目的 探讨大气细颗粒物(PM2.5)浓度与儿童咳嗽变异性哮喘的关系.方法 选择2015年4月至2016年4月南京医科大学附属淮安第一人民医院诊断为咳嗽变异性哮喘儿童48例(咳嗽变异性哮喘组)和典型哮喘儿童50例(典型哮喘组),同期选择慢性肺炎儿童50例(肺炎组)和健康儿童50例(对照组),比较发病1个月内环境中平均PM2.5浓度,检测血清淋巴细胞比率、CD+4/CD+8、IgE、肺通气指标水平.结果 ①咳嗽变异性哮喘组和典型哮喘组的平均PM2.5浓度高于肺炎组和对照组[(85.6±10.3)、(76.4±11.4) μg/m3 vs(41.3±12.5)、(25.9±10.5) μg/m3],差异有统计学意义(P<0.05);②咳嗽变异性哮喘组和典型哮喘组的淋巴细胞比率和IgE水平高于其他两组,CD+4/CD+8低于其他两组,差异均有统计学意义(P<0.05);③咳嗽变异性哮喘组的FEV1%Pred、FEV1/FVC和MMEF%Pred分别为(88.7±13.5)%、(80.2±7.8)%、(78.6±15.4)%,典型哮喘组分别为(85.4±14.6)%、(76.3±7.6)%、(72.5±16.3)%,均分别低于其他两组(P<0.05),而咳嗽变异性哮喘组相关数据与典型哮喘组则基本一致(P>0.05).结论 PM2.5与儿童咳嗽变异性哮喘发作有关,免疫调节和通气功能降低与典型哮喘改变可能一致.%Objective To study the relationship between atmospheric fine particles concentration(PM2.5) and children with cough variant asthma.Methods The study was conducted in 48 cases of cough variant asthma and 50 cases of typical asthma, 50 cases of chronic pneumonia and 50 cases of healthy control from April 2015 to April 2016 in Huai’an First People’s Hospital, Nanjing Medical University.The mean PM2.5 during onerecent month, serum lymphocyte ratio, CD+4/ CD+8T, immunoglobulin IgE and lung ventilation indicatorswere compared.Results The mean PM2.5 in cough variant asthma and typical asthma groups were higher than those in the chronic pneumonia group and healthy control [(85.6±10.3), (76.4±11.4) μg/m3 vs (41.3±12.5), (25.9±10.5) μg/m3(P<0.05)];the lymphocyte ratio and IgE levels were higher, but CD+4/ CD+8T was lower in cough variant asthma and typical asthma groups(P<0.05);the FEV1%Pred, FEV1/FVC and MMEF%Pred was (88.7±13.5)%, (80.2±7.8)% and (78.6±15.4)% in the cough variant asthma group, respectively, and (85.4±14.6)%, (76.3±7.6)% and (72.5±16.3)% in the typical asthma group, respectively, all significantly lower than those of the other groups(P<0.05),but were no statistical differences between the cough variant asthma and typical asthma groups (P>0.05).Conclusion PM2.5 is related to children with cough variant asthma, the decrease of the immune regulation and ventilation functions may be related to typical asthma.
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