肥胖对哮喘预测指数阳性喘息婴幼儿治疗效果的影响

Effect of obesity on treatment outcome of asthma predictive index-positive infants and young children with wheezing

摘要:

目的 探讨肥胖对哮喘预测指数（API）阳性喘息婴幼儿治疗效果的影响。方法 选取API 阳性的喘息婴幼儿208 例，按Kaup 指数分为肥胖组（93 例）和非肥胖组（115 例）。在急性喘息发作期给予综合治疗，缓解期给予吸入性糖皮质激素（ICS）布地奈德混悬液压缩泵雾化吸入治疗。根据临床控制情况调整ICS治疗用量，共治疗6 个月。治疗后2 周随访1 次，之后每月随访1 次。结果 治疗后2 周、1 个月肥胖组的临床症状缓解率分别为35.5% 及75.3%，低于非肥胖组的53.0% 和87.8%（P < 0.05）。肥胖组患儿在治疗后3 个月、6 个月的喘息发生率及6 个月内因喘息引起的急诊就诊率和住院率均高于非肥胖组（P < 0.05）。结论 肥胖可抑制API 阳性喘息婴幼儿对ICS 治疗的反应。

Abstract:

Objective To study the effect of obesity on the treatment outcome of asthma predictive index (API) -positive infants and young children with wheezing. Methods A total of 208 API-positive infants and young children with wheezing were enrolled. According to the Kaup index, the patients were divided into an obese group (n=93) and a non-obese group (n=115). The patients were given multimodality therapy in an acute episode of wheezing and aerosol inhalation of inhaled corticosteroid (ICS) budesonide suspension in the remission stage. The dose of ICS was adjusted according to clinical control. The patients were treated for 6 months, and were followed up at 2 weeks after treatment and once per month afterwards. Results At 2 weeks and 1 month after treatment, the obese group had significantly lower remission rates of clinical symptoms than the non-obese group (35.5%/75.3% vs 53.0%/87.8%; P < 0.05). Compared with the non-obese group, the obese group had significantly higher incidence rates of wheezing at 3 and 6 months after treatment and a significantly higher proportion of patients who visited the emergency service or were hospitalized due to wheezing within 6 months (P < 0.05). Conclusions Obesity can inhibit the response to ICS treatment in API-positive infants and young children with wheezing.