儿童运动激发试验的临床应用

Clinical application of exercise challenge testing in children

运动是儿童支气管哮喘发作的常见诱因,运动激发试验(ECT)是诊断运动诱发性支气管痉挛(EIB)的金标准,并作为哮喘的诊断性检查。ECT对诊断儿童运动性哮喘具有高度特异性,对已确诊的哮喘儿童,ECT阳性反映气道炎症存在,提示哮喘未控制。因此ECT亦可用于研究哮喘的病理生理机制及指导哮喘的治疗。该文重点介绍了ECT的原理、方法(包括受试者的准备、试验步骤、结果判断)、影响因素、安全性及目前临床应用现状等内容,以利于临床更好地开展ECT检查,提高哮喘的诊断水平。

Exercise is a common trigger of bronchial asthma in children. Exercise challenge testing(ECT)is the gold standard for diagnosing exercise-induced bronchoconstriction(EIB)and serves as a diagnostic test for asthma. In children,ECT is highly specific for exercise-induced asthma,and because EIB reflects airway inflammation,it indicates uncontrolled asthma. Thus,ECT can be used to study the underlying pathophysiology of asthma and as a guide for therapy. In order to perform ECT better in clinical application and improve the level of asthma diagnosis,this paper focuses on the mechanisms,the detailed test methods(including patient preparation,procedures,assessing the response),the influence factors,safety and the current clinical application of ECT.