婴幼儿乙酰甲胆碱人工支气管激发试验的安全性研究  

Safety of artificial bronchial provocation tests with methacholine in diagnosis of chronic cough in infants

作　　者：杜继宇[1] 刘蓉[1] 李艳[1] 邓琳凡 余静[1] 王敏[1] 董金蓉[1] 杨进宇[1] 

机构地区：[1]四川省绵阳市中心医院儿科,绵阳621000

出　　处：《临床医学》2014年第1期8-9,共2页Clinical Medicine

摘　　要：目的评价婴幼儿用乙酰甲胆碱进行人工支气管激发试验(即通过肺部听诊判断结果)的安全性。方法对2010年1月至2013年2月在绵阳市中心医院门诊及住院部就诊的1108例慢性咳嗽婴幼儿采用乙酰甲胆碱进行支气管激发试验,观察试验中患儿呼吸、心率、动脉血氧饱和度、咳嗽情况及肺部哮鸣音等。结果婴幼儿乙酰甲胆碱人工支气管激发试验总阳性率为80.3%,激发后患儿心率、呼吸频率较激发前有所增快,氧饱和度较前有所下降,82.31%患儿无症状;17.69%的患儿有一过性症状,其中咳嗽占15.52%,喘息占1.53%,声音嘶哑占0.63%,经用沙丁胺醇后15 min内患儿呼吸、心率、氧饱和度均恢复到检查前水平,上述症状及肺部哮鸣音均消失,在激发试验中无一例患儿氧饱和度<85%、呼吸窘迫及哮喘重度以上发作。结论婴幼儿乙酰甲胆碱人工支气管激发试验是一种安全可靠简单的检查方法,在婴幼儿慢性咳嗽病因诊断中具有非常重要的作用,在不具备婴幼儿潮气肺功能设备或患儿家属不愿使用水合氯醛镇静时可考虑使用。Objective To evaluate the safety of artificial bronchial provocation tests （that is judgment resulted by lung aus- cultation） with methacholine in infants. Methods One thousand one hundred and eight infants with chronic cough from January 2010 to February 2013, completed bronchial provocation with methacholine. The heart rate, breathing, oxygen saturation, cough and pulmonary wheeze of the infants in the process of test were observed. Results The total positive rate of artificial bronchial provocation tests was 80. 3%. Compared with before the test, heart rate, respiratory rate increased and oxygen saturation de- creased, 82.31% of the infants were asymptomatic, 17.69% of the infants had transient symptoms, including coughing （ 15.52% ）, wheezing （1.53%）, hoarseness （0. 63% ）. The respiratory heart rate, oxygen saturation returned to check the lev- el before the examination, the above symptoms and lung wheeze disappeared within 15 minutes after inhaled salbutamol. No in- fant oxygen saturation less than 85% or more episodes of respiratory distress and severe asthma. Conclusion Infant artificial bronchial methacholine provocation test is a safe, reliable and simple check, has a very important role in the etiological diagnosis of chronic cough. The present method can be used in the hospital that does not have the infant tidal lung function device or when the family members do not want to use chloral hydrate sedation.

关 键 词：人工支气管激发试验 乙酰甲胆碱 安全性 婴幼儿 

分 类 号：R725.6[医药卫生—儿科]