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山东大学学报 (医学版) ›› 2020, Vol. 58 ›› Issue (3): 107-112.doi: 10.6040/j.issn.1671-7554.0.2019.1325

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吸入性变应原对腺样体肥大合并支气管哮喘患儿肺功能影响

杨丽萍1,慕婷婷1,2,杨玉娟1,张宇1,宋西成1,2   

  1. 1. 青岛大学附属烟台毓璜顶医院耳鼻咽喉头颈外科, 山东 烟台 264000;2. 滨州医学院, 山东 烟台 264003
  • 出版日期:2020-03-10 发布日期:2022-09-27
  • 通讯作者: 宋西成. E-mail:songxicheng@126.com
  • 基金资助:
    国家自然科学基金面上项目(81670907)

Effects of inhaled allergens on pulmonary function in children with adenoid hypertrophy complicated with bronchial asthma

YANG Liping1, MU Tingting1,2, YANG Yujuan1, ZHANG Yu1, SONG Xicheng1,2   

  1. 1. Department of Otorhinolaryngology Head and Neck Surgery, Yantai Yuhuangding Hospital, Qingdao University, Yantai 264000, Shandong, China;
    2. Binzhou Medical College, Yantai 264003, Shandong, China
  • Online:2020-03-10 Published:2022-09-27

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摘要： 目的 分析吸入性变应原对腺样体肥大合并支气管哮喘患儿肺功能的影响。 方法 选取既往有哮喘病史的腺样体肥大患儿50例,随机选取同期就诊的170例既往无哮喘病史的腺样体肥大患儿做对照,对患儿临床资料进行分析,入院行吸入性变应原血清特异性IgE检测(sIgE)及肺功能检查,针对吸入性变应原sIgE不同致敏模式进行分层比较,肺功能主要指标包括第1秒用力呼气容积(FEV1)占预计值的百分比(FEV1% pre)、FEV1与用力肺活量(FVC)的比值占预计值的百分比(FEV1/FVC% pre)、最大通气量(MVV)占预计值的百分比(MVV% pre)、用力呼出75%肺活量时的瞬间呼气流(FEF75%%)占预计值的百分比(FEF75%% pre)、用力呼出 50%肺活量时的瞬间呼气流(FEF50%% )占预计值的百分比(FEF50%% pre),最大呼气中期流量(MMEF)占预计值的百分比(MMEF% pre)。 结果 合并哮喘病史组与非合并哮喘病史组的腺样体肥大患儿在性别、年龄、吸入性变应原阳性率比较无明显差异(P>0.05)。入院时合并哮喘病史组的腺样体肥大患儿的FEV1% pre、FEV1/FVC% pre、MVV% pre、FEF75%% pre、FEF50%% pre、MMEF% pre均低于非哮喘组患儿(t值分别为8.129、14.106、5.101、9.95、12.006、10.933,P值均为0.000)。50例合并哮喘的腺样体肥大患儿吸入性变应原sIgE阳性21例,阴性29例;其中单一吸入性变应原阳性组、多重吸入性变应原阳性组与阴性组比较无显著性差异(P>0.05);吸入性变应原低级别者(<3级)、高级别者(≥3级)FEV1% pre较阴性者显著下降(F值分别为3.495,P值分别为0.038)。吸入性变应原的级别与腺样体肥大合并哮喘病史患儿肺功能(FEV1% pre)有相关性(P值为0.028,R2为0.568)。 结论 吸入性变应原阳性级别与腺样体肥大合并哮喘患儿的肺功能严重程度密切相关;如患儿肺功能检查缺失,吸入性变应原检测可初步预测肺功能下降程度,有助于气道评估及干预。

关键词: 腺样体肥大, 支气管哮喘, 肺功能, 吸入性变应原

Abstract: Objective To explore the effects of inhaled allergens on pulmonary function in children with adenoid hypertrophy complicated with bronchial asthma. Methods A total of 50 children with adenoid hypertrophy with a history of asthma treated during Dec. 2018 and May 2019 were enrolled as the study group, and another 170 children with adenoid hypertrophy but with no history of asthma served as controls. All patients received inhaled allergens serum-specific IgE test(sIgE)and pulmonary function tests at admission, and the different sensitization patterns of inhaled allergens sIgE were compared, including the percentage of forced expiratory volume in 1 second(FEV1)as a percentage of predicted value(FEV1% pre), the ratio of FEV1 to forced vital capacity(FVC)as a percentage of predicted value(FEV1/FVC% pre), maximum ventilation(MVV)as a percentage of predicted value(MVV% pre), instantaneous expiratory 山 东 大 学 学 报 (医 学 版)58卷3期 -杨丽萍,等.吸入性变应原对腺样体肥大合并支气管哮喘患儿肺功能影响 \=-flow(FEF75%%)when forced to exhale 75% of vital capacity(FEF75%% pre), instant call when forced exhalation of 50% vital capacity Airflow(FEF50%%)as a percentage of predicted value(FEF50%% pre), maximum expiratory mid-flow flow(MMEF)as a percentage of predicted value(MMEF% pre). Results There were no significant differences in gender, age, and allergen positive rate between the two groups (P>0.05). The study group had lower FEV1% pre, FEV1/FVC% pre, MVV% pre, FEF75%% pre, FEF50%% pre and MMEF% pre than the control group(t=8.219, 14.106, 5.101, 9.95, 12.006 and 10.933, respectively, all P=0.000). In the study group, 21 had positive sIgE and 29 had negative sIgE, and there were no significant differences among the positive single allergen group, positive multiple allergens group and negative allergen group(P>0.05). The FEV1% pre of lower inhaled allergens group(<3)and higher inhaled allergens group(≥3)were significantly lower than the negative inhaled allergens group(F=3.596, P=0.035). There was correlation between the inhaled allergens level and pulmonary function(FEV1% pre)in the study group(P=0.028, R2=0.568). Conclusion Inhaled allergens level is closely related to severity of pulmonary function abnormalities in children with adenoid hypertrophy and asthma. Allergen testing can preliminarily predict pulmonary function impairment and contribute to airway assessment and intervention.

Key words: Adenoid hypertrophy, Bronchial asthma, Pulmonary function, Inhaled allergen

中图分类号: 

  • R763
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