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[哮喘儿童持续性气流受限的临床特征分析]

[Clinical characteristics analysis of persistent airflow limitation in asthmatic children].

作者信息

Xiong S Q, Tian C Y, Chen W, Liu C H

机构信息

Department of Allergy, Children's Hospital of the Capital Institute of Pediatrics, Beijing 100020, China.

出版信息

Zhonghua Jie He He Hu Xi Za Zhi. 2024 Sep 12;47(9):807-814. doi: 10.3760/cma.j.cn112147-20240111-00021.

Abstract

To analyze the clinical characteristics of asthmatic children with persistent airflow limitation (PAL) in order to improve understanding of PAL and improve asthma management. The clinic data of asthmatic children aged 6 to 18 years with and without PAL, who visited the Department of Allergy at Children's Hospital of the Capital Institute of Pediatrics between January 2021 and June 2023, were analyzed retrospectively. The study included a total of 197 patients (153 males and 44 females), with a median age of 9.0 (7.0, 12.0) years. The analysis encompassed demographic features, disease-related factors, laboratory tests, and spirometry parameters. Quantitative data differences between the two groups were assessed using the Student's -test or the Mann-Whitney test. Qualitative data comparisons were made using the Chi-square test or Fisher's exact test. This study included 100 non-PAL and 97 PAL patients. The female-to-male ratio in the two groups was 27/73 and 17/80, respectively. Age and BMI were 11.0 (10.0, 13.0) years and 20.3 (17.7, 24.1) kg/m in the PAL group, which was significantly higher than in the non-PAL group (<0.001). Among the PAL group, 49.5% fell within the 9-12 age group. The PAL group had a higher percentage of patients with an asthma duration of more than 3 years (89.7% 62.0%, 0.001) and a history of pneumonia (13.4% 4.0%, =0.036) compared to the non-PAL group. Regarding laboratory tests, a higher percentage of patients in the PAL group had an elevated FeNO level (60.9% 37.6%, =0.002) and animal sensitization (50.7% 30.7%, =0.022) compared to the non-PAL group. Of the 69 patients who underwent spirometry before and after PAL development, FEV%pred, FEV/FVC, and MMEF%pred values gradually decreased, with a significant decline in the year preceding PAL development. Asthmatic children with PAL had characteristics such as relatively older age, higher BMI, longer duration of asthma, eosinophilic inflammation, and atopy. Lung function decline occurred several years before PAL development. Long-term follow-up should focus on the evolving trend of spirometry parameters.

摘要

分析持续性气流受限(PAL)哮喘儿童的临床特征,以提高对PAL的认识并改善哮喘管理。回顾性分析2021年1月至2023年6月期间在首都儿科研究所附属儿童医院过敏科就诊的6至18岁有或无PAL的哮喘儿童的临床资料。该研究共纳入197例患者(男153例,女44例),中位年龄为9.0(7.0,12.0)岁。分析内容包括人口统计学特征、疾病相关因素、实验室检查和肺功能参数。两组间定量数据差异采用Student's t检验或Mann-Whitney检验进行评估。定性数据比较采用卡方检验或Fisher精确检验。本研究包括100例非PAL患者和97例PAL患者。两组的男女比例分别为27/73和17/80。PAL组的年龄和BMI分别为11.0(10.0,13.0)岁和20.3(17.7,24.1)kg/m²,显著高于非PAL组(P<0.001)。在PAL组中,49.5%的患者年龄在9至12岁之间。与非PAL组相比,PAL组哮喘病程超过3年的患者比例更高(89.7%对62.0%,P=0.001),有肺炎病史的患者比例更高(13.4%对4.0%,P=0.036)。在实验室检查方面,与非PAL组相比,PAL组FeNO水平升高的患者比例更高(60.9%对37.6%,P=0.002),对动物致敏的患者比例更高(50.7%对30.7%,P=0.022)。在PAL发生前后接受肺功能检查的69例患者中,FEV%pred、FEV/FVC和MMEF%pred值逐渐下降,在PAL发生前一年显著下降。患有PAL的哮喘儿童具有年龄相对较大、BMI较高、哮喘病程较长、嗜酸性粒细胞炎症和特应性等特征。肺功能下降发生在PAL出现前数年。长期随访应关注肺功能参数的变化趋势。

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