儿童变应性鼻炎肺功能及相关因素的研究  

Clinical study of pulmonary function and its associated factors in pediatric allergic rhinitis patients

作　　者：陈亚秋[1] 丁文英[1] 汪旭[1] 万莉雅[2] 张琴[3] 郭智勇 袁艳[3] 

机构地区：[1]天津市儿童医院耳鼻咽喉科,天津300074 [2]天津市儿童医院呼吸科,天津300074 [3]天津市儿童医院肺功能室,天津300074

出　　处：《中国耳鼻咽喉颅底外科杂志》2008年第2期111-114,共4页Chinese Journal of Otorhinolaryngology-skull Base Surgery

摘　　要：目的探讨变应性鼻炎患儿肺功能改变对早期发现气道高反应性及预测哮喘发生可能性的临床应用价值。方法变应性鼻炎患儿94例,并设60例同龄健康儿童作对照组。全部患儿应用振荡法测定:呼吸阻抗(Zrs),气道总阻力(R5),中心气道阻力(R20),周边小气道阻力(R5-R20),弹性阻力(X5),响应频率(Fres);5.岁以上患儿同时做常规用力通气肺功能检查:用力肺活量(FVC),用力呼吸量(FEF1),呼气峰流量(PEF),用力呼气中流量25%、50%、75%(FEF25,FEF50,FEF75)。肺功能正常时加做支气管激发试验,肺功能异常时加做支气管舒张试验。结果52例(55%)变应性鼻炎肺功能检测结果正常,与正常对照组比较无差异;42例(45%),异常与正常对照组比较有差异,表现FEF25,FEF50,FEF75均明显低于正常对照组(P<0.01),R5,R20,X5,Fres较健康同龄儿增高(P<0.05)。52例结果正常加做激发试验,其中25例为阳性;42例结果异常加做舒张试验,其中32例为阳性。肺功能异常患儿与过敏史及家族史有明显相关性(P<0.01)。结论①本研究得出变应性鼻炎患儿肺功能异常发生率61%,同时存在支气管激发试验和舒张试验阳性,提示变应性鼻炎患儿存在着发生支气管哮喘的危险。为早期诊断和干预治疗隐匿哮喘提供依据。②变应性鼻炎及支气管哮喘与过敏史和家族史等因素有关。Objective To discuss the clinical of airway hypersensitivity and prediction of asthma value of pulmonary function onset in chilidren. Methods tests in the early diagnosis 94 children suffering from allergic rhinitis were included in the study group, with 60 healthy ones of the same ages as control group： Oscillatory methods were used for measuring the respiratory resistance, including ZrS, R5, R20 , R5-R20 , X5 , Fres. In addition, children with age of 5 years or more were given regular forced pulmonary function tests （FVC, FEF1 , PEF, FEF25 , FEF50 , FEF75 ）. Bronchial excitation or dilation tests were performed in children with normal or abnormal pulmonary functions. Results The pulmonary function of 52 （55% ） cases in the study group was normal, and 25 of them showed positive response to bronchial excitation test. The other 42 （45%） cases showed abnormal pulmonary function. Their values of FEF25 , FEF50 , and FEF75 were all significantly less than those of the control group （ P 〈 0. 0 1 ） , while the values of R5 ,R50, X5, and Fres were higher than those of the control group （ P〈0. 05）. Furthermore, 32 of them reacted positively to the bronchial delation tests. Their abnormalities of pulmonary function were correlated significantly with their anaphylactic history and family history （ P 〈0. 01 ）. Conclusion ① The incidence of abnormal pulmonary function in children with allergic rhinitis is 61% , and most of them show positive reaction to bronchial excitation or dilation tests, which indicates high risk to develop bronchial asthma in children with allergic rhinitis. This may provide a basis for early diagnosis and intervention of dormant asthma. ② Allergic rhinitis and bronchial asthma are related with many factors： such as heredity and anaphylactic history.

关 键 词：儿童 变应性鼻炎 肺功能 气道高反应 

分 类 号：R765.213[医药卫生—耳鼻咽喉科]