支气管激发试验在协助婴幼儿咳嗽变异性哮喘诊断中的应用体会  

Application of bronchial provocation test in diagnosis of infants with cough variant asthma

作　　者：刘莎[1] 刘芳君[1] 符州[1] 龚财惠[1] 刘铮[1] LIU Sha;LIU Fang-jun;FU Zhou;GONG Cai-hui;LIU Zheng(Department of Respiratory Medicine,Children’s Hospital of Chongqing Medical University,National Clinical Research Center for Child Health and Disorders,Ministry of Education Key Laboratory of Child Development and Disorders,Chongqing Key Laboratory of Pediatric,Chongqing 400014,China)

机构地区：[1]重庆医科大学附属儿童医院呼吸中心,国家儿童健康与疾病临床医学研究中心,儿童发育疾病研究教育部重点实验室,儿科学重庆市重点实验室,重庆400014

出　　处：《临床肺科杂志》2020年第11期1659-1663,共5页Journal of Clinical Pulmonary Medicine

基　　金：重庆医科大学附属儿童医院转化医学/疑难罕见病专项(No.223-zhyx2013-4)。

摘　　要：目的评价支气管激发试验(BPT)在婴幼儿咳嗽变异性哮喘(CVA)诊断中的应用价值。方法回顾性调查自2018年1月至2018年6月在我院哮喘专科门诊确诊的70例CVA患儿初诊时的潮气肺功能检测及BPT检测结果。结果 CVA患儿BPT的阳性率为98.6%,程度以中度(40.0%)及轻度(37.1%)阳性反应为主。在BPT的三个不同阶段(基础值、BPT后、给予支气管扩张剂后),RR、VT/kg、TPTEF/TE%、VPTEF/VE%、PEF/TEF25、TI/TE数值改变明显(P<0.01)。吸入激发剂后患儿主要出现的临床表现有气促(18.6%)、喘息(50.0%)、剧烈咳嗽(20.0%)和SPO2明显下降(91.4%),潮气流速容量(TBFV)环表现出典型的阻塞性病变的图形。吸入支气管扩张剂后15min以内所有患儿的症状均消失,肺功能恢复到激发前的状态。结论 BPT能够较好的协助CVA婴幼儿的诊断。在检测过程中密切观察患儿临床表现的前提下,该方法安全可靠。Objective To evaluate the value of bronchial provocation test(BPT)in diagnosis of infants with cough variant asthma(CVA).Methods A retrospective study was conducted on the tidal pulmonary function test and BPT test results of 70 children with CVA diagnosed in our asthma clinic from January 2018 to June 2018.Results The positive rate of BPT in children with CVA was 98.6%,with moderate(40.0%)and mild(37.1%)positive reactions.The values of RR,VT/kg,TPTEF/TE%,VPTEF/VE%,PEF/TEF25,and TI/TE were significantly changed in three different stages of BPT(baseline,after BPT,after bronchodilator)(P<0.01).The main clinical symptoms were tachypnea(18.6%),wheeze(50.0%),severe cough(20.0%)and dramatically decrease of SPO2(91.4%)after inhalation of bronchial stimulator.Tidal flow volume(TBFV)curve showed typical graph of obstructive lesions.All the symptoms disappeared within 15 minutes after inhalation of bronchodilator and the lung function returned to its baseline.Conclusion BPT can assist the diagnosis of CVA for infants.This method is safe and reliable under the premise of closely observe the symptoms of the children during the process of detection.

关 键 词：支气管激发试验 婴幼儿 咳嗽变异性哮喘 

分 类 号：R725.6[医药卫生—儿科]