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已发表论文
儿童表面呼吸肌肌电图评估支气管扩张剂反应
Authors He B, Li F, Liu S, Wang L, Chen Z , Zhu Q , Wang L, Liang S, Al-Sherif M, Sun L, Luo Y
Received 7 May 2025
Accepted for publication 9 September 2025
Published 22 September 2025 Volume 2025:18 Pages 1327—1335
DOI https://doi.org/10.2147/JAA.S537519
Checked for plagiarism Yes
Review by Single anonymous peer review
Peer reviewer comments 2
Editor who approved publication: Dr Luis Garcia-Marcos
Baiting He,1 Feng Li,2 Simin Liu,1 Lu Wang,1 Zhiqiang Chen,1 Qihua Zhu,1 Lishuang Wang,3 Shanfeng Liang,1 Miral Al-Sherif,4 Lihong Sun,1 Yuanming Luo1,5,6
1State Key Laboratory of Respiratory Disease, The First Affiliated Hospital of Guangzhou Medical University, Guangzhou Medical University, Guangzhou, People’s Republic of China; 2Department of Respiratory and Critical Care Medicine, The Fifth Affiliated Hospital, Guangzhou Medical University, Guangzhou, People’s Republic of China; 3Department of Respiratory and Critical Care Medicine, Peking University Shenzhen Hospital, Shenzhen Peking University - the Hong Kong University of Science and Technology Medical Center, Shenzhen, People’s Republic of China; 4Department of Respiratory Medicine, Minia University, Minia, Egypt; 5Division of Sleep and Circadian Disorders, Brigham and Women’s Hospital and Harvard Medical School, Boston, MA, USA; 6AISH, College of Medicine and Public Health, Flinders University, Adelaide, Australia
Correspondence: Yuanming Luo, State Key Laboratory of Respiratory Disease, The First Affiliated Hospital of Guangzhou Medical University, Guangzhou Medical University, 151 Yanjiang Road, Guangzhou, 510120, People’s Republic of China, Email y.m.luo@vip.163.com
Background: An increase of ≥ 12% in forced expiratory volume in the first second (FEV1) after inhalation of bronchodilator indicates airway reversibility. However, it is difficult to measure FEV1 in children. The aim of the study is to determine whether respiratory muscle electromyograms recorded from chest wall surface electrodes can be used to distinguish children with uncontrolled asthma from healthy subjects.
Methods: Fourteen children with uncontrolled asthma [aged 6.1 (3 ~ 13) years] and 28 healthy children [aged 7.6 (3 ~ 13) years] were recruited. Uncontrolled asthma was defined as having poorly controlled symptoms, along with an increase in FEV1 of at least 12%, or presenting with a wheezing symptom that improved after inhaling a bronchodilator. Diaphragm electromyogram (EMGdi), parasternal intercostal EMG (EMGpara), airflow, FEV1, and wheezing were recorded before and after inhalation of bronchodilator.
Results: Good-quality EMGdi and EMGpara could be recorded in all subjects. However, 18 of 42 children could not perform the spirometer properly. Changes in EMGdi [− 24.6% (− 43.5 ~ − 12.4%) vs − 0.1% (− 13.2 ~ 16.9%), p< 0.001] and EMGpara [− 11.2% (− 31.5 ~ 32.4%) vs − 0.5% (− 24.9 ~ 13.0%), p< 0.05] in children with asthma were, respectively, significantly larger than those in healthy subjects during bronchodilator response. The area under the receiver operating characteristic curves for the changes of EMGdi and EMGpara were 0.995 (95% CI 0.906 to 1.000) and 0.755 (95% CI 0.598 to 0.874).
Conclusion: Surface respiratory muscle EMG could be feasible and useful to assess bronchodilator response to differentiate children with uncontrolled asthma from healthy subjects.
Keywords: respiratory muscle electromyogram, bronchodilator test, spirometry, children asthma
1State Key Laboratory of Respiratory Disease, The First Affiliated Hospital of Guangzhou Medical University, Guangzhou Medical University, Guangzhou, People’s Republic of China; 2Department of Respiratory and Critical Care Medicine, The Fifth Affiliated Hospital, Guangzhou Medical University, Guangzhou, People’s Republic of China; 3Department of Respiratory and Critical Care Medicine, Peking University Shenzhen Hospital, Shenzhen Peking University - the Hong Kong University of Science and Technology Medical Center, Shenzhen, People’s Republic of China; 4Department of Respiratory Medicine, Minia University, Minia, Egypt; 5Division of Sleep and Circadian Disorders, Brigham and Women’s Hospital and Harvard Medical School, Boston, MA, USA; 6AISH, College of Medicine and Public Health, Flinders University, Adelaide, Australia
Correspondence: Yuanming Luo, State Key Laboratory of Respiratory Disease, The First Affiliated Hospital of Guangzhou Medical University, Guangzhou Medical University, 151 Yanjiang Road, Guangzhou, 510120, People’s Republic of China, Email y.m.luo@vip.163.com
Background: An increase of ≥ 12% in forced expiratory volume in the first second (FEV1) after inhalation of bronchodilator indicates airway reversibility. However, it is difficult to measure FEV1 in children. The aim of the study is to determine whether respiratory muscle electromyograms recorded from chest wall surface electrodes can be used to distinguish children with uncontrolled asthma from healthy subjects.
Methods: Fourteen children with uncontrolled asthma [aged 6.1 (3 ~ 13) years] and 28 healthy children [aged 7.6 (3 ~ 13) years] were recruited. Uncontrolled asthma was defined as having poorly controlled symptoms, along with an increase in FEV1 of at least 12%, or presenting with a wheezing symptom that improved after inhaling a bronchodilator. Diaphragm electromyogram (EMGdi), parasternal intercostal EMG (EMGpara), airflow, FEV1, and wheezing were recorded before and after inhalation of bronchodilator.
Results: Good-quality EMGdi and EMGpara could be recorded in all subjects. However, 18 of 42 children could not perform the spirometer properly. Changes in EMGdi [− 24.6% (− 43.5 ~ − 12.4%) vs − 0.1% (− 13.2 ~ 16.9%), p< 0.001] and EMGpara [− 11.2% (− 31.5 ~ 32.4%) vs − 0.5% (− 24.9 ~ 13.0%), p< 0.05] in children with asthma were, respectively, significantly larger than those in healthy subjects during bronchodilator response. The area under the receiver operating characteristic curves for the changes of EMGdi and EMGpara were 0.995 (95% CI 0.906 to 1.000) and 0.755 (95% CI 0.598 to 0.874).
Conclusion: Surface respiratory muscle EMG could be feasible and useful to assess bronchodilator response to differentiate children with uncontrolled asthma from healthy subjects.
Keywords: respiratory muscle electromyogram, bronchodilator test, spirometry, children asthma