咳嗽变异性哮喘合并肺炎支原体感染患儿哮喘控制测试评分与肺功能状况研究

Asthma control test scores and lung function in children with cough variant asthma complicated with mycoplasma pneumoniae infection

目的探讨咳嗽变异性哮喘(CVA)合并肺炎支原体(MP)感染患儿的哮喘控制测试(ACT)评分与肺功能状况。方法选取北部战区总医院自2018年3月至2020年12月收治的90例CVA合并MP感染患儿为B组。另选取我院同期收治的50例单纯CVA患儿为A组。记录并比较两组患儿就诊当日与治疗后1、2、3个月的肺功能[用力肺活量(FVC)、第1秒用力呼气容积(FEV1)、最大中段呼气流速(MMEF75/25)、最大呼气峰流速(PEF)]、ACT评分、MP-IgM抗体效价变化情况。结果B组患儿就诊当日与治疗后1、2、3个月的FVC、FEV1、MMEF75/25、PEF均低于A组,差异均有统计学意义(P<0.05);两组患儿治疗后1、2、3个月的FVC、FEV1、MMEF75/25、PEF均高于就诊当日,差异均有统计学意义(P<0.05)。B组患儿治疗后1个月的ACT评分低于A组,差异有统计学意义(P<0.05);两组患儿治疗后2、3个月的ACT评分均高于治疗后1个月,差异均有统计学意义(P<0.05)。B组患儿就诊当日与治疗后1、2、3个月的MP-IgM抗体滴度<1∶80比例低于A组,而MP-IgM抗体滴度1∶80~1∶160比例高于A组,差异均有统计学意义(P<0.05);B组患儿就诊当日与治疗后1、2个月的MP-IgM抗体滴度>1∶160比例高于A组,差异均有统计学意义(P<0.05);B组患儿治疗后1、2、3个月的MP-IgM抗体滴度<1∶80比例高于就诊当日,MP-IgM抗体滴度1∶80~1∶160与MP-IgM抗体滴度>1∶160比例低于就诊当日,差异均有统计学意义(P<0.05)。结论对CVA患儿而言,MP感染可损害其通气功能及整体肺功能,影响哮喘症状控制效果,不利于患儿康复,临床需加强MP感染的治疗管理,进而积极推进其病情恢复进程。

Objective To investigate the asthma control test(ACT)scores and lung function in children with cough variant asthma(CVA)with mycoplasma pneumoniae(MP)infection.Methods A total of 90 children with MP-infected CVA admitted to the General Hospital of Northern Theater Command from March 2018 to December 2020 were selected as Group B.Another 50 children with simple CVA admitted to our hospital during the same period were selected as group A.The changes of lung function[forced vital capacity(FVC),forced expiratory volume in one second(FEV1),maximum middle expiratory flow rate(MMEF75/25),maximum peak expiratory flow rate(PEF)],ACT score and MP-IgM antibody titer were recorded and compared between the two groups on the day of treatment and 1,2 and 3 months after treatment.Results The FVC,FEV1,MMEF75/25 and PEF of group B on the day of treatment and 1,2 and 3 months after treatment were lower than those of group A,with statistical significance(P<0.05).The levels of FVC,FEV1,MMEF75/25 and PEF 1,2 and 3 months after treatment were higher than those on the day of treatment,and the differences were statistically significant(P<0.05).The ACT score of group B was lower than that of group A one month after treatment,and the difference was statistically significant(P<0.05).The ACT scores of the two groups 2 and 3 months after treatment were higher than 1 month after treatment,the differences were statistically significant(P<0.05).On the day of treatment and 1,2 and 3 months after treatment,the proportion of MP-IgM antibody titer<1∶80 in group B was lower than that in group A,while the proportion of MP-IgM antibody titer 1∶80 to 1∶160 was higher than that in group A,with statistical significance(P<0.05).The proportion of MP-IgM antibody titer>1∶160 in group B was higher than that in group A on the day of treatment and 1 and 2 months after treatment,with statistical significance(P<0.05).At 1,2 and 3 months after treatment,the proportion of MP-IgM titer<1∶80 was higher than that on the day of treatment,and the proportion of MP-IgM titer 1∶80 to 1∶160 and MP-IgM titer>1∶160 were lower than that on the day of treatment,with statistical significance(P<0.05).Conclusion For children with CVA,MP infection can damage their ventilation function and overall lung function,affect the control effect of asthma symptoms,and is not conducive to the rehabilitation of children.Clinical treatment and management of MP infection should be strengthened to actively promote the recovery process of the disease.