无症状气道高反应性与哮喘关系——气道反应性普查3年随访研究  

Relationship between asymptomatic bronchial hyperresponsiveness and asthma:Three year follow up in a survey for bronchial responsiveness

作　　者：邓念强[1] 王琦筠[1] 杨伟华[1] 唐鸣秋[1] 刘扶兴[1] 叶键锋[1] 

机构地区：[1]广东省东莞市人民医院呼吸内科,523000

出　　处：《中华微生物学和免疫学杂志》2001年第S2期87-89,共3页Chinese Journal of Microbiology and Immunology

基　　金：广东省卫生厅医学科研课题〔粤卫科 (1996) 19号〕

摘　　要：目的　探讨无症状气道高反应性发展为症状性哮喘的一些有关因素。方法　随访了1997年气道反应性普查的 4 1例无症状气道高反应性学生和对照组 31例正常气道反应性学生。结果可随访的无症状气道高反应性学生有 18% (7 38)出现哮喘 ,与对照组 (0 % ,0 30 )比较差异有显著性(P <0 .0 5 )。在可随访的 38例无症状气道高反应性学生中 ,有哮喘家族史发病率 (5 4 .5 % ,6 11)与无哮喘家族史发病率 (3% ,1 2 7)比较差异有显著性 (P <0 .0 1) ,发病者一秒钟用力呼气容积降低 2 0 %所需组胺累积量 =(1.4± 0 .72 ) μmol (HisPD2 0 FEV1=1.4± 0 .72 μmol) ,sIgEQ值 (2 8.1± 13.2 5 ) ,与无发病者HisPD2 0 FEV1(5 .6 3± 2 .5 8) μmol,sIgEQ值 (12 .1± 11.5 3)比较 ,差异有显著性 (P <0 .0 5 ,P <0 .0 5 )。发病者ECP值 (6 4 .5 2± 75 .11) μg L与无发病者ECP值 (40 .32± 5 9.93) μg L比较差异无显著性。结论　部分无症状气道高反应性者在一定时间内可发展为症状性哮喘 ,特别是有哮喘家族史 ,sIgEQ值较高 ,ECP阳性 ,HisPD2 0 FEV1≤ 1.96 μmol的无症状气道高反应性者 ,是发展为症状性哮喘的“高危人群” 。Objective To study factors affecting the development of asymptomatic bronchial hyperresponsiveness to symptomatic asthma. Method 41 cases with asymptomatic bronchial hyperresponsiveness detected in a survey in 1997 and 31 cases with normal bronchial responsiveness were followed. Results 18%(7/38) of the asymptomatic bronchial hyperresponsiveness developed asthma. This rate was higher than that of the control (0%, 0/30) and with statistical significance ( P <0.05). Among the 38 cases of asymptomatic bronchial hyperresponsiveness that were followed up, the incidence rate with family history of asthma was 54.5%(6/11), higher than that of without family history (3%,1/27) and with statistical significance( P <0.01).The His PD20 FEV1 and sIgE Q value of the symptomatic cases 1.4±0.72μmol and 2.81±13.25 were different from those of asymptomatic cases 5.63±2.58μmol and 12.1±11.53 respectively, with statistical significance ( P <0.05 and P < 0.05 ). Conclusion Some asymptomatic bronchial hyperresponsiveness would develop asthma within certain period of time, especially those with family history.Cases of asymptomatic bronchial hyperresponsiveness with high sIgE Q value, ECP positive, and His PD20 FEV1≤1.96μmol could easily develop symptomatic asthma. These individuals should be given preventing treatment.

关 键 词：气道高反应性 哮喘 特异性IGE 嗜酸细胞阳离子蛋白 

分 类 号：R562.25[医药卫生—呼吸系统]