以胸闷为主诉的不典型支气管哮喘患儿激发试验前后的肺功能特点

Characteristics of pulmonary function in children with atypical asthma with chest tightness as chief complaint before and after bronchial provocation test

摘要:

目的 了解以胸闷为主诉的不典型支气管哮喘患儿在支气管激发试验前后的肺功能特点。方法 选取2010 年1 月至2013 年12 月在我院肺功能室进行支气管激发试验的不典型哮喘患儿34 例为研究对象(不典型哮喘组),同期选取典型哮喘患儿34 例为对照,检测不典型哮喘组患儿支气管激发试验前后的肺功能,以及典型哮喘组患儿发作期和缓解期肺功能。结果 不典型哮喘组激发前肺功能指标用力肺活量(FVC)、第1 秒最大呼气量(FEV1)、FEV1/FVC、呼气峰流速(PEF)、用力呼气25 %、50 %、75%肺活量时的呼气峰流速(FEF25、FEF50、FEF75)、最大呼气中期流量(MMEF75/25)分别为105%±12%、104%±12%、100%±7%、88% ±13%、90% ±14%、81% ±17%、73% ±25%、80%±17%,明显高于典型哮喘组患儿发作期肺功能各指标(P<0.05),与典型哮喘组患儿缓解期肺功能指标相比差异无统计学意义(P>0.05)。不典型哮喘组激发后肺功能各指标与典型哮喘组发作期相比差异无统计学意义(P>0.05),但均低于典型哮喘组缓解期和不典型哮喘组激发前水平。结论 支气管激发试验有助于不典型哮喘患儿的诊断。

Abstract:

Objective To investigate the characteristics of pulmonary function in children with atypical asthma with chest tightness as the chief complaint before and after a bronchial provocation test. Methods This study included 34 children with atypical asthmas who underwent bronchial provocation test between January 2010 and December 2013. Thirty-four children with typical asthmas were selected as the control group. The pulmonary function of the atypical asthma group was examined before and after the bronchial provocation test and compared with that of the control group in the acute episode and remission stages. Results The forced vital capacity (FVC), forced expiratory volume in 1 second (FEV1), FEV1/FVC, peak expiratory flow, forced expiratory flow 25%, 50%, 75% (FEF25, FEF50, FEF75), and maximum mid-expiratory flow (MMEF75/25) in the atypical asthma group before the bronchial provocation test were (105±12)%, (104±12)%, (100±7)%, (88±13)%, (90±14)%, (81±17)%, (73±25)%, and (80±17)%, respectively; these functional indices were significantly higher than in the control group in the acute episode stage (P<0.05), but were similar to those of the control group in the remission stage (P>0.05). In addition, no significant difference in pulmonary indices was observed between the atypical asthma group after the bronchial provocation test and the control group in the acute episode stage (P>0.05), but functional indices above were significantly lower in the atypical asthma group after the bronchial provocation test than in the control group in the remission stage and the atypical asthma group before the bronchial provocation test (P<0.05). Conclusions Bronchial provocation test is useful in the diagnosis of atypical asthma in children.