慢性咳嗽伴支气管激发试验阳性患儿的临床特征研究  

Study on the clinical features of children patients with chronic cough and positive bronchial provocation test

作　　者：李晓丽[1] 邹武军[1] 贺蓉 常静 LI Xiaoli;ZOU Wujun;HE Rong(Department of Pediatrics,Central Hospital of Ankang City,Shaanxi,Ankang 725000,China)

机构地区：[1]陕西省安康市中心医院儿科,725000

出　　处：《河北医药》2018年第6期878-881,共4页Hebei Medical Journal

摘　　要：目的研究慢性咳嗽患儿的临床特征,并评估其预测支气管激发试验结果。方法选取进行支气管激发试验的慢性咳嗽患儿273例,于其就诊和随访时完成常规肺通气功能检查、病史采集和问卷调查,根据其支气管激发试验结果将患儿分为2组。比较2组临床特征及肺通气功能发生率上存在的差异;分析产生差异的因素在预测支气管激发试验结果的效果。结果单因素分析结果显示,气管激发试验阳性组在干咳、夜间咳嗽、湿疹患儿比例、变应性结膜炎患儿比例、吸入过敏患儿比例、哮喘家族史以及小气道受损程度的发生率上均高于阴性组(均P<0.05)。干咳、夜间咳嗽以及小气道功能病变的敏感性和特异性均较高(70.89%&71.50%;60.40%&68.35%;51.31%&64.74%);哮喘家族史和吸入过敏虽具有较高的特异性但敏感性较低(20.05%&71.36%;40.55%&60.24%)。伴随较多临床体征数量的患儿支气管激发试验阳性发生率较单个因素的患儿明显上升(均P<0.05)。结论常气管激发试验阳性的咳嗽变异性哮喘患儿的临床特点表现在包括临床症状、病史及肺功能等多个方面,在实际临床操作中应当综合考虑各个因素来最终决定患儿是否有必要进行支气管激发试验。Objective To investigate the clinical features of children patients with chronic cough,and to evaluate the diagnostic value of bronchial provocation test.Methods A total of 273 children patients with chronic cough who underwent bronchial provocation test were enrolled in the study.The pulmonary function test and questionnaires investigation were performed to collect patients’cinical data.Firstly,according to the examination results of bronchial provocation test,these patients were divided into two groups,then the clinical characteristics of patients,the differences of pulmonary ventilation function were analyzed and compared between two groups.On basis of that,these factors were used to predict the results of bronchial provocation tests.Results The univariate analysis showed that the incidence rates of dry cough,nighttime cough,proportion of eczema patients,the proportion of allergic conjunctivitis and inhalation allergy,the family history of asthma and small airway damage degree in bronchial provocation test positive group were significantly higher than those in negative group(P<0.05).In the aspect of the results prediction of bronchial provocation test,the sensitivity and specificity of dry cough,nighttime cough and small airway function lesion were higher(70.89%&71.50%,60.40%&68.35%,51.31%&64.74%,respectively),the specificity of family history of asthma and medical history was higher,but the sensitivity was lower(20.05%&71.36%and 40.55%&60.24%).Moreover the positive rates of bronchial provocation test in the patients with more clinical signs were increased,as compared with those of patients with single clinical sign(P<0.05).Conclusion The clinical features of children with cough variant asthma can be found in many aspects including clinical symptoms,medical history and pulmonary ventilation function,therefor all kinds of factors should be taken into account when deciding whether a child with chronic cough needs to recive bronchial provocation test or not.

关 键 词：慢性咳嗽 支气管激发试验 临床特征 小气道 

分 类 号：R256.11[医药卫生—中医内科学]