews the operation techniques,evaluation parameters,cut-off value and clinical application of bronchodilation test in infants and young children.
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Objective To discuss the characteristics of pulmonary function in children patients with positive bronchodilating response using impulse oscillation system(IOS) and provide the evidence for clinical diagnosis and performing IOS.Methods Seventy children patients with bronchodilating response using IOS were recruited randomly for this study.Forty children patients with positive bronchodilating response were regarded as positive group and the other thirty children patients with negative bronchodilating response were regarded as negative group.The IOS parameters,for example,total respiratory impedance (Z5),respiratory resistance at 5 Hz(R5),reactance at 5 Hz(X5),peripheral respiratory resistance(Rp) in the two groups were analyzed.Results Z5,R5,X5 of the positive group [(123.45 ± 24.75)％,(120.09 ± 25.40)％,(138.62 ± 33.48)％] were higher than those of the negative group [(103.89 ± 16.30)％,(102.67 ± 18.16)％,(111.85 ± 14.93)％].There were significantly different between the two groups (P ＜ 0.05).Moreover,Rp ≥ 19.89 cmH2O/ (L·s)(1 cmH2O =0.098 kPa) in the positive group was 50.00％(20/40),which was higher than that in the negative group[23.33％(7/30)].There was significant difference between the two groups(P＜ 0.05).Conclusions The impedance of children patients with positive bronchodilating response using IOS is significantly increased,especially X5.When IOS parameters ≥ 100％,especially X5 ≥ 100％,which suggest that perform the bronchodilation test in order to decrease the rate of missed diagnosis of asthma.
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Objective To explore the linearic regularity of airways′ spasm and spasmolysis in hyperreactive guinea pigs.Methods Asthmatic guinea pig models were established with acetylcholine(Ach).Then the animals inhaled salbutamol.At 0,15,30 min and 1 h after inhalation of salbutamol,the animals were sacrificed,and the small and large airways were fixed with formaldehyde and embedded in paraffin wax to acquire the consecutive slides.The pathologic changes of both the large and small airways were observed and the caliber changes of the airways were determined.Results The diameters of small and large airways of the control guinea pig models(0.41?0.10 and 1.78?0.41 mm,respectively) were significantly short than that in normal(0.55?0.20 and 2.41?0.50 mm,respectively)(P
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Objective To explore the linearic regularity of airways′ spasm and spasmolysis in asthmatic patients,and provide theory bases for clinic treatment.Methods After regular bronchodilation test,the pulmonary function in(16 asthmatic) patients and 14 volunteers were examined 15 min,30 min, 1 h,2 h and 4 h later,respectively.The indexes included forced vital capacity(FVC),forced expiratory flow in one second(FEV_1),peak expiratory flow(PEF),maximal midexpiratory flow(MMEF),expiration of 50% FVC(V_(50)) and expiration of 75% FVC(V_(25)).Results 2 h after bronchodilation test,the big airways dilated completely(P