哮喘患儿对长程控制治疗反应性的差异及其相关因素分析  

Related factors for asthmatic children's responses to long-term treatment

作　　者：刘晓颖[1] 王静[1] 王群[1] 任亦欣[1] 刘永革[1] 苗青[1] 李珍[1] 向莉[1] 

机构地区：[1]首都医科大学附属北京儿童医院过敏反应科,北京100045

出　　处：《中国当代儿科杂志》2015年第7期692-697,共6页Chinese Journal of Contemporary Pediatrics

基　　金：国家自然科学基金(81100022);北京市科技专项(Z131100006813044);国家科技支撑计划(2012BAI03B02)

摘　　要：目的分析在不同治疗反应性哮喘患儿中肺功能和呼出气一氧化氮浓度(Fe NO)的动态变化,为了解哮喘患儿对长程控制治疗的反应性提供依据。方法选取52例规律阶梯式控制治疗且依从性好的哮喘患儿,每3个月评估哮喘控制情况,并检测肺通气功能及Fe NO,记录患儿哮喘治疗情况,随访至9个月。结果第3、6、9个月随访时点对控制治疗反应稳定组患儿采用1、2级控制治疗的病例比例显著高于不稳定组,而3级治疗比例显著低于不稳定组(P<0.05)。第3、6、9个月随访时点时稳定组肺通气功能指标第1秒用力呼气容积与用力肺活量比值(FEV1/FVC)显著高于不稳定组(P<0.05);第3、9个月随访时点稳定组最大呼气中期流速占预计值百分比(MMEF%)显著高于不稳定组(P<0.05)。初次评估和第3个月随访时点稳定组Fe NO显著高于不稳定组(P<0.05)。结论持续监测FEV1/FVC、MMEF%以及Fe NO的变化有助于早期了解哮喘患儿对控制治疗的反应性。ObjectiveTo study the changes in pulmonary function and fractional exhaled nitric oxide in exhaled breath （FeNO） in asthmatic children who have different responses to regular treatment.MethodsA total of 52 asthmatic children who had a good compliance with regular stepped control treatment were selected as subjects. They were followed up every three months to evaluate the asthma control level, pulmonary ventilation function, and FeNO for 9 months. Besides, medications for asthma control were recorded.ResultsAt three follow-up points （months 3, 6, and 9）, the percentage of asthmatic children who used the ifrst or the second level of control treatment in the stable group （with stable response to the treatment） was signiifcantly higher than in the unstable group （with unstable response to the treatment） （P〈0.05）, while the percentage of asthmatic children who used the third level of control treatment in the stable group was signiifcantly lower than in the unstable group （P〈0.05）. At the three follow-up points, the stable group had a significantly higher ratio of forced expiratory volume in 1 second to forced vital capacity （FEV1/FVC） than the unstable group （P〈0.05）; at the 3-month and 9-month follow-up points, the stable group had a signiifcantly higher percentage of predicted maximum mid-expiratory flow （MMEF%） than the unstable group （P〈0.05）; at the initial evaluation and 3-month follow-up point, the stable group had a signiifcantly higher FeNO than the unstable group （P〈0.05）.ConclusionsContinuously monitoring FEV1/FVC, MMEF% and FeNO is useful in the early evaluation of the responses to treatment in children with asthma.

关 键 词：哮喘 肺功能 呼出气一氧化氮浓度 儿童 

分 类 号：R725.6[医药卫生—儿科]