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目的通过随访支气管哮喘患儿肺功能及气道反应性,了解哮喘患儿的症状/肺功能与气道炎症之间的关系,为哮喘规范治疗提供依据。方法对32例7~14岁、规范吸入糖皮质激素(ICS)治疗的支气管哮喘患儿的进行肺功能、组胺激发试验检查,评估患儿症状/肺功能与气道反应性的关系。结果经过规范治疗,非发作期的一秒用力呼气容积(FEV1)、25%和50%肺活量用力呼气流速(FEF25和FEF50)占预计值的百分比在吸入治疗后比治疗前的有显著改善(P<0.01);FEV1在治疗3个月后完全恢复正常;而小气道通气功能异常要到1年才完全恢复;气道高反应性治疗前后也有显著改善(P<0.01),但2年后组胺激发试验阳性率仍达72%,均为轻度气道高反应。结论哮喘缓解期,虽然症状消失,肺功能检测接近正常,但大部分患儿组胺激发试验持续阳性,说明气道炎症持续存在。定期复查肺功能及支气管激发试验是指导临床治疗的有效指标。
Objective To investigate the relationship between pulmonary function and airway responsiveness in children with bronchial asthma and to find out the relationship between the symptoms and lung function and airway inflammation in children with asthma and provide the basis for the standard treatment of asthma. Methods Thirty-two children with bronchial asthma undergoing inhalation of glucocorticoid (ICS) were enrolled in this study. The pulmonary function and histamine challenge test were performed in 32 children aged 7-14 years. The relationship between symptoms and lung function and airway responsiveness was evaluated. Results After standard therapy, the percent of predicted forced expiratory volume in one second episode (FEV1), forced expiratory flow at 25% and 50% (FEF25 and FEF50) at non-episode was significantly improved after inhalation compared with pretreatment (P <0.01). FEV1 completely returned to normal after 3 months of treatment. However, the recovery of airway function was not completely recovered until 1 year. The airway hyperresponsiveness was significantly improved before and after treatment (P <0.01) After histamine test positive rate was still up to 72%, are mild airway hyperresponsiveness. Conclusions Although the symptoms disappear and the pulmonary function tests are close to normal in the remission period of asthma, most of the patients have persistent positive histamine stimulation test, indicating that airway inflammation persists. Regular review of lung function and bronchial provocation test is an effective indicator of clinical treatment.