学龄期支气管哮喘患儿运动状态及影响因素  

Exercise status and influencing factors in school-age asthmatics

作　　者：许巍[1] 李珍[1] 任亦欣[1] 王燕[1] 苗青[1] 向莉[1] Xu Wei;Li Zhen;Ren Yixin;Wang Yan;Miao Qing;Xiang Li(Department of Allergy,Children′s Hospital Affiliated to Capital Medical University,Beijing 100045,China)

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：《中华实用儿科临床杂志》2021年第11期827-830,共4页Chinese Journal of Applied Clinical Pediatrics

摘　　要：目的了解学龄期支气管哮喘(哮喘)患儿运动状态,探讨相关影响因素。方法2016年1月至2017年1月连续纳入首都医科大学附属北京儿童医院过敏反应科哮喘门诊确诊为哮喘的学龄期患儿,将运动后无不适症状且无运动受限者定义为运动状态正常组(NE),运动后有不适症状和/或运动受限者定义为运动状态异常组(ANE),将性别、年龄、哮喘控制状态、反复咳喘病史长度、持续吸入糖皮质激素(ICS)治疗时长、体质量指数(BMI)和各项肺功能指标进行回顾性分析。结果共纳入194例哮喘患儿,哮喘控制135例(69.6%)、哮喘部分控制39例(20.1%)、哮喘未控制20例(10.3%);NE组99例(51.0%),ANE组95例(49.0%);BMI正常111例(57.2%),超重32例(16.5%),肥胖51例(26.3%)。在所有病例的Logistic回归模型中,哮喘控制水平差(部分控制OR=4.77,95%CI:2.07~11.00,P<0.001;未控制OR=10.02,95%CI:2.70~37.22,P=0.001)、BMI增高(OR=1.15,95%CI:1.06~1.25,P=0.001),显著增加运动状态异常的风险。BMI正常的病例中,ANE组出现肺过度充气的病例显著多于NE组(43.8%比19.0%,P=0.005)。结论哮喘控制状态差、超重/肥胖是出现运动受限的危险因素,肺过度充气也可能对哮喘患儿运动产生影响。Objective To know the exercise status of asthmatic in school-age,and to identify possible influen-cing factors.Methods School-age children with a firm diagnosis of asthma were continuously included in Asthma Clinic of Allergy Department,Children′s Hospital Affiliated to Capital Medical University from January 2016 to January 2017.Patients who complain any symptoms during or after exercise with or without exercise limitation were assigned to the abnormal exercise group(ANE),and children who stated no symptoms and exercise limitation were defined as normal exercise group(NE),correspondingly.These data include age,gender,length of recurrent wheezing history,duration of treatment with inhaled corticosteroids(ICS),asthma control status,body mass index(BMI),pulmonary function parameters by spirometry and plethysmography that were collected and analyzed.Results A total of 194 cases were included:135 cases(69.6%)were well controlled,39 cases(20.1%)were partially controlled,and 20 cases(10.3%)were uncontrolled.Totally,95 cases(49.0%)were distributed in ANE group,while 99 cases(51.0%)were in NE group.Meanwhile,111 patients(57.2%)had normal BMI,32 patients(16.5%)were overweight,and 51 patients(26.3%)were obese.In the Logistic regression model of all cases,the worse asthma control level(partially controlled OR=4.77,95%CI:2.07-11.00,P<0.001,uncontrolled OR=10.02,95%CI:2.70-37.22,P=0.001)and higher BMI(OR=1.15,95%CI:1.06-1.25,P=0.001)were closely associated with the significantly increased risk of exercise abnormality.Among the patients with normal BMI,ANE group had more cases with hyperinflation than normal exercise group(43.8%vs.19.0%,P=0.005).Conclusions The results suggested that poor asthma control status and overweight/obesity are risk factors for exercise limitation,and excessive lung inflation may also affect exercise in children with asthma.

关 键 词：支气管哮喘 运动 肺功能 影响因素 儿童 

分 类 号：R725.6[医药卫生—儿科]