儿童变应性鼻炎鼻阻力与肺功能相关性分析  

Analysis of related factors for postoperative recurrence of antrochoanal polyps in children

作　　者：陈奕均 高映勤[1] 马静[1] 王美兰[1] 李果 李正才[1] 张铁松[1] CHEN Yijun;GAO Yingqin;MA Jing;WANG Meilan;LI Guo;LI Zhengcai;ZHANG Tiesong(Department of Otolaryngology Head and Neck Surgery,Kunming Children's Hospital,Children's Hospital Affiliated to Kunming Medical Universiy,Kunming,650100,China)

机构地区：[1]昆明市儿童医院(昆明医科大学附属儿童医院)耳鼻咽喉头颈外科,昆明650100

出　　处：《临床耳鼻咽喉头颈外科杂志》2023年第6期463-468,共6页Journal of Clinical Otorhinolaryngology Head And Neck Surgery

基　　金：云南省科技厅科技计划项目重点研发计划(No:202103AF140008);云南省科技厅科技计划项目昆医联合专项(No:202001AY070001-272)。

摘　　要：目的分析变应性鼻炎(allergic rhinitis,AR)患儿鼻阻力和肺功能之间的相关性,探究鼻阻力升高的AR患儿是否伴有潜在的下呼吸道受累。方法选取2021年12月—2022年12月确诊为AR的88例患儿作为研究组,同期20例正常儿童作为对照组。研究组及对照组儿童均进行肺功能检查、支气管舒张试验、鼻阻力测定,将鼻阻力和肺功能检查结果进行Spearman相关性分析和多重性线性回归分析,探究两者间的关系及影响因素。根据鼻阻力测定结果将鼻阻力升高伴肺功能异常的患儿分为鼻阻力轻度升高伴肺功能异常组及鼻阻力中-重度升高伴肺功能异常组,分析鼻阻力升高的程度是否会影响肺功能。结果研究组用力呼出25%、50%、75%肺活量时的平均呼气流量(FEF_(25)、FEF_(50)、FEF_(75))明显低于对照组(P<0.05)。AR鼻阻力中-重度升高的患儿第一秒用力呼气量(FEV_(1))明显低于AR鼻阻力轻度升高的患儿(P<0.05)。AR患儿鼻阻力与一秒率(FEV_(1)/FVC)、中心呼吸道阻力(R20)具有相关性,FEV_(1)/FVC、R20是AR患儿鼻阻力的影响因素(P<0.05)。AR患儿血清总IgE与肺功能及支气管舒张试验均无相关性(P>0.05)。结论AR患儿鼻腔通气功能发生了改变,小气道功能有下降趋势。AR鼻阻力中-重度升高的患儿比轻度升高的患儿肺通气功能下降更明显。AR患儿鼻阻力受FEV_(1)/FVC、R20的影响,FEV_(1)/FVC、R20随着鼻阻力值升高而降低。肺功能和FEV_(1)改善率不是血清总IgE升高的影响因素。Objective To analyze the correlation between nasal resistance and lung function in children with allergic rhinitis(AR),and explore whether AR children with increased nasal resistance are accompanied by potential lower respiratory tract involvement.Methods A total of 88 children diagnosed with AR from December 2021 to December 2022 were selected as the study group,while 20 normal children were selected as the control group during the same period.Both the study group and the control group children underwent lung function tests,bronchodilator tests,and nasal resistance measurements.Spearman correlation analysis and multiple linear regression analysis were performed on the results of nasal resistance and lung function tests to explore the relationship and influencing factors between the two groups.According to the results of nasal resistance measurement,children with increased nasal resistance and abnormal lung function were divided into a mild increase in nasal resistance with abnormal lung function group and a moderate to severe increase in nasal resistance with abnormal lung function group.The degree of increased nasal resistance was analyzed to determine whether it would affect lung function.Results The FEF_(25),FEF_(50),and FEF_(75)levels in the study group were significantly lower than those in the control group(P<0.05).The FEV_(1)of children with moderate to severe increase in AR nasal resistance was significantly lower than that of children with mild increase in AR nasal resistance(P<0.05).There was a correlation between nasal resistance and FEV_(1)/FVC,R20 in AR children,and FEV_(1)/FVC,R20 were the influencing factors of nasal resistance in AR children(P<0.05).There was no correlation between total serum IgE,lung function,and bronchodilation test in AR patients(P>0.05).Conclusion The nasal ventilation function of AR patients has changed,and there is a downward trend in small airway function.Children with moderate to severe increase in AR nasal resistance have a more significant decrease in lung ventilation

关 键 词：变应性鼻炎 儿童 鼻阻力 肺功能 

分 类 号：R765.21[医药卫生—耳鼻咽喉科]