Clinical Study Of Parameter Of Pulmonary Ventilation Function In Asthmatic Children

Objectives To evaluate the parameters of pulmonary ventilation function in assessing asthmatic status and instructing treatment by measuring parameters of pulmonary ventilation function in children with asthma in acute exacerbation and chronic persistent period, in order to evaluate the correlation of asthma control test(ACT) and pulmonary function parameters.Methods Forty three in5to12years old children with asthma were enrolled in the study. The parameters of pulmonary ventilation function of asthmatic children both in stage of asthma attack (acute exacerbation group) and in remission after ICS treatment for one month (chronic persistent period group) were measured respectively by using Jaeger Master Screen diffusion determinator. Also the essential information and ACT scores were collected before and after treatment. The parameters of pulmonary ventilation function were including large-airway pulmonary function values(FVC、FEV1、 FEV1/FVC、PEF) and small-airway pulmonary function measurements(FEF25、 FEF50、FEF75、MMEF). It was compared the change of parameters of pulmonary function in two groups of asthmatic children with the stage of before and after ICS treatment. And the difference of parameters of pulmonary function in different degree of severity in acute exacerbation and the correlation of ACT scores and pulmonary function parameters were studied.Result1. The values of large-airway pulmonary function:There were statistically significant that pulmonary ventilation function parameters FVC、 FEV1、FEV1/FVC、PEF of asthmatic children in acute exacerbation were decreased as compared to that of those in chronic persistent stage and healthy children group (P<0.01); while pulmonary ventilation function parameters including FVC、FEV1、PEF in chronic persistent period children after therapy with asthma were normal comparing to those in healthy control group (P>0.05).2. The measurements of small-airway pulmonary function:The small airway function parameters FEF25、FEF50、FEF75、MMEF in children with asthma attack were obviously decreased, which were significantly different from that of those in chronic persistent period and healthy children (P<0.01); the parameters of FEF25、FEF50、FEF75、MMEF in asthmatic children in chronic persistent stage were lower significantly than that of those in healthy children(P <0.05).3. The lower each index of pulmonary ventilation function parameters (FVC%Pre、FEV1%Pre、PEF%Pre、FEF25%Pre、FEF50%Pre. FEF75%Pre、 MMEF%Pre、except FEV1/FVC%Pre) and the more severe in episode in asthmatic children in acute stage, there were statistically significant (P<0.05).4. ACT scores were lower in acute exacerbation than that in chronic persistent period in asthmatic children. The change of ACT scores were positively correlated with the large airway pulmonary function value (FEV1%Pre、PEF%Pre) and the small airway function parameter(MMEF%Pre)(P<0.01). Conclusion1. Parameter of pulmonary function was abnormal in stage of asthma attack, which were improved in chronic persistent period in asthmatic children.2. Small airway obstruction was persisted although asthmatic symptoms well controlled in asthmatic children, that was likely to be interpreted that small airway was main pathological change in asthmatic children.3. Compared to the large-airway pulmonary function values, small airway function indexes of pulmonary ventilation function could play a more significant role in judging the state of asthma and instructing treatment.4. Asthmatic children’s FEV1/FVC was in normal range both in acute stage and in chronic persistent period. There was no significant difference of FEV1/FVC among in difference degree of severity in acute stage of asthmatic children, which is likely to say the value of FEV1/FVC in assessing the airway obstruction in asthmatic children was limited.5. ACT scores were positively correlated with the parameters of pulmonary ventilation function in the children with asthma.