Application of Impulse Oscillometry Combined with Fractional Exhaled Nitric Oxide in Monitoring Asthma Control Levels in Children.

IF 3.7 3区 医学 Q2 ALLERGY
Journal of Asthma and Allergy Pub Date : 2025-03-07 eCollection Date: 2025-01-01 DOI:10.2147/JAA.S507446
Jie Hu, Yinghong Fan, Ronghua Luo, Qianqian Li, Tao Ai, Li Wang
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Abstract

Purpose: To investigate whether Impulse Oscillometry (IOS) could more effectively monitor children with uncontrolled asthma and evaluate small airway function changes, while establishing a prediction model in combination with fractional exhaled nitric oxide (FeNO) to assist in clinical management and treatment of asthmatic children.

Patients and methods: A retrospective study was conducted on 203 asthmatic children who were followed up in our hospital from August 2023 to August 2024. Patients were divided into controlled asthma group (n=80) and uncontrolled asthma group (n=123). Conventional ventilatory parameters, IOS parameters, FeNO levels, and clinical data were analyzed and compared between the two groups. The optimal prediction model was established through multivariate logistic regression.

Results: In the uncontrolled asthma group, the respiratory system impedance at 5 hz (Z5), resistance at 5 hz (R5), the difference between resistance at 5 hz and resistance at 20 hz (R5-R20), resonant frequency (Fres), and FeNO levels were significantly higher compared to the controlled asthma group. The ratio of forced expiratory volume in one second to forced vital capacity (FEV1/FVC), forced expiratory flow at 50% (FEF50), forced expiratory flow at 75% (FEF75), and maximal mid-expiratory flow (MMEF) were lower in the uncontrolled group (P<0.05). Receiver operating characteristic curve (ROC) analysis demonstrated that Z5, R5, R5-R20, Fres, and FeNO were valuable in asthma diagnosis (P<0.05), with higher sensitivity in monitoring small airway function compared to MMEF. Multivariate logistic regression analysis established the optimal prediction model combining R5+(R5-R20) +FeNO, with an area under curve (AUC) of 0.915 (P<0.05), sensitivity of 0.831, and specificity of 0. 892.

Conclusion: Compared to conventional pulmonary function tests, IOS effectively identifies uncontrolled status in asthmatic children, particularly in younger patients, with higher sensitivity to small airway function changes. The model comprising R5+(R5-R20) +FeNO demonstrates clinical value in identifying uncontrolled status in asthmatic children.

脉冲振荡法联合呼气一氧化氮分数在监测儿童哮喘控制水平中的应用。
目的:探讨脉冲振荡法(Impulse Oscillometry, IOS)是否能更有效地监测哮喘患儿,评估气道小功能变化,并结合呼气一氧化氮分数(FeNO)建立预测模型,以辅助哮喘患儿的临床管理和治疗。患者与方法:对2023年8月至2024年8月在我院随访的203例哮喘患儿进行回顾性研究。患者分为哮喘控制组(n=80)和非控制组(n=123)。分析比较两组常规通气参数、IOS参数、FeNO水平及临床资料。通过多元logistic回归建立最优预测模型。结果:哮喘未控制组呼吸系统5 hz阻抗(Z5)、5 hz阻力(R5)、5 hz阻力与20 hz阻力之差(R5- r20)、共振频率(Fres)、FeNO水平均显著高于哮喘对照组。未控制组1秒用力呼气量与用力肺活量之比(FEV1/FVC)、50%用力呼气流量(FEF50)、75%用力呼气流量(FEF75)和最大呼气中流量(MMEF)均较低(p)。结论:与常规肺功能试验相比,IOS可有效识别哮喘患儿的不控制状态,尤其是年轻患者,对气道功能的微小变化具有更高的敏感性。由R5+(R5- r20) +FeNO组成的模型在识别哮喘患儿的控制状态方面具有临床价值。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
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来源期刊
Journal of Asthma and Allergy
Journal of Asthma and Allergy Medicine-Immunology and Allergy
CiteScore
5.30
自引率
6.20%
发文量
185
审稿时长
16 weeks
期刊介绍: An international, peer-reviewed journal publishing original research, reports, editorials and commentaries on the following topics: Asthma; Pulmonary physiology; Asthma related clinical health; Clinical immunology and the immunological basis of disease; Pharmacological interventions and new therapies. Although the main focus of the journal will be to publish research and clinical results in humans, preclinical, animal and in vitro studies will be published where they shed light on disease processes and potential new therapies.
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