最大用力呼气流量-容积曲线法检测学龄期儿童肺功能的质量控制分析

Quality control for maximal expiratory flow-volume curve as a pulmonary function test in school-age children

摘要:

目的 了解最大用力呼气流量- 容积曲线法(MEFV)测定学龄期儿童肺功能的质控符合情况。方法 将行MEFV 次数≥ 2 的862 例患儿按年龄分为6 岁~ 组(n=379)、8 岁~ 组(n=210)、10 岁~ 组(n=164)和12~17 岁组(n=109), 比较MEFV 测定各组患儿肺功能质控参数和质控标准符合率。将诊断为哮喘的417 例患儿分为肺功能异常组(n=262)与肺功能正常组(n=155), 比较两组间肺功能质控参数的差异性。结果 862 例患儿共行2 367 次肺功能检测用于质控分析;符合起始标准外推容积(VBE)<0.15 L 百分率为97.8%, 其中6 岁~ 组符合率最高, 12~17 岁组符合率最低;符合结束标准呼气时间(FET)百分率为44.2%, 其中10 岁以上患儿符合率低于10 岁以下患儿(P<0.05);符合可重复标准最佳两次第一秒用力呼气容积差(⊿ FEV1)<0.15 L 与最佳两次用力肺活量差(⊿ FVC)<0.15 L 的百分率分别为91.9% 和84.8%。肺功能异常的哮喘患儿肺功能质控参数均优于肺功能正常组(P<0.05)。结论 MEFV 检测肺功能起始标准与可重复性标准符合率较高, 结束标准符合率较低, 建议进一步优化提高FET 标准符合率。

Abstract:

Objective To assess the quality control for the maximal expiratory flow-volume (MEFV) curve in school-age children. Methods Eight hundred and sixty-two children who had two or more MEFV manoeuvres were classified into ≥6-year-old (n=379), ≥8-year-old (n=210), ≥10-year-old (n=64), and 12-17-year-old groups (n=109). The parameters of quality control and concordance with quality control criteria for MEFV were compared between the two groups. In addition, patients who were diagnosed with asthma were classified into two groups, one with normal pulmonary function (n=155) and the other with abnormal pulmonary function (n=62), based on the results of spirometry. Differences in the parameters of quality control for spirometry were compared between the two groups. Results Eight hundred and sixty-two children underwent 2 367 MEFV manoeuvres, 97.8% of which met the start of test criterion for backward extrapolated volume (VBE) of less than 0.15 L, with the highest concordance in the ≥6-year-old group and the lowest concordance in the 12-17-year-old group. Three hundred and eighty-one children (44.2%) met the end of test criterion for forced expiratory time (FET) and the concordance in children over 10 years of age was lower than that in children under 10 years of age (P<0.05). Differences in two best forced expiratory volume in first second (FEV1) and forced vital capacity (FVC) manoeuvres were within 150 mL in 91.9% and 84.8%, respectively, of the children. The parameters of quality control for spirometry were better for asthmatic children with abnormal pulmonary function compared with asthmatic children with normal pulmonary function (P<0.05). Conclusions Concordance with the start of test criteria and the manoeuvre repeatability criteria is high, whereas the concordance with the end of test criteria is low. It is suggested that the concordance with the FET criteria should be improved.