肺功能、皮肤点刺试验与嗜酸性粒细胞在小儿哮喘和咳嗽变异性哮喘中的相关性分析

摘要

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.%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。