人工支气管激发试验在儿童慢性咳嗽诊断中的应用

Application of Artificial Bronchial Provocation Test in the Diagnosis of Chronic Cough in Children

目的探讨使用乙酰甲胆碱(MCH)对慢性咳嗽儿童进行人工支气管激发试验(BPT)判定呼吸道高反应性(AHR)及其程度的应用价值及安全性。方法选择2010年1月至2011年8月在本院就诊并治疗的700例慢性咳嗽儿童为研究对象,并根据其年龄分为≤3岁组(n=534)和>3岁组(n=166)(本研究遵循的程序符合本院人体试验委员会所制定的伦理学标准,得到该委员会的批准,分组征得受试对象监护人的知情同意,并与之签署临床知情同意书)。对其使用MCH进行BPT,记录试验前、后患儿生命体征,咳嗽情况及肺部哮鸣音改善情况等。结果 700例患儿中,BPT的总阳性率为80%(560/700)。两组患儿BPT阳性率比较,差异无统计学意义(P>0.05)。700例患儿试验前、后生命体征比较,差异亦无统计学意义(P>0.05)。两组无一例患儿出现严重不良反应。结论对慢性咳嗽儿童使用MCH进行BPT安全可靠,在其病因诊断中具非常重要作用,适用于不具备儿童潮气肺功能仪等设备的基层医院。

Objective To evaluation the safety and application value of artificial bronchial provocation tests（BPT）with methacholine（MCH） in children which judged by lung auscultation（AHR）. Methods From January 2010 to August 2010,700 children with chronic cough were included in the study,and divided into 43 years old group（n=534）and D3 years old group（n=166）. They were all accepted artificial BPT with MCH. Heart rate,breathing, oxygen saturation, cough and pulmonary wheeze were monitored in the process of test. The study protocol was approved by the Ethical Review Board of Investigation in Human Being of the Central Hospital of Mianyang. Informed concent was obtained from each parents. Results The total positive rate of BPT was 80% （560/700）. No significant difference was found between 43 years old group and 〉3 years old group（P〉0.05）. There was no significant difference in vital sign changes between before and after BPT in both groups（P〉0.05）. All patients had no serious adverse reaction. Conclusions Artificial BPT with MCH is a reliable and safe method for children with chronic cough, and plays an important role in the etiologic diagnosis. This method is suitable for primary hospitals without baby tidal breathing pulmonary function equipment.