特应性体质与儿童感染后咳嗽的相关性分析

Clinical study on cough after infection in children with atopic constitution

目的探讨特应性体质与儿童感染后咳嗽(PIC)的关系,为儿童感染后咳嗽的临床诊疗提供参考依据。方法采用回顾性分析选取2014年8月—2019年8月于大连市儿童医院慢性咳嗽门诊就诊,且符合儿童感染后咳嗽的患儿,完善肺功能、呼出气一氧化氮(FeNO)及血清白三烯检查,观察特应性体质与非特应性体质感染后咳嗽患儿上述各指标的变化并进行统计学分析。结果在符合纳入标准的116例PIC患儿中,疾病初期感染病原以肺炎支原体感染最多,其次为病毒感染;疾病初期以上呼吸道感染最多,其次为肺炎。特应性体质组患儿63例(54.31%),非特应性体质患儿53例(45.69%),特应性体质组肺功能各指标为1秒用力呼气容积(FEV1)、用力肺活量(FVC)、FEV1/FVC、呼气峰流速(PEF)、用力呼出25%肺活量的呼吸流速(FEF;)、用力呼出50%肺活量的呼吸流速(FEF;)、用力呼出75%肺活量的呼吸流速(FEF;)及最大呼气中期流速(MMEF)分别为(102.42±19.17)%、(103.35±26.85)%、(103.51±7.62)%、(124.39±57.26)%、(113.71±42.06)%、(83.41±22.85)%、(88.57±35.21)%及(89.67±26.85)%;非特应性体质组分别为(104.50±27.03)%、(105.81±37.01)%、(104.21±7.76)%、(114.76±52.29)%、(107.51±42.93)%、(93.87±26.32)%、(83.72±28.10)%及(95.66±32.69)%,FEF;组间差异有统计学意义(P<0.05),其余差异均无统计学意义(均P>0.05);特应性体质组与非特应性体质组FeNO值分别为18.42±11.73、13.84±7.25,差异有统计学意义(P<0.05);特应性体质组与非特应性体质组血清白三烯值分别为250.14±314.28、66.74±70.35,差异有统计学意义(P<0.05)。结论少数PIC患儿肺功能异常者以小气道功能减退为主;特应性体质PIC患儿FeNO和血清白三烯水平明显高于非特应性体质PIC患儿。

Objective To investigate the relationship between atopic constitution and post-infection cough(PIC)in children,and to provide reference for clinical diagnosis and treatment of post-infection cough in children.Methods Retrospective analysis was performed on children with postinfection cough who received treatment in the chronic cough Clinic of Dalian Children's Hospital from August 2014 to August 2019,and their lung function,fractional exhaled Nitric oxide(FeNO)and serum leutriene were improved.The changes of above indexes in children with cough after infection with atopic constitution and non-atopic constitution were observed and statistically analyzed.Results Among 116 children with PIC who met the inclusion criteria,mycoplasma pneumoniae infection was the most common pathogen in the early stage of disease,followed by virus infection.In the early stage of the disease,upper respiratory tract infection was the most common,followed by pneumonia.There were 63(54.31%)children in atopic constitution group,53(45.69%)children in non-atopic constitution group,FEV1,FVC,FEV1/FVC,PEF,FEF_(25%),FEF_(50%),FEF_(75%)and MMEF atopic constitution group were(102.42±19.17)%,(103.35±26.85)%,(103.51±7.62)%,(124.39±57.26)%,(113.71±42.06)%,(83.41±22.85)%,(88.57±35.21)%and(89.67±26.85)%;Non-atopic constitution group were(104.50±27.03)%,(105.81±37.01)%,(104.21±7.76)%,(114.76±52.29)%,(107.51±42.93)%,(93.87±26.32)%,(83.72±28.10)%,(95.66±32.69)%,respectively.Fef 50%difference between groups was statistically significant(P<0.05),and there was no statistical significance in other differences(allP>0.05);FeNO values of atopic constitution group and non-atopic constitution group were 18.42±11.73 and 13.84±7.25,respectively,and the difference was statistically significant(P<0.05);Serum leukotriene values in atopic constitution group and non-atopic constitution group were(250.14±314.28)%and(66.74±70.35)%,respectively,and the difference was statistically significant(P<0.05).Conclusion A few children with PIC have abnormal lung function mainly with small airway dysfunction.FeNO and serum leukotriene levels in atopic PIC children were significantly higher than those in non-atopic PIC children.