肺通气功能正常的儿童支气管哮喘控制情况及急性发作随访的研究

Control status and follow-up of acute attacks in children with bronchial asthma with normal pulmonary ventilation function

目的探讨学龄期肺通气功能正常的支气管哮喘(简称“哮喘”)患儿病情控制情况及随访1年内急性发作情况。方法回顾性分析2021年4—9月327例6~14岁肺通气功能正常哮喘患儿临床资料。根据一秒率实测值,分为≥80%组(267例)和<80%组(60例),比较两组肺通气功能、哮喘控制水平差异,以及随访1年急性发作情况。结果<80%组基线肺通气功能低于≥80%组,小气道功能障碍比例高于≥80%组(P<0.05);规范治疗1年后,<80%组小气道功能指标均改善,但仍低于≥80%组(P<0.05)。入组时哮喘未完全控制率为34.6%(113/327),<80%组哮喘控制水平低于≥80%组(P<0.05);规范治疗1年后,<80%组哮喘控制水平仍低于≥80%组,且哮喘急性发作比例高于≥80%组(P<0.05)。结论学龄期哮喘患儿在肺通气功能正常时,仍有约1/3为哮喘未完全控制,其中一秒率实测值低于80%的患儿哮喘急性发作风险增加,需密切随访,强化哮喘管理。

Objective To investigate the control status of bronchial asthma(referred to as"asthma")in school-age children with normal pulmonary ventilation function and the occurrence of acute attacks within 1 year of follow-up.Methods A retrospective analysis was conducted on clinical data of 327 children aged 6-14 years with bronchial asthma and normal pulmonary ventilation function from April to September 2021.Based on the measured value of one second rate(FEV1/FVC),the children were divided into the≥80%group(267 cases)and the<80%group(60 cases).The pulmonary ventilation function,asthma control level,and occurrence of acute attacks within 1 year were compared between the two groups.Results The baseline pulmonary ventilation function in the<80%group was lower than that in the≥80%group,and the proportion of small airway dysfunction was higher than that in the≥80%group(P<0.05).After standardized treatment for 1 year,the small airway function indices in the<80%group improved but remained lower than those in the≥80%group(P<0.05).The rate of incomplete asthma control at baseline was 34.6%(113/327),and the asthma control level in the<80%group was lower than that in the≥80%group(P<0.05).After standardized treatment for 1 year,the asthma control level in the<80%group remained lower than that in the≥80%group,and the proportion of acute asthma attacks was higher than that in the≥80%group(P<0.05).Conclusions Approximately one-third of school-age children with asthma still have incomplete asthma control when their pulmonary ventilation function is normal.Among them,children with measured FEV1/FVC<80%have an increased risk of acute asthma attacks and require close follow-up and strengthened asthma management.