组胺激发试验结合呼吸道阻力测定在学龄前儿童哮喘诊断和疗效判定中的应用价值

Value of Application of Histamine Provocation Test and Airway Resistance Detection in Diagnosis and Therapeutic Efficacy in Preschool Children with Asthma

目的探讨组胺激发试验结合呼吸道阻力测定在学龄前儿童哮喘诊断和疗效判定中的应用价值。方法利用意大利MEFARMB3激发仪和德国产Microloop肺功能仪对42例哮喘(其中支气管哮喘27例,咳嗽变异性哮喘15例)和21例健康对照组儿童进行组胺激发试验和呼吸道阻力测定,比较其差异并评价在疗效判定中的价值。结果呼吸道阻力比值在健康对照组为(97.11±9.09)%,哮喘组为(229.37±57.48)%,咳嗽变异性哮喘组为(248.80±76.80)%。哮喘、咳嗽变异性哮喘组与健康对照组间比较有统计学意义(F=48.466P<0.001)。哮喘组16例予激素治疗,治疗前平均呼吸道阻力比值为(223.85±49.24)%,治疗3个月为(122.35±26.14)%,治疗后较治疗前呼吸道阻力比值显著降低(t=10.405P<0.005)。结论组胺激发试验结合呼吸道阻力测定是诊断和评价学龄前儿童哮喘的非常有效的一种方法。

Objective To study the value of application of histamine provocation test and airway resistance measurement in diagnosis and therapeutic efficacy in preschool children with asthma. Methods Histamine provocation test and airway resistance measurement by the Italian MEFAR MB3 provocating instrument and Germen Microloop lung function instrument for 42 cases who were diagnosed as asthmatic （27 patients with bronchial asthma and 15 cases of cough variant asthma） and 21 healthy cases was compared, and the differences between the 2 groups and the value of therapeutic efficacy were analyzed. Results The resistance ratio of respiratory tract of control group was （97. 11 ± 9.09） % , which in asthma and cough variant asthma group was （ 229.37 ± 57.48 ） % and （ 248.80 ± 76.80） %. There was significant difference between the 3 groups （ F = 48. 466 P 〈 0. 001 ）. Sixteen of 27 asthmatic patients were reexamined after treated with hormone for 3 months, the mean respiratory resistance ratio of before and after treatment was （223.85 ± 49.24） % and （ 122.35 ± 26.14） % , respectively. The resistance ratio of respiratory tract after treatment increased significantly than that of before treatment（ t = 10. 405 P 〈 0. 005 ）. Conclusion Histamine provocation test - airway resistance measurement is one of important value methods in the diagnosis and treatment therapeutic efficacy of preschool children with asthma.