PDF(Pubmed)
Abstract：
BACKGROUND: Cough variant asthma (CVA) is one of the most common causes of chronic cough in children worldwide. The diagnosis of CVA in children remains challenging. This study aimed to assess the diagnostic utility of impulse oscillometry (IOS) pulmonary function in children with CVA.
METHODS: This study included children aged 4 to 12 years diagnosed with CVA who underwent IOS pulmonary function and bronchodilation (BD) tests. A control group of healthy children was matched. Pre- and post-BD IOS parameters were recorded and presented as mean ± standard deviation or median. Receiver operating characteristic (ROC) curves were plotted, and the area under the curve (AUC) was calculated to evaluate the discriminatory potential of the IOS parameters for diagnosing CVA.
RESULTS: A total of 180 patients with CVA and 65 control subjects were included. The baseline IOS parameters in the CVA group, except X5%pred, were significantly greater compared to the control group. After inhalation of salbutamol sulfate, all IOS parameters improved significantly in the CVA group. However, Z5%pred, R5%pred, and R20%pred remained greater in the CVA group compared to the control group. The improvement rates of IOS parameters in the CVA group significantly surpassed those in the control group. The ROC curve results for pre-BD IOS parameters and the improvement rate during the BD test showed that the combinations of pre-Z5%pred+△Z5% and pre-R5%pred+△R5% achieved the highest AUC value of 0.920 and 0.898, respectively. The AUC values of these combined parameters surpassed those of individual ones.
CONCLUSIONS: This study highlights that children with CVA exhibit greater IOS parameters compared to healthy children. The changes in IOS parameters during the BD test provided valuable diagnostic information for CVA, and the combination of various parameters can help pediatricians accurately identify CVA in children.
METHODS: This study included children aged 4 to 12 years diagnosed with CVA who underwent IOS pulmonary function and bronchodilation (BD) tests. A control group of healthy children was matched. Pre- and post-BD IOS parameters were recorded and presented as mean ± standard deviation or median. Receiver operating characteristic (ROC) curves were plotted, and the area under the curve (AUC) was calculated to evaluate the discriminatory potential of the IOS parameters for diagnosing CVA.
RESULTS: A total of 180 patients with CVA and 65 control subjects were included. The baseline IOS parameters in the CVA group, except X5%pred, were significantly greater compared to the control group. After inhalation of salbutamol sulfate, all IOS parameters improved significantly in the CVA group. However, Z5%pred, R5%pred, and R20%pred remained greater in the CVA group compared to the control group. The improvement rates of IOS parameters in the CVA group significantly surpassed those in the control group. The ROC curve results for pre-BD IOS parameters and the improvement rate during the BD test showed that the combinations of pre-Z5%pred+△Z5% and pre-R5%pred+△R5% achieved the highest AUC value of 0.920 and 0.898, respectively. The AUC values of these combined parameters surpassed those of individual ones.
CONCLUSIONS: This study highlights that children with CVA exhibit greater IOS parameters compared to healthy children. The changes in IOS parameters during the BD test provided valuable diagnostic information for CVA, and the combination of various parameters can help pediatricians accurately identify CVA in children.
摘要：
背景：咳嗽变异性哮喘（CVA）是全球儿童慢性咳嗽的最常见原因之一。儿童CVA的诊断仍然具有挑战性。这项研究旨在评估脉冲振荡法（IOS）肺功能在CVA儿童中的诊断实用性。
方法：这项研究包括4至12岁被诊断为CVA的儿童，他们接受了IOS肺功能和支气管扩张（BD）测试。对照组为健康儿童。记录BD前和BD后IOS参数，并表示为平均值±标准偏差或中位数。绘制受试者工作特征(ROC)曲线,并计算曲线下面积(AUC)以评估IOS参数诊断CVA的鉴别潜力。
结果：共包括180例CVA患者和65例对照受试者。CVA组中的基线IOS参数，除了X5%pred，显著高于对照组。吸入硫酸沙丁胺醇后，CVA组的所有IOS参数均显著改善.然而,Z5%pred,R5％pred，与对照组相比，CVA组的R20%pred仍然更高。CVA组IOS参数改善率明显优于对照组。BD前IOS参数和BD试验过程中改善率的ROC曲线结果显示，Pre-Z5%pred+△Z5%和Pre-R5%pred+△R5%组合的AUC值最高，分别为0.920和0.898。这些组合参数的AUC值超过单个参数的AUC值。
结论：这项研究强调，与健康儿童相比，患有CVA的儿童表现出更高的IOS参数。BD测试期间IOS参数的变化为CVA提供了有价值的诊断信息，各种参数的组合可以帮助儿科医生准确识别儿童的CVA。
方法：这项研究包括4至12岁被诊断为CVA的儿童，他们接受了IOS肺功能和支气管扩张（BD）测试。对照组为健康儿童。记录BD前和BD后IOS参数，并表示为平均值±标准偏差或中位数。绘制受试者工作特征(ROC)曲线,并计算曲线下面积(AUC)以评估IOS参数诊断CVA的鉴别潜力。
结果：共包括180例CVA患者和65例对照受试者。CVA组中的基线IOS参数，除了X5%pred，显著高于对照组。吸入硫酸沙丁胺醇后，CVA组的所有IOS参数均显著改善.然而,Z5%pred,R5％pred，与对照组相比，CVA组的R20%pred仍然更高。CVA组IOS参数改善率明显优于对照组。BD前IOS参数和BD试验过程中改善率的ROC曲线结果显示，Pre-Z5%pred+△Z5%和Pre-R5%pred+△R5%组合的AUC值最高，分别为0.920和0.898。这些组合参数的AUC值超过单个参数的AUC值。
结论：这项研究强调，与健康儿童相比，患有CVA的儿童表现出更高的IOS参数。BD测试期间IOS参数的变化为CVA提供了有价值的诊断信息，各种参数的组合可以帮助儿科医生准确识别儿童的CVA。
