儿童支气管哮喘过敏原测定及肺功能的变化

Measurement of the allergens in as thmatic children aswell as their pulmonary function changes during the stages of attack and remission

目的了解广州地区儿童支气管哮喘的过敏原及哮喘发作和缓解时肺功能的变化。方法应用MAST过敏原测定仪测定73例哮喘儿童的血清总IgE和35种过敏原，然后分别应用F2600型和303型肺功能促进行测定其哮喘发作和缓解时的肺功能变化。结果73例哮喘儿童中血清总IgE升高68例，占93．1％，这68例中可检出过敏原46例，占67．6％，46例中对尘螨过敏43例，占93．5％，对豚草、动物毛、蟑螂过敏3例，占6．5％。0～3a组哮喘发作时75％潮气量与最高呼气流速之比（25－PF）值为0．424±0．089，与正常预定值（0．6±0）比较显著降低．P＜0．01：而哮喘缓解时25－PF值为0．603±0.021，与正常预定值比较差异无显著性，P＞0．05。4～6a组和7a以上组哮喘发作时最大肺活量（FVC）、ls最大呼气量（FEV1）与正常预定值比较差异无显著性，P＞0．05．FEV1／FVC、FEF25％～75％与正常预定值比较差鼻有显著性，P＜0．05；而哮喘缓解时上述参数正常。结论广州地区儿童支气管哮喘与外源性过敏原密切相关．其中尘螨是诱发哮喘最主要的过敏原。肺功能仪测定哮喘儿童的肺功能变化可用来判断哮喘的严重程度，指导治疗和评价预后。

To study the allergens in asthmatiC children inGuangzhou area as well as their pulmonary function challges duringthe slages of attack and remission.Methods Serum total IgE and 35 types of allergens were measured in 73 cases with tile MAST allergy lest .and 60 cases of theseasthmatic children were divided in 3 groups to measure their pulmonary function changes during the stages of attack and remissionWith F 2600 type or 303 type pulmonary function spirometry.Results Sixty-eight out of 73 cases were inereased with theserum total IgE (93. 1 %). 46 out of these 68 cases were detectedwith allergens positively (67. 6 % ). while 43 cut of 46 cases weremites (93.5% ). 3 cases were others Sucll as ragweed. dander of catand cockroach (6. 5 % ). In 0～3-year group the value of Pulmonaryfunction parameter 25-PF was decreased as asthma attacked. the difference was significant compared with the control group (P<0. 01 ),while in remission stage the difference was no significance (P>0. 05). In 4～6-year group and ≥7-year group. the value of FVC andFEV1 were normal (P>0. 05 ), while FEV1 /FVC and FEF25%～75 % were decreased significantly(p<0. on or P<0. 01 )as foe asthma was attacking compared with tile control group resI3cctively.while in remission stage. such parameters were normal (P> 0. 05).Conclusion iI suggested that in Guangzhou area children'sasthma are highly related with exogenous allergens. mites are themost impoltant allergen. Pulmonary function tasl might help to decide the severity of asthma and instruet clinical treatment as well ascstimate the prognosis of asthma.