体外过敏原与潮气呼吸肺功能测定在毛细支气管炎中的作用  

The role of in vitro testing for allergen and tidal breathing measurement in infants with bronchiolitis

作　　者：谢娟娟[1] 郁志伟[1] 钱俊[1] 潘剑蓉[1] 张晓娟[1] 

机构地区：[1]无锡市人民医院儿科,江苏无锡214023

出　　处：《临床儿科杂志》2009年第12期1181-1184,共4页Journal of Clinical Pediatrics

基　　金：无锡市社会发展计划项目(No.CSZ00853)

摘　　要：目的研究体外过敏原与潮气呼吸肺功能测定在毛细支气管炎中的作用。方法毛细支气管炎77例、婴幼儿哮喘81例、支气管肺炎72例纳入本次研究。应用Pharmacia UniCAP免疫检测分析仪,进行血吸入过敏原、食入过敏原筛查和尘螨特异性IgE检测,同时检测血总IgE和血嗜酸性粒细胞阳离子蛋白(ECP)。患儿镇静后进行潮气呼吸肺功能检测,主要测定参数为每公斤体质量潮气量(VT)、达峰时间比(TPTEF/TE)、达峰容积比(VPTEF/VE)。结果毛细支气管炎组(毛支组)与哮喘组吸入过敏原、食入过敏原阳性率、总IgE均高于肺炎组;毛支组VT值、TPTEF/TE值、VPTEF/VE值与哮喘组相比,差异无统计学意义;毛支组血ECP水平低于哮喘组,与肺炎组相比差异无统计学意义,毛支组血ECP与TPTEF/TE、VPTEF/VE无相关;毛支组吸入过敏原检测阳性14例,该14例患儿的血ECP水平与哮喘组相比差异无统计学意义,且血ECP与TPTEF/TE、与VPTEF/VE呈负相关。结论通过检测血过敏原、ECP、肺功能,有助于了解毛细支气管炎气道炎症变化及肺部阻塞情况。Objective To study the role of in vitro testing for allergen and tidal breathing measurement m infants with bronchiolitis. Methods Seventy-seven infants with bronchiolitis, 81 infants with asthma, and 72 with pneumonia were recruited in the study. Inhaled allergen, food allergen, and mite-specific IgE were determined by Pharmacia UniCAP system. The serum eosinophil cationic protein （ECP） and total IgE were measured as well. Tidal breathing flow-volume loops were obtained after the patients had been sedated. The tidal volume per kilogram （VT/kg）, the ratio of exhaled time at peak tidal expiratory flow （PTEF） to total expiratory time （TPTEF/TE）, and the ratio of tidal volume exhaled at PTEF to total tidal volume （VPTEF/VE） were measured. Results Positive findings of inhaled allergen and food allergen, and total IgE level were elevated in both bronchiolitis and asthma groups in comparison with pneumonia group. There were no significant differences in VT/kg, TPTEF/TE, and VPTEF/VE between bronchiolitis group and asthma group. ECP level was lower in bronchiolitis group than that in asthma group, but showed no significant difference between bronchiolitis group and pneumonia groups. ECP level did not correlate with VPTEF/VE or TPTEF/TE in bronchiolitis group. Fourteen patients in bronchiolitis group were sensitive to inhaled allergen test. There was no significant difference in ECP level between these 14 patients and asthma group. And, ECP levels in these 14 patients were negatively correlated with VPTEF/ VE and TPTEF/TE. Conclusions The measurement of allergen, serum ECP, and tidal breathing flow-volume loops were helpful for evaluating airway inflammation and airway obstruction in infants with bronchiolitis.

关 键 词：毛细支气管炎 过敏原 潮气呼吸流速-容量曲线 肺功能 嗜酸性粒细胞阳离子蛋白 

分 类 号：R725.6[医药卫生—儿科]