Li Yun, Liu Dan, Yi Hong-Ling, Guo Chun, Chen Min, Li Wen-Kai
Department of Pediatrics, Hunan People's Hospital, Changsha, China.
Zhongguo Dang Dai Er Ke Za Zhi. 2013 Feb;15(2):105-8.
To observe changes in the lung function of asthmatic children with different symptoms during treatment, and to investigate the clinical significance of bronchial reversibility test in the treatment of asthma in children.
A total of 417 asthmatic children were treated by salmeterol/fluticasone inhalation for more than 3 months. These patients were divided into asymptomatic, single cough, paroxysmal cough and wheeze (cough+wheeze or wheeze alone) groups based on the symptoms when they revisited the clinic. Thirty-four healthy children were used as a control group. All children underwent bronchial reversibility test using nebulized salbutamol. Lung function testing was performed before and after the test.
After nebulization of salbutamol, each asthma group showed significantly decreased rate of abnormal lung function and significantly increased forced expiratory volume in one second percent (FEV1%) predicted (P<0.05). Before salbutamol nebulization, the single cough, paroxysmal cough and wheeze groups had significantly higher rates of abnormal lung function and significantly lower FEV1% predicted than the control group (P<0.05). There were significant differences in the rate of abnormal lung function and FEV1% predicted among the asthma groups (P<0.05). After salbutamol nebulization, the paroxysmal cough and wheeze groups had significantly higher rates of abnormal lung function than the control group (P<0.05), but there were no significant differences between other asthma and control groups; the wheeze group had significantly lower FEV1% predicted than the control group, but no significant differences were found between other asthma and the control groups. The positive rate of bronchial reversibility test in each asthma group was significantly higher than in the control group (P<0.05). There were significant differences in the positive rate of the test between the asthma groups except between the asymptomatic and single cough groups (P<0.05).
Asthmatic children with different symptoms demonstrate different lung functions during treatment. Bronchial reversibility test combined with lung function test is useful in assessing asthma control and guiding treatment.
观察不同症状的哮喘儿童在治疗过程中的肺功能变化,探讨支气管舒张试验在儿童哮喘治疗中的临床意义。
417例哮喘儿童采用沙美特罗/氟替卡松吸入治疗3个月以上。根据复诊时症状将这些患儿分为无症状组、单纯咳嗽组、阵发性咳嗽组和喘息组(咳嗽伴喘息或单纯喘息)。选取34例健康儿童作为对照组。所有儿童均采用沙丁胺醇雾化吸入进行支气管舒张试验。试验前后进行肺功能检测。
沙丁胺醇雾化吸入后,各哮喘组肺功能异常率显著降低,预计第一秒用力呼气容积百分比(FEV1%)显著升高(P<0.05)。沙丁胺醇雾化前,单纯咳嗽组、阵发性咳嗽组和喘息组肺功能异常率显著高于对照组,预计FEV1%显著低于对照组(P<0.05)。各哮喘组间肺功能异常率和预计FEV1%差异有统计学意义(P<0.日)。沙丁胺醇雾化后,阵发性咳嗽组和喘息组肺功能异常率显著高于对照组(P<0.05),但其他哮喘组与对照组间差异无统计学意义;喘息组预计FEV1%显著低于对照组,但其他哮喘组与对照组间差异无统计学意义。各哮喘组支气管舒张试验阳性率显著高于对照组(P<0.05)。除无症状组和单纯咳嗽组外,各哮喘组间试验阳性率差异有统计学意义(P<0.05)。
不同症状的哮喘儿童在治疗过程中肺功能表现不同。支气管舒张试验联合肺功能检测有助于评估哮喘控制情况并指导治疗。