反复喘息儿童的哮喘风险预测指标研究

Predictive indicators of asthma risks for children with recurrent wheezing

目的建立儿童哮喘发作风险的评估指标,用于预测喘息患儿的哮喘发病风险。方法选取我院2011年1月至2015年1月符合中华医学会诊断标准的620名喘息患儿,由经统一培训的医务人员对患儿及其父母进行问卷调查,根据患儿及其父母的特征症状总结出哮喘预测指标,并统计出不同年龄阶段患儿哮喘发作的情况,以及不同年龄阶段患儿在哮喘预测指标下的敏感性、特异性、阳性预测值和阴性预测值。结果在预测哮喘的特征症状中,男性哮喘患儿组在早期喘息、早期频繁喘息、非感冒性喘息方面与女性患儿组相比差异有统计学意义(P<0.05)。喘息患儿在13周岁前,男性患儿的哮喘发作率与女性患儿相比差异有统计学意义(P<0.05)。哮喘预测指标的灵敏度和阳性预测值随着患儿年龄的增长呈上升趋势,而阴性预测值和特异度呈下降趋势。结论早期频繁喘息的儿童大多数将会在后期患有哮喘,哮喘症状会随着年龄增长而不断加重,且会一直持续到患儿的学龄期。早期仅有轻微喘息的患儿在后期发作哮喘的概率较低,即具有较高水平的哮喘阴性预测值。

Objective To establish the evaluation battery of asthma risks,so as to predict asthma onsets in children with recurrent wheezing. Methods Six hundred and twenty asthma children confirmed to the CMA Diagnostic Standards and admitted into the hospital from January 2011 to January 2015 were chosen for our study. A questionnaire survey involving both children and their parents was conducted by trained medical personnel. Asthma predicting indicators of the specific symptoms of the disorder described by child patients and their parents were summarized accordingly. Then,the onsets of asthma at different age stages were summarized and analyzed,and the sensitivity,specificity and positive rate of predicative cases as well as negative rate of predicative cases at different age stages were also analyzed. Results There was statistical significance in the prediction of specific asthma symptoms,initial wheezing,initial frequent wheezing and non-cold type wheezing,when comparisons were made between the child male patient group and the child female patient group（ P〈0. 05）. Statistical significance could be noted,when the morbidity rate of the male group before the age of 13 was compared with that of the male group（ P〈0. 05）. The sensitivity and the positive value of the asthma predictive indicators were increased with the increase of the patient age,while the negative value of the asthma predictive indicators and specificity were decreased.Conclusion Most of the children with initial frequent wheezing would have asthma at late stage,with the symptoms of asthma deteriorated with age,and the symptoms would continue until school age. The probability of asthma onset at late stage was quite low for children with initial mild wheezing,which indicated that it had a relatively high negative predictive value.