支气管激发试验在婴幼儿慢性咳嗽诊断中的应用

Application of bronchial provocation test to diagnose chronic cough in infants

目的评价支气管激发试验(bronchial provocation test,BPT)在婴幼儿慢性咳嗽诊断及鉴别诊断中的应用价值。方法选取慢性咳嗽患儿50例,喘息性疾病患儿23例,正常婴幼儿10例进行BPT,试验中观察肺部哮鸣音、血氧饱和度(SaO2)、气道阻力(Rrs)、达峰时间比、达峰容积比等,作为阳性判断指标。结果在50例慢性咳嗽患儿中有39例BPT为阳性(78%),而23例有喘息症状的患儿中有21例阳性(91.3%),正常对照组全部为阴性(10/10例)。在BPT阳性患儿中SaO2、Rrs、% T-PF、% V-PF在激发前后变化均有显著性差异(P<0.01),而阴性患儿中只有SaO2、Rrs前后变化有统计学意义(P<0.05)。结论用BPT来辅助婴幼儿慢性咳嗽的诊断及鉴别诊断有很高的临床实用价值,用综合指标来判断激发试验,结果更为准确、可靠。

Objective To evaluate bronchial provocation test （BPT） in diagnosis and differential diagnosis of chronic cough in infants. Methods Fifty infants with chronic cough, 23 wheezed infants and 10 controls were included. BPT was performed and the indexes including SaO2, Rrs, % T-PF, % V-PF and lung symptoms were recorded. Results Thirty-nine out of 50 infants with chronic cough were positive （78%） in BPT, while 21 out of 23 wheezed infants positive （91.3%） ; the controls were all negative （ 100% ）. Significant difference in SaO2, Rrs, % T-PF, % V-PF was found in the infants positive in BPT before and after BPT. And in the in- fants who were negative, only SaO2 and Rrs were of significant difference before and after BPT. Conclusion BPT is of high clinic value in auxiliary diagnosis and differential diagnosis of chronic cough in infants. To judge the BPT result with comprehensive index is more stable and reliable.