哮喘预测指数在婴幼儿哮喘诊疗中的意义作者:滑超侯沛君郭春艳等来源:《中国医药导报》第05期[摘要]目的探讨哮喘预测指数(API)在婴幼儿哮喘诊疗中的价值。办法选用10月~10月于山东大学附属省立医院小儿呼吸科住院的6~36个月患儿242例,根据API将其分为API阳性组164例与API阴性组78例。分别对两组患儿进行潮气呼吸肺功效、呼出气一氧化氮(FeNO)、外周血嗜酸性粒细胞比例(EOS%)、血清免疫球蛋白E(IgE)检测;分析潮气呼吸肺功效、FeNO在两组患儿之间与否存在差别;分析API阳性组FeNO与IgE、EOS%与否存在有关性。成果API阳性组达峰时间比[(18.76±6.47)%]、达峰容积比[(22.54±5.34)%]均低于API阴性组[(30.97±7.80)%、(32.98±5.93)%],差别都有统计学意义(P<0.05);API阳性组FeNO[(32.41±4.41)×10-9]、EOS%[(5.17±0.25)%]、IgE[(60.15±10.12)U/mL]均高于API阴性组[(9.05±0.56)×10-9、(2.07±0.24)%、(20.33±1.89)U/mL],差别都有统计学意义(P<0.05);有关性分析发现,阳性组FeNO与IgE及EOS%均呈正有关(r=0.851、0.759,均P<0.05)。结论API可有效预测婴幼儿喘息发展为持续性哮喘的危险性,结合潮气呼吸肺功效与FeNO检测有助于识别哮喘高危小朋友,为重复喘息婴幼儿预测哮喘提供客观的临床指标。[核心词]婴幼儿哮喘;哮喘预测指数;潮气呼吸肺功效;呼出气一氧化氮;诊疗[中图分类号]R562.25[文献标记码]A[文章编号]1673-7210()02(b)-0099-04SignificanceofasthmapredictiveindexinthediagnosisofinfantswithasthmaticHUAChao1,2HOUPeijun2GUOChunyan1CHENXing1WANGJinrong11.DepartmentofPediatricsRespiratory,ShandongProvincialHospitalAffiliatedtoShandongUniversity,ShandongProvince,Ji′nan250021,China;2.TheSecondClinicalCollegeAffiliatedtoShandongUniversityofTraditionalChineseMedicine,ShandongProvince,Ji′nan250000,China[Abstract]ObjectiveTodiscussthevalueofasthmapredictingindex(API)indiagnosisofinfantswithasthma.Methods242infantsaged6-36monthsfromOctobertoOctoberinDepartmentofPediatrics,ShandongProvincialHospitalAffiliatedtoShandongUniversitywereselected,accordingtotheAPI,theyweredividedintoAPIpositivegroup(164cases)andAPInegativegroup(78cases).Tidalbreathpulmonaryfunction,FeNO,bloodeosinophils(EOS%),andtotalserumimmunoglobulinE(IgE)weredeterminedrespectively;thedifferencesintidalbreathpulmonaryfunctionandFeNObetweentwogroupswereanalyzed;correlationbetweenFENOandEOS%,IgEwereanalyzed.ResultsTPTEF/TE[(18.76±6.47)%]andVPEF/VE[(22.54±5.34)%]inAPIpositivegroupwerelowerthanthoseoftheAPInegativegroup[(30.97±7.80)%,(32.98±5.93)%],thedifferenceswerestatisticallysignificant(P<0.05);FeNO[(32.41±4.41)×10-9],EOS%[(5.17±0.25)%],IgE[(60.15±10.12)U/mL]inAPIpositivegroupwerehigherthanthoseoftheAPInegativegroup[(9.05±0.56)×10-9,(2.07±0.24)%,(20.33±1.89)U/mL],thedifferenceswerestatisticallysignificant(P<0.05).InAPIpositivegroup,FeNOwaspositivelycorrelatedwithIgEandEOS%(r=0.851,0.759,allP<0.05).ConclusionAPIcanbeusedtopredictthewheezinginfantsdevelopingpersistentasthmaeffectively,APIcombinedwithtidalbreathpulmonaryfunctionandFeNOwerebeneficialtodistinguishhigh-riskofchildrenwithasthma,andprovideobjectiveclinicalindicatorsforpredictingasthmaofinfantswithrecurrentwheeze.[Keywords]Infantsasthma;API;Tidalbreathpulmonaryfunction;FeNO;Diagnose喘息不是一种疾病,它是一种症状,体现为呼吸过程中出现的持续的哮鸣音,提示呼吸气道的狭窄或阻塞。婴幼儿喘息的诊疗与管理是含有挑战性的,由于这种症状能够与许多疾病有关,其中两个最常见疾病是毛细支气管炎与哮喘。80%以上的哮喘起始于婴幼儿期[1],早期识别哮喘...