肺炎支原体抗体与小儿咳嗽变异性哮喘相关性分析  

Analysis of correlation between mycoplasma pneumoniae antibody and cough variant asthma in children

作　　者：罗再春 王燕[1] Luo Zaichun;Wang Yan(Department of Pediatric Yongchuan Hospital Affiliated to Chongqing Medical University)

机构地区：[1]重庆医科大学附属永川医院儿科,重庆402160

出　　处：《重庆医科大学学报》2020年第6期782-785,共4页Journal of Chongqing Medical University

基　　金：重庆市永川区科委资助项目(编号:Ycstc2014nc5023)。

摘　　要：目的:探讨肺炎支原体(Mycoplasma pneumoniae,MP)抗体阳性对咳嗽变异性哮喘(cough variant asthma,CVA)儿童肺功能及变应原感染情况的影响。方法:选取2017年3月至2018年3月重庆医科大学附属永川医院门诊诊治的171例CVA患儿,根据MP抗体阳性与否,分为CVA+MP组及CVA组,收集其肺功能及激发试验、MP抗体滴度、变应原结果。结果:CVA+MP组比CVA组的1s用力呼气容积(forced expiratory volume in 1 second,FEV1)%值低(59.04±19.97 vs.81.21±18.09,P=0.000);初诊时CVA+MP组的中重度肺功能比例比CVA组高(24.56%vs.16.37%,P=0.000);CVA+MP初诊的用力肺活量(forced vital capacity,FVC)、FEV1、FEV1%、呼气峰流速(peak expiratory flow,PEF)、用力呼出25%肺活量的呼气流量(forced expiratory flow at25%of FVC exhaled,FEF25%)、FEF50%、FEF75%值均比治疗1个月后复查的值低(1.41±0.54 vs.1.85±0.63,0.85±0.50 vs.1.40±0.41,59.04±19.97 vs.75.11±16.83,2.46±0.81 vs.2.67±0.82,2.23±0.75 vs.2.43±0.77,1.62±0.67 vs.1.85±0.69,0.85±0.33 vs.0.99±0.32,P=0.000);CVA+MP组变应原阳性率较CVA组高(60.34%vs.43.36%,P<0.05)。MP抗体1∶80与1∶160、1∶320的FEV1无统计学差异(0.87±0.32 vs.0.79±0.39 vs.0.90±0.57,P>0.05);CVA组与CVA+MP组激发试验中重度比例无统计学差异(29.76%vs.14.29%,P>0.05)。结论:MP阳性患儿肺功能比MP阴性患儿肺功能损害程度更重,MP阳性的患儿肺功能各项主要指标均比MP阴性患儿低,但肺功能激发试验的程度无明显加重。CVA患儿可同时检测MP抗体及变应原,进行MP治疗及变应原规避。MP抗体1∶80的患儿,肺功能也受到了一定损伤,建议预防性给予抗MP的药物。阿奇霉素治疗对于肺功能恢复有一定意义。Objective:To investigate the effect of mycoplasma pneumoniae(MP)antibody positive on lung function and allergen infection in children with cough variant asthma(CVA).Methods:Totally 171 children with CVA were selected from the outpatient clinic of Yongchuan Hospital Affiliated to Chongqing Medical University from March 2017 to March 2018.According to the positive or not of MP antibody,they were divided into CVA+MP group and CVA group.The pulmonary function and provocation test,MP antibody titer and allergen results were collected.Results:The FEV1%value of CVA+MP group was lower than that of CVA group(59.04±19.97 vs.81.21±18.09,P=0.000);the proportion of moderate to severe lung function of CVA+MP group was higher than that of CVA group(24.56%vs.16.37%,P=0.000);the values of FVC,FEV1,FEV1,PEF,FEF25%,FEF50%and FEF75%of CVA+MP group were lower than those of one month after treatment(1.41±0.54 vs.1.85±0.63,0.85±0.50 vs.1.40±0.41,59.04±19.97 vs.75.11±16.83,2.46±0.81 vs.2.67±0.82,2.23±0.75 vs.2.43±0.77,1.62±0.67 vs.1.85±0.69,0.85±0.33 vs.0.99±0.32,P=0.000).The positive rates of allergens in CVA+MP group were higher than those in CVA group(60.34%vs.43.36%,P<0.05).There was no significant difference between 1∶80 of MP antibody and 1∶160,1∶320 of FEV1(0.87±0.32 vs.0.79±0.39 vs.0.90±0.57,P>0.05);there was no significant difference between CVA group and CVA+MP group(29.76%vs.14.29%,P>0.05).Conclusion:Pulmonary function damage of MP positive children is more serious than that of MP negative children.The main indexes of pulmonary function in MP-positive children were lower than those in MP-negative children,but the degree of pulmonary function provocation test was not significantly aggravated.Children with CVA can simultaneously detect MP antibodies and allergens,and carry out MP treatment and allergen avoidance.The pulmonary function of children with MP antibody 1∶80 is also impaired.It is suggested that anti-MP drugs be given prophylactically.Azithromycin treatment has certain significance for the r

关 键 词：咳嗽变异性哮喘 肺炎支原体 肺炎支原体抗体 肺功能 变应原 儿童 

分 类 号：R563.1[医药卫生—呼吸系统] R725.6[医药卫生—内科学]