支气管激发试验在儿童哮喘诊断和治疗中的应用

目的探讨支气管激发试验在儿童哮喘诊断和治疗中的价值及安全性。方法采用组胺支气管激发试验对103例疑诊为哮喘或哮喘缓解期患儿进行气道反应性的测定,阳性者计算其FEV1下降20%预计值时的累积吸入组胺量(PD20FEV1),并以此判定其气道高反应性(BHR)的程度。结果观察组支气管激发试验阳性62例(60.2%),其中极轻度BHR10例(16.2%),轻度34例(54.8%),中度18例(29.0%),重度0例(0%)。在试验过程中,有1例患儿出现气喘、咳嗽,2例患儿出现胸闷,4例出现刺激性咳嗽,对症处理后迅速消失。对照组30例中有2例为支气管激发试验阳性(阳性率6.7%),均为极轻度BHR,无一例出现气喘、咳嗽、胸闷、声嘶等症状。结论支气管激发试验提高了临床医生对儿童哮喘的诊断水平,并且对病情评估以及疗效的判断均具有重要价值。

Application of the bronchial provocation test on diagnosis and treatment in the children with asthma

Objective To investigate the value and the security of bronchial provocation test in diagnosis and treatment of the children with asthma.Methods The airway response of 103 children who were suspected asthma or asthma with remission were measured by histamine bronchial provocation test. To determine the degree of the bronchial high response(BHR), we calculated the PD_ 20 FEV_1 as the bronchial provocation test was positive.Results There were 62 cases(60.2%) whose bronchial provocation test were positive in the observe group.There were 10 children whose BHR were very mild (16.1%),34 children were mild (54.8%),18 children were moderate (29.0%) and nobody were severe.Conclusion Histamine bronchial provocation test can help physician to improve the diagnosis of children with asthma,and it was a very important index to judge the patient's condition and the curative effect.