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目的了解门诊哮喘患儿中肥胖者所占比例;探究肥胖与肺通气功能的关系。方法将2011年1月至2013年12月于上海儿童医学中心哮喘专科门诊就诊的2343例哮喘儿童,根据体重指数(BMI)分为肥胖组358例(15.3%)、超重组476例(20.3%)及体重正常组1509例(64.4%)。检测3组患儿治疗前、随访及规范化治疗1年后的肺功能指标:包括第1秒用力呼气容积(FEV1)、用力肺活量(FVC)、1秒率(FEV1/FVC),用力呼气流量(FEF)占用力肺活量的25%,50%,75%(FEF25%、FEF50%、FEF75%),呼吸峰流速(PEFR)。结果 358例肥胖哮喘患儿中,男性明显多于女性[307(85.8%)vs.51(14.2%),P<0.01];随着BMI增加,哮喘患儿FEV1/FVC明显降低,三组间比较差异具有统计学意义(83.3±9.04 vs.81.54±9.08 vs.80.26±8.66,F=3.41,P=0.03);随访期间,各组哮喘患儿肺功能组间无明显差异;与初诊时基础肺功能相比,每次随访各肺通气功能参数前后比较差异均有统计学意义(P值均<0.05);治疗1年后,肥胖组哮喘患儿FEF75%明显低于超重组及体重正常组(0.70±0.26 vs.0.65±0.24 vs.0.60±0.25,P=0.04)。结论在肥胖哮喘患儿中,男性多见;BMI增高与FEV1/FVC降低有关,且降低规范化治疗对哮喘患儿肺功能的改善效应,表现为治疗1年后肥胖患儿FEF75%较正常体重组差异明显。
Objective To understand the proportion of obese children with outpatient asthma and explore the relationship between obesity and pulmonary ventilation. Methods From January 2011 to December 2013, 2343 asthmatic children with asthma specialist clinic in Shanghai Children’s Medical Center were divided into 358 cases (15.3%) in obesity group and 476 cases (20.3%) in overweight group according to body mass index (BMI) ) And normal weight group 1509 cases (64.4%). The indexes of lung function, including FEV1, FVC, FEV1 / FVC, forced expiratory volume (FEV1 / FVC) were measured before treatment, 1 year after follow- FEF accounted for 25%, 50%, 75% (FEF25%, FEF50%, FEF75%) and peak respiratory rate (PEFR) of vital capacity. Results Among 358 obese asthmatic children, the number of males was significantly higher than that of females [307 (85.8%) vs.51 (14.2%), P <0.01]. With the increase of BMI, the FEV1 / FVC of asthmatic children decreased significantly The difference was statistically significant (83.3 ± 9.04 vs.81.54 ± 9.08 vs.80.26 ± 8.66, F = 3.41, P = 0.03). There was no significant difference between the groups of asthmatic children in each group during follow-up Compared with the lung function, the ventilatory function parameters of each lung were significantly different before and after each follow-up (P <0.05). After 1 year of treatment, the FEF75% of obese children with asthma was significantly lower than that of overweight group and normal weight group (0.70 ± 0.26 vs.0.65 ± 0.24 vs.0.60 ± 0.25, P = 0.04). Conclusions The increase of BMI is associated with the decrease of FEV1 / FVC in obese asthmatic children, and the effect of normalized treatment on the improvement of pulmonary function in children with asthma is reduced. The FEF75% of obese children after 1 year of treatment is significantly lower than that of normal weight group The difference is obvious.