Probe Of Impulse Oscillometry Pulmonary Function And Eosinophil Cationic Protein In The Evaluation Of Asthma Therapy

Objective: To probe the pole of Impulse Oscillometry pulmonary function (IOS), general pulmonary function (PFT) and Eosinophil Cationic Protein (ECP) in the evaluation of children's asthma therapy , through which we aim to find the best evaluation criteria.Method: 25 cases during attack period and 18 cases in remission period and 12 cases of control group were tested by PFT, another 35 cases during the attack period and 22 cases in remission period as well as 16 cases of control group were tested by I OS in Master Screen System. In the same time the last 35 cases during the attack period and 22 cases in remission period as well as 16 cases of control group received ECP evaluation in Pharmacia CAP System.Results: First, these were significant differences between attack group and remission group with PFT evaluation to FVC, FEV1.0%, FEV1.0, PEF, FEF25-75 (q=3.82-10.31, P<0.05 or<0.01),while very significant differences between attack group and control group (q=5.21 ~ 11.04, P<0.01).Also, FEF25-75 had significant differences between remission group and control group (q=4.03~7.41, P<0.05 or <0.01).The abnormality of FEF50 arose at 96% in attack period and that of FEF75 arose at 72.22% in remission period, which mean that functional disturbance of small airway can be found even in remission period. Second, when we tested them with IOS, we found these were significant differences between attack group and remission group in the evaluation of R5, R5-R20, X5, Fres, Zrs, Rp (q=5.81~8.91,P<0.01), but only R5-R20, Fres had significant differences between remission group and control group(q=5.78,6.02,P<0.01).The abnormality of R5-R20 got to 100% in attack period while R20 abnormality was the lowest (14.29%). So, you can get the conclusion that the peripheral airway obstruction is themain change during attack period. Third, IOS and PFT show good relativity which can be proved by the following data: there were negative relativity in Zrs via FVC, R5-R20 via FEF25-75 and Fres via FEV1.0 (r=-0.42 ~ -0.65, P<0.05 or <0.01) as well as significant positive relativity in Xs via FEF50 and FEF75 during attack period. Also, we found the sensibility of IOS was higher than that of PFT, which is showed by the contract in the criteria abnormality between IOS and PFT in attack period. {Zrs higher than FVC, Fres higher than FEVi.o(X2 =4.07, 4.44, P<0.05) but they were the same in remission period}. Another, serum ECP of attack group was significantly higher than that of control group (q=5.21,8.32, P<0.01) and the latter also had significant difference with the remission group (q=3.21, P<0.05), which mean airway inflammation exist even in remission period. The last but not the least, we found that FEF25-75 and R5-R20 can indirectly reflect the level of airway inflammation. Serum ECP had negative relativity with PEF and FEF75 in attack period (r=-0.40, -0.42, P<0.05) and positive relativity with R5-R20 (r=0.53, P<0.01).Conclusion: There are good relativity between IOS and PFT as well as ECP. The sensibility of IOS is higher than that of PFT. So, IOS is better than PFT and serum ECP in the evaluation of children's asthma. Esp. infantile asthma. From above, we can draw the following conclusion that IOS is the best criteria in the evaluation and surveillance of children's asthma therapy.