| Objectives: To investigate the changes in large and small airway function of asthmatic children and the time interval of changes by comparison of the lung function index changes pre and post regular treatment and to evaluate the relationship among lung function index and asthmatic disease at the same time. To reveal the response of airway to bronchodilator and the reversibility of airway stenosis and obstruction in children with asthma in different ages by comparing the changes of lung function pre and post asthmatic children used bronchodilator.Methods: We studied 45 asthmatic children who were newly diagnosed From Jan,2008 to Dec,2009 in Hebei Children's Hospital ,divided them into two part according to age. 25 children aged above 5 as part one were measured with general pulmonary at acute stage, remission stage of 3 months,6 months and 1 year ;20 children under age 5 as part two were measured with tidal flow volume curve function test pre and post treatment,with 20 healthy children were used as control groups to part two .1 Grouping According to the disease (1) general pulmonary function test was divided into four groups, include acute stage group and remission stage of 3 months,6 months and 1 yare.(2) In Tidal breathing flow volume function test was divided into two groups, include acute stage group and remission stage, with 20 healthy children were used as control .(3) Moreover, each part of 10 patients who were among acute attack period received bronchodilation test Respectively.2 Determination standard and data processing (1)In general pulmonary function test ,the follow indices were recorded : forced vital capacity (FVC), forced expiratory volume in one second(FEV1.0),forced expiratory volume in one second to forced vital capacity ratio(FEV1.0%), peak expiratory flow(PEF), forced expiratory flow after25%～75%(FEF25～75), maximal midexpiratory flow (MMEF),then measured value and predicted value were test by T-test within group and the ratio in multiple groups were analyzed by Repeated Measures Variance Analysis test in different stage .(2)In Tidal breathing flow volume function test, the follow indices were recorded : tidal volume per kilogram(VT/kg),respiratory rate(Rr),inspiratory time to expiratory time(TI/TE),the ratio of peak expiratory flow time to total expiratory time(TPEF/TE),the ratio of peak expiratory flow volume to total expiratory volum(eVPEF/VE),tidal expiratory flow at 75%～25% remaining(TEF75%).T-test and Variance Analysis were used to process data.Results: 1 General pulmonary function result (1)In acute stage ,there was no significant difference between the measured value and the predicted value of FEV1. 0% (p>0.05). The measured value of VT was higher than predicted value; The measured value of other lung function index was lower than predicted value and there were significant difference between the measured values and predicted values(p<0.05).(2)In remission stage of 3 month ,there was no significant difference between the measured value and the predicted value of FVC ,FEV1 (p>0.05), but not until remission stage of 6 month, PEF came to normal. In remission stage of 1 year, there was no significant difference between the measured value and the predicted value of all the lung function index(p>0.05).(3)There was significant difference between the percentage of measured value and the predicted value in all four stages(p<0.05). (4) FVC,FEV1.0,PEF,FEF25,FEF50,FEF75 were significant difference between the two groups of Pre and Post aerosolized(p<0.05). (5) There was negative relation between the disease severity and lung function index.2 Tidal flow volume curve function result(1)In acute stage, VT/kg, Ti/Te,TPTEF/TE,VPEF/VE,TEF25% ,TEF50%, were significantly different between asthmatic and normal children(P<0.05), all of them reduced except for Rr. Moreover, PEF,TEF75% were slightly higher than the normal group but not significantly different between them(P>0.05)(.2)In remission stage,VT/kg increased and Rr reduced which were significantly different compared with the acute stage(P<0.05)but were not significantly different compared with normal children(P>0.05).Furthermore,TPTEF/TE,VPEF/VE,TEF50%,TEF25% recovered, TPTEF/TE,VPEF/VE were significantly different between the acute stage and remission stage of asthma(P<0.05), TEF50%,TEF25% were not significantly different between them(P>0.05), and all the indices were significantly different between asthmatic and normal children(P<0.05)(.3) After inhaling bronchodilator , VT/kg,TPTEF/TE,VPEF/VE increased but Rr reduced,all of them were significant difference between Pre and Post aerosolized(P<0.05).And Ti/Te was slightly higher compared with pre-atomized, however, there was not significantly different with asthma(P>0.05).(4)There was positive relationship between the disease severity and lung function index, however, a small number of symptoms and lung function in children showed the reverse trend. (5)TBFV loop showed forced expiratory curve graphic in the acute stage of asthmatic children, but the slope of descending branch of the TBFV loop was depressed, the PTEF shifted backward in remission stage and After inhaling bronchodilator.Conclusion: There are dynamical changes of the lung function index during acute and remission stage, so pulmonary function testing has a good assessment in diagnosis, efficacy and disease in children with asthma.1 There are airway dysfunction in acute stage of asthmatic children . The large airway function will recovery after 3 months'therapy and after a treatment of 1 year or more, the small airway function recovery. It suggested that the treatment of children with asthma need long-term persist medication and gradually reducing the dosage.2 There is negative relation between the disease severity and lung function index.3 Asthma is a disease characterized by reversible airway obstruction and it has a better response to the bronchodilator. 4 Tidal expiratory flow pulmonary function testing has a certain reference value in the diagnosis and treatment of asthmatic child who are under age 5.
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