变应性鼻炎儿童潮气肺功能变化及其与反复喘息的相关性研究

Changes of tidal pulmonary function and its relationship with recurrent wheezing in children with allergic rhinitis

目的观察2~5岁变应性鼻炎儿童潮气肺功能水平,探讨其潮气肺功能的变化与反复喘息的相关性。方法随机收集符合诊断标准的儿童,分为单纯鼻炎组(AR)49例、鼻炎哮喘组(AR&A组)50例及对照组43例,检测并比较各组患儿的潮气肺功能结果,结果异常者行支气管舒张试验。AR组与对照组行非干预性随访观察1年,调查其反复喘息发作次数及情况。结果AR组潮气量为(8.26±1.03)mL/kg,吸呼比为(0.76±0.08),TPTEF/TE和VPEF/VE分别为(30.98±6.84)%和(32.97±6.39)%,与对照组比较均无差异;AR&A组肺功能结果与其他两组比较除潮气量外各指标均明显下降(P<0.01);肺功能异常者AR组15例,AR&A组为27例,对照组有5例,进一步行支气管舒张试验,阳性AR组4例,AR&A组11例,卡方比较无明显差异(P>0.05)。AR组与对照组随访一年,AR组潮气肺功能异常组有5例(10.2%)反复喘息发作,正常组仅一例(2.3%)发生反复喘息,对照组无一例发生反复喘息。结论变应性鼻炎儿童潮气肺功能可存在小气道功能障碍,且肺功能异常者反复喘息发作次数更多。

Objective To observe the changes of tidal pulmonary function in 2~5 years old children with allergic rhinitis,and to explore its correlation with repeated wheezing.Methods Children who met the diagnostic criteria were randomly collected and divided into simple allergic rhinitis group(AR group,49 cases),allergic rhinitis concomitant with asthma group(AR&A group,50 cases),and control group(43 cases).The tidal pulmonary function results of each group were detected and compared,and those with abnormal results further underwent a bronchodilation test.The AR group and the control group underwent non-interventional follow-up observation for 1 year,and the frequency and condition of recurrent wheezing were investigated.Results In the AR group,the tidal volume was(8.26±1.03)mL/kg,the inspiratory/expiratory ratio was(0.76±0.08),the time to peak ratio and the peak volume ratio was(30.98±6.84)%and(32.97±6.39)%,respectively,which had no difference compared with the control group.Compared with the other two groups,the results of pulmonary function in AR&A group were significantly decreased except for tidal volume(P<0.01).There were 15 cases in AR group,27 cases in AR&A group,and 5 cases in control group with abnormal lung function,and further bronchodilation test was performed.Among them,4 cases in AR group and 11 cases in AR&A group showed positive bronchial dilation test,which had no significant difference between two groups.After followed-up one year,There were 5 cases(10.2%)in the AR group with abnormal tidal pulmonary function,and only 1 case(2.3%)in the normal group had recurrent wheezing,and none in the control group had recurrent wheezing.Conclusion The tidal pulmonary function of children with allergic rhinitis may have small airway dysfunction,and those with abnormal pulmonary function have more frequent wheezing episodes.