肺炎支原体抗体阳性对咳嗽变异性哮喘患儿肺功能的影响研究

Influence of Mycoplasma Pneumoniae Positive Antibody on Lung Function in Children with Cough Variant Asthma

目的：通过探讨肺炎支原体（M P）抗体阳性感染对咳嗽变异性哮喘（C V A）患儿肺功能的影响,为临床治疗提供依据。方法：选择201 2年6月~201 4年6月本院收治的C V A患儿共60例,依据支原体抗体检查和肺功能检测结果,分为C V A合并M P组（合并组）和C V A组,检测两组患儿初诊时肺通气功能、支气管激发试验阳性率,分析初诊时、治疗1、3个月后M P抗体对肺功能第一秒用力呼吸容积/用力肺活量（F E V 1%）的影响。结果：初诊时两组患儿肺活量（F V C）、最大呼气峰流速（PE F）、F E V 1%、最大中段呼气流速（M M E F 75/25）实测值均低于预测值（P〈0.05）,合并组M M E F 75/25预测值/实测值的比值较C V A组高（P〈0.05）。支气管激发试验阳性患儿中,合并组以轻度和极轻度为主,C V A组以重度和中度为主（P〈0.05）。M P抗体滴度持续阳性和阴性患儿F E V 1%无统计学差异（P〉0.05）。结论：合并M P抗体阳性C V A患儿气道高反应性程度较低,小气道阻塞加重,对肺通气功能无影响。

Objective： To explore the influence of mycoplasma pneumoniae （MP） positive antibody on lung fimction in children with cough variant asthma （CVA）, and provide the evidence for clinical therapy. Methods： A total of 60 children with CVA, who were treated in Xining Third People＇s Hospital of Qinghai Province from June 2012 to June 2014, were selected and divided into MP and CVA group （combination group） and CVA group according to the inspection results of mycoplasma antibody and lung function. The lung function and positive rates of bronchial provocation test of the two groups at first diagnosis were detected. The influence of MP antibodies on forced expiratory volume in one second （FEVI%） in the two groups at first diagnosis and after 1 month and 3 months of treatment were analyzed. Results： The measured values of forced vital capacity （FVC）, FEV 1%, peak expiratory flow （PEF）, and maximal midexpiratory flow75/25 （MMEF75/25） were lower than the predicted value in the two groups （P〈0.05）. The ratio of MMEF75/25 predictive value/measured value in the combination group was higher than that in the CVA group （P〈0.05）. In the positive results of bronchial provocation test, combination group was mainly mild and very mild degree, while the CVA group was mainly severe and moderate degree （P〈0.05）. There was no difference in FEVI% between MP antibody titers continued positive and titers continued negative children patients （P〉0.05）. Conclusions： The children with CVA complicated with MP positive antibody has milder airway hyperreactivity and heavier small airway obstruction,which has no impact on pulmonary ventilation function.