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目的探讨小呼吸道病变(SAD)对慢性咳嗽儿童非典型哮喘的预测价值。方法收集广东省中医院2007年6月-2010年6月慢性咳嗽儿童176例。男95例,女81例;年龄5～12岁。对其进行肺功能检测及支气管激发试验(BPT),分别分析SAD、呼吸道高反应性(AHR)与哮喘的关系。应用SPSS 17.0软件进行统计学分析。结果 170例慢性咳嗽儿童完成全部检测项目。其中122例肺功能正常,48例有SAD。BPT检测发现78例有AHR,阳性率为45.88%(78/170例)。其中SAD组BPT阳性率为87.50%(42/48例),远远高于肺功能正常组[29.51%(36/122例)](2χ=46.655,P<0.01)。随访发现,78例AHR患儿中72例确诊为哮喘,其中SAD组41例(85.42%),肺功能正常组31例(25.41%),二组哮喘患病率比较,差异有统计学意义(2χ=50.803,P<0.01)。结论慢性咳嗽儿童SAD与AHR发生密切相关,SAD对慢性咳嗽儿童非典型哮喘的预测价值较高,无BPT检测条件的基层医院可将其作为哮喘的初筛检查。
Objective To investigate the predictive value of small respiratory tract disease (SAD) in the treatment of atypical asthma in children with chronic cough. Methods A total of 176 children with chronic cough were collected from June 2007 to June 2010 in Guangdong Provincial Hospital of Traditional Chinese Medicine. 95 males and 81 females; aged 5 to 12 years old. The pulmonary function test and bronchial provocation test (BPT) were performed to analyze the relationship between SAD, airway hyperresponsiveness (AHR) and asthma. Application SPSS 17.0 software for statistical analysis. Results 170 cases of chronic cough children to complete all testing items. 122 cases of normal lung function, 48 cases with SAD. BPT test found 78 cases have AHR, the positive rate was 45.88% (78/170 cases). The positive rate of BPT in SAD group was 87.50% (42/48 cases), which was much higher than that in normal pulmonary function group [29.51% (36/122 cases)] (2χ = 46.655, P <0.01). Follow-up found that 72 of 78 children with AHR were diagnosed as asthma, including 41 cases (85.42%) in SAD group and 31 cases (25.41%) in normal pulmonary function group. The prevalence of asthma in the two groups was statistically significant 2χ = 50.803, P <0.01). Conclusions There is a close relationship between SAD and AHR in children with chronic cough. SAD has a higher predictive value for atypical asthma in children with chronic cough and can be used as a primary screening test for asthma in primary hospitals without BPT testing.