CAJ | 학술논문

目的：探讨肺通气功能测定、皮肤点刺试验与嗜酸性粒细胞在儿童哮喘与咳嗽变异性哮喘中的临床价值，分析皮肤点刺试验与嗜酸性粒细胞的相关性。方法选择5岁以上门诊哮喘及咳嗽变异性哮喘患儿80例，正常健康体检儿童30例。哮喘及咳嗽变异性哮喘患儿分为哮喘发作组（ A组）33例、哮喘缓解组（ B组）27例、咳嗽变异性哮喘组（ C组）20例，正常儿童作为对照组（ D组）。4组均行：肺功能检测，测定FVC、FEV1、PEF、FEF25、FEF50、FEF75等6项指标；外周血EOS绝对值；皮肤点刺试验（除外A组）。结果 A、B、C3组各项肺功能指标（ B、C组除外FEV1）均低于D组（ P ＜0．05或＜0．01），且A组患儿各项肺功能指标均低于B和C组（ P ＜0．01），但B和C组差异无统计学意义（ P ＞0．05）。 A、B、C 3组患儿EOS绝对值均明显高于D组且A组高于C组（ P ＜0．05或＜0．01），而A组与B组、B组与C组差异无统计学意义（ P ＞0．05）。 B、C、D 3组儿童进行皮肤点刺试验，阳性率为B组70．37％（19/27），C组55％（11/20），D组0，总阳性率63．83％；B、C组点刺阳性结果差异无统计学意义（ P ＞0．05）。皮肤点刺试验阳性与EOS绝对值存在相关性（ P ＜0．05），且二者呈正相关（ r ＝0．22）。结论肺功能检测是哮喘诊断及病情评估的重要依据，外周血EOS计数和皮肤点刺试验在哮喘和咳嗽变异性哮喘诊断中具有同样重要价值。
목적：탐토폐통기공능측정、피부점자시험여기산성립세포재인동효천여해수변이성효천중적림상개치，분석피부점자시험여기산성립세포적상관성。방법선택5세이상문진효천급해수변이성효천환인80례，정상건강체검인동30례。효천급해수변이성효천환인분위효천발작조（ A조）33례、효천완해조（ B조）27례、해수변이성효천조（ C조）20례，정상인동작위대조조（ D조）。4조균행：폐공능검측，측정FVC、FEV1、PEF、FEF25、FEF50、FEF75등6항지표；외주혈EOS절대치；피부점자시험（제외A조）。결과 A、B、C3조각항폐공능지표（ B、C조제외FEV1）균저우D조（ P ＜0．05혹＜0．01），차A조환인각항폐공능지표균저우B화C조（ P ＜0．01），단B화C조차이무통계학의의（ P ＞0．05）。 A、B、C 3조환인EOS절대치균명현고우D조차A조고우C조（ P ＜0．05혹＜0．01），이A조여B조、B조여C조차이무통계학의의（ P ＞0．05）。 B、C、D 3조인동진행피부점자시험，양성솔위B조70．37％（19/27），C조55％（11/20），D조0，총양성솔63．83％；B、C조점자양성결과차이무통계학의의（ P ＞0．05）。피부점자시험양성여EOS절대치존재상관성（ P ＜0．05），차이자정정상관（ r ＝0．22）。결론폐공능검측시효천진단급병정평고적중요의거，외주혈EOS계수화피부점자시험재효천화해수변이성효천진단중구유동양중요개치。
Objective To explore the diagnostic significance of pulmonary function test and skin prick test ( SPT) in children with asthma or cough variability asthma ( CVA) .Methods Eighty children patients who were diagnosed as asthma or CVA at outpatient department of our hospital from May to November in 2010 were enrolled in the study.They were divided into three groups:asthmatic attack group (group A, n =33),asthma remission group (group B, n =27),CVA group (group C, n=20),and the other 30 healthy children were enrolled as control group.All the children were 5~14 years old.The children in the four groups underwent pulmonary function test to detect the parameters including FVC,FEV1,PEF,FEF25,FEF50 and FEF75,and EOS absolute value in peripheral blood was counted in the four groups.Except for group A,SPT was performed in the other three groups.Results The lung functional parameters ( except for FEV1 in group B and group C) in group A,B,C were significantly lower than those in group D ( P <0.05 or <0.01),moreover,which in group A were obviously lower than those group B and group C ( P <0.01),however,there were no significant differences between group B and group C ( P >0.05).The EOS absolute value in group A,B,C was significantly higher than that in group D ( P <0.05),furthermore,which in group A was obviously higher than that in group C ( P <0.05),however,there was no significant difference between group A and group B and between group B and group C ( P >0.05).The positive rate by SPT was 70.37%(19/27)in group B, 55%(11/20)in group C,and 0 in group D,with total positive rate being 63.83%,there was no significant difference between group B and group C ( P >0.05).The positive rate of SPT was positively correlated to EOS absolute value ( r =0.22, P <0.05).Conclusion Pulmonary function test plays an important role in diagnosis and assessment for children with asthma or CVA,EOS counting and SPT are of great value in the process.