支气管激发试验联用诱导痰嗜酸性粒细胞检查在儿童慢性咳嗽中的应用价值  

Application of Bronchial Provocation Test Combined With Induced Sputum Eosinophil Test in Children With Chronic Cough

作　　者：赵军育[1] 刘晓莉[1] 

机构地区：[1]天津医科大学总医院滨海医院儿科,天津300480

出　　处：《继续医学教育》2017年第4期98-100,共3页Continuing Medical Education

摘　　要：目的研究支气管激发试验(BPT)和诱导痰嗜酸性粒细胞检查(痰EOS)两种技术在评估儿童慢性咳嗽——咳嗽变异型哮喘和上呼吸道综合症中的应用价值。方法对86例慢性咳嗽儿童采用痰液嗜酸性粒细胞(EOS)分类计数、支气管激发试验,药物治疗4周后随访,复查。结果 86例患儿中主要为咳嗽变异型哮喘和上呼吸道综合征双病因(CVA+UACS)29例,上气道综合征(UACS)28例,咳嗽变异型哮喘(CVA)14例,感染后咳嗽(PIC)9例,嗜酸细胞性支气管炎与上气道综合征双病因4例,胃食管反流性咳嗽与上气道综合征综合征2例。痰EOS计数:CVA和CVA+UACS两组的痰EOS与UACS和PIC相比增高,差异有统计学意义(P<0.05);但药物治疗4周后下降,差异有统计学意义(P<0.05)。支气管激发试验(BPT)阳性率:CVA和CVA+UACS组治疗前后均为100.00%,UACS与PIC组则在治疗后下降,差异有统计学意义(P<0.05)。结论 UACS+CVA与UACS所占的比例较高,痰EOS技术对检测CVA与CVA+UACS作用较明显,BPT对检查UACS与PIC作用较明显。Objective To study the value of bronchial provocation test （BPT） and induced sputum eosinophil （EOS） in assessing children with chronic cough-cough variant asthma and upper respiratory syndrome. Methods Totally 86 patients with chronic cough were enrolled. The EOS classification and BPT were performed and follow-up was carried out 4 weeks after treatment. Results The main cause of 86 children was cough variant asthma double combined with upper respiratory syndrome （CVA ＋ UACS） （n=29）. Totally 28 cases were upper airway syndrome （UACS）. 14 cases were cough variant asthma （CVA）. 9 cases were post-infection cough （PIC）. 4 cases were eosinophilic bronchitis and upper airway syndrome. 2 cases were gastroesophageal reflux cough and upper airway syndrome. EOS count： The EOS and UACS in CVA and CVA ＋ UACS groups were higher than PIC group, and the differences were statistically significant （P〈0.05）.They decreased after 4 weeks treatment （P〈0.05）. Positive rate of BPT： CVA and CVA ＋ UACS group were 100.00% regardless of the time before and after treatment. UACS and PIC group decreased after treatment, and the differences were statistically significant （P〈0.05）. Conclusion The proportion of CVA ＋ UACS and UACS is high, and the effect of sputum EOS on CVA and CVA ＋ UACS is obvious. BPT is more effective in detecting UACS and PIC.

关 键 词：儿童慢性咳嗽 支气管激发实验 诱导痰嗜酸性粒细胞检查 

分 类 号：R749[医药卫生—神经病学与精神病学]