小呼吸道病变对慢性咳嗽儿童非典型哮喘的预测价值  

Value of Small Airway Disease on Predicting Asymptomatic Asthma in Children with Chronic Cough

作　　者：周明娟 崔彦芹[2] 许银姬 辛瑾琛 林琳 

机构地区：[1]广州中医药大学第二附属医院呼吸科,广州510120 [2]广州市儿童医院,广州510120

出　　处：《实用儿科临床杂志》2011年第4期244-245,249,共3页Journal of Applied Clinical Pediatrics

基　　金："十一.五"国家支撑计划项目(2007BAI20B086);广州中医药大学科研创新基金(10CX056)

摘　　要：目的探讨小呼吸道病变(SAD)对慢性咳嗽儿童非典型哮喘的预测价值。方法收集广东省中医院2007年6月-2010年6月慢性咳嗽儿童176例。男95例,女81例;年龄5～12岁。对其进行肺功能检测及支气管激发试验(BPT),分别分析SAD、呼吸道高反应性(AHR)与哮喘的关系。应用SPSS 17.0软件进行统计学分析。结果 170例慢性咳嗽儿童完成全部检测项目。其中122例肺功能正常,48例有SAD。BPT检测发现78例有AHR,阳性率为45.88%(78/170例)。其中SAD组BPT阳性率为87.50%(42/48例),远远高于肺功能正常组[29.51%(36/122例)](2χ=46.655,P<0.01)。随访发现,78例AHR患儿中72例确诊为哮喘,其中SAD组41例(85.42%),肺功能正常组31例(25.41%),二组哮喘患病率比较,差异有统计学意义(2χ=50.803,P<0.01)。结论慢性咳嗽儿童SAD与AHR发生密切相关,SAD对慢性咳嗽儿童非典型哮喘的预测价值较高,无BPT检测条件的基层医院可将其作为哮喘的初筛检查。Objective To investigate the value of small airway disease（SAD） on predicting asymptomatic asthma in children with chronic cough.Methods One hundred and seventy-six children with chronic cough（aged from 5 to 12 years） were retrospectively selected who were hospitalized in the Department of Respiratory,Guangdong Provincial Hospital of Traditional Chinese Medicine from Jun.2007 to Jun.2010.Parameters of pulmonary function test（PFT） and bronchial provocation test（BPT） were performed,and the relationship of SAD,airway hyper-responsiveness（AHR） and asthma were analyzed.SPSS 17.0 software was used to analyze the data.Results PFT and BPT were completely performed in 170 cases of 176 children with chronic cough during the 3 years.Of which,48（28.24%） children had SAD.Se-venty-eight（45.88%） children had positive BPT.The rate of BPT-positive in children with SAD was significantly higher than that in normal pulmonary function group（87.50% vs 29.51%,χ2=46.655,P0.01）.After followed-up,72 cases of 78 children with BPT-positive were diagnosed as asthma.The incidence of asthma in children with SAD（85.42%） was significantly higher than that in normal pulmonary function group（25.41%）（χ2=50.803,P0.01）.Conclusions SAD is significantly associated with AHR,and it seems be a good predictive factor for asymptomatic asthma in children with chronic cough,which may be a suitable replacement for asthma screening,especially in health care institutions without instrument for BPT in country.

关 键 词：哮喘 呼吸功能试验 小呼吸道病变 支气管激发试验 儿童 

分 类 号：R725.6[医药卫生—儿科]