肥胖对哮喘预测指数阳性喘息婴幼儿治疗效果的影响

目的 探讨肥胖对哮喘预测指数（API）阳性喘息婴幼儿治疗效果的影响。方法 选取API 阳性的喘息婴幼儿208 例,按Kaup 指数分为肥胖组（93 例）和非肥胖组（115 例）。在急性喘息发作期给予综合治疗,缓解期给予吸入性糖皮质激素（ICS）布地奈德混悬液压缩泵雾化吸入治疗。根据临床控制情况调整ICS治疗用量,共治疗6 个月。治疗后2 周随访1 次,之后每月随访1 次。结果 治疗后2 周、1 个月肥胖组的临床症状缓解率分别为35.5% 及75.3%,低于非肥胖组的53.0% 和87.8%（P P 结论 肥胖可抑制API 阳性喘息婴幼儿对ICS 治疗的反应。     

Clara细胞分泌蛋白10在5岁以下喘息儿童外周血中的表达

目的：探讨外周血中Clara细胞分泌蛋白10（CC10）和血清总IgE浓度在5岁以下喘息儿童中的表达。方法：随机选取5岁以下反复喘息患儿59例,分为有特应质高危因素的喘息Ⅰ组（n=33）和无特应质高危因素的喘息Ⅱ组（n=26）,对照组为近期无感染疾病史的外科术前患儿(n=23)。采用固相夹心酶免疫吸附实验（ELISA）测定3组患儿外周血CC10与IgE水平。结果：喘息Ⅰ组、Ⅱ组CC10水平(3.95±1.26, 5.41±1.64 ng/mL)均低于对照组(8.72±2.23 ng/mL),差异有统计学意义(P<0.01);喘息Ⅰ组CC10水平低于喘息Ⅱ组(P＜0.05)。喘息Ⅰ组IgE水平高于喘息Ⅱ组和对照组,差异有统计学意义（P＜0.05）,喘息Ⅱ组和对照组之间差异无统计学意义（P＞0.05）。喘息Ⅰ组血清CC10与IgE呈负相关（r=-0.912, P＜0.01）。结论：外周血CC10水平在5岁以下患儿喘息发作期显著降低,有特应质高危因素的患儿降低更为明显,并与外周血IgE水平呈负相关。     

Prevalence and risk factors for wheezing and allergic diseases in preschool children: A perspective from the Mediterranean coast of Turkey

ObjectivesThe aim of the present study was to determine the prevalence and risk factors of allergic diseases in preschool children from one of the biggest cities in the Mediterranean Region of Turkey.MethodsThe study population included 396 preschool children attending to urban daycare centres in Mersin. In the first stage, a comprehensive standardised questionnaire modified from the International Study of Asthma and Allergies in Childhood (ISAAC) was employed. In the second stage, serum food and inhalant specific IgE, and skin tests were performed in 45 children with frequent wheezing and 28 children with no wheezing.ResultsThe prevalence of ever wheezing, current wheezing, physician-diagnosed asthma, allergic rhinitis and eczema were 53% (210), 33.3% (132), 27.3% (108), 13.4% (53) and 8.3% (33), respectively. A family history of atopy (OR = 2.5, 95% CI: 1.3–4.7, p = 0.004), dampness at home (OR = 2.4, 95% CI: 1.2–4.8, p = 0.008), a history of intestinal parasites (OR = 4.3, 95% CI: 1.7–10.9, p = 0.002), previous history of pneumonia (OR = 6.9, 95% CI: 1.9–25.9, p = 0.004), initiation of complementary foods before the age of three months (OR = 6.1, 95%CI: 1.4–26.9, p = 0.02) and presence of food allergy (OR = 3.1, 95% CI: 1.1–9.2, p = 0.03) were found to be significant risk factors for physician-diagnosed asthma. The risk factors for frequent wheezing were maternal smoking during pregnancy (OR = 5.2, 95% CI: 0.9–28.7, p = 0.05) and high serum IgE levels (OR = 2.9, 95% CI: 0.9–9.0, p = 0.05) at borderline significance.ConclusionOur study was the first epidemiological study in preschool children in the Mediterranean region of Turkey and demonstrated a high prevalence of asthma and allergic diseases, probably related to humid climatic properties in addition to other environmental and genetic factors.     

Side Effects of Leukotriene Receptor Antagonists in Asthmatic Children

Background:

Leukotriene receptor antagonists (LTRAs) are drugs which have been widely used more than ten years. As the use of LTRAs increases, our knowledge with respect to their side effects increases as well.

Objectives:

The objective of our study was to evaluat the observed side effects of LTRAs used in patients with astma.

Patients and Methods:

1024 patients treated only with LTRAs owing to asthma or early wheezing were included in the study for a five-year period. The observed side effects of LTRAs in these patients were retrospectively investigated. The side effects were divided into two parts as psychiatric and non-psychiatric.

Results:

Among the 1024 cases included in the study, 67.5% of the patients out of 41 with side effects were male, 32.5% were female and the average age was 6.5 years. The rate of patients with asthma was 63.41% and 36.58% of the patients had early wheezing. It was determined that sex, age and diagnosis (early wheezing or asthma) of the patients were ineffective in the emergence of side effects. The average period for the emergence of side effects was the first month. It was observed that hyperactivity was the most frequently observed psychiatric side effect and that abdominal pain was the non-psychiatric side effect.

Conclusions:

The side effects of LTRAs were common in children. Therefore, patients must be informed at the beginning of the treatment and they must be evaluated at certain intervals.     

A breath sound analysis in children with cough variant asthma

Background

Cough variant asthma (CVA) is characterized by a chronic cough and bronchial hyperresponsiveness without confirmation of wheezing. Using a breath sound analyzer, we evaluate the characteristics of breath sound in children with CVA.