Clinical observation on the changes of pulmonary ventilation function and height in children with uncontrolled asthma

doi:10.11852/zgetbjzz2018-1301

Abstract

Abstract: Objective To observe the changes of pulmonary ventilation function, fractional exhaled nitric oxide (FeNO) and height in children with uncontrolled group and well-controllled group of moderate asthma. Methods Children with moderate asthma from January 2017 to June 2018 were collected, and were divided into uncontrolled asthma group (50 cases with intermittent use of ICS combined with Menglusite) and well-controlled group (50 cases with regular use of ICS combined with Menglusite). Meantime, 50 cases with non-asthmatic children were selected into the control group. After 6 months and 12 months of treatment, the uncontrolled group and the well-controlled group performed FEV1, PEF, and FeNO tests, and the height of three groups of children was measured. Results After 6 months and 12 months of treatment, FEV1 and PEF were significantly lower in uncontrolled group than those in well-controlled group (P<0.05). And FeNO in uncontrolled group did not decrease significantly and was higher than that in well-controlled group (P<0.05).After 12 months of treatment, the height of children in well-controlled group was not significantly different compared with that of the control group (P>0.05), while the height of children in the uncontrolled group was significantly lower than that of the control group (P<0.05). Conclusion Irregular use of drugs leads to poor asthma control, resulting in hyperractivity of airway and ventilation dysfunction, and is also an important factor affecting the height of children.

Key words: asthma, height, pulmonary ventilation function, fractional exhaled nitric oxide

摘要： 目的观察中度哮喘未控制与良好控制患儿肺通气功能、呼气一氧化氮及身高的变化,为临床指导规范用药提供依据。方法收集2017年1月-2018年6月期间符合中度哮喘儿童,分为2组,未控制组(50例,间断使用ICS联合孟鲁司特治疗),良好控制组(50例,规律使用ICS联合孟鲁司特治疗),同时选取50例非哮喘健康儿童作为对照组。在治疗6个月和12个月后,未控制组与良好控制组进行FEV1、PEF和FeNO检测,同时对三组患儿进行身高检测。结果治疗6个月和12个月后,未控制组FEV1、PEF缓解程度明显低于良好控制组(P<0.05),而且未控制组FeNO下降不明显,且高于良好控制组(P<0.05)。治疗12个月后,良好控制组患儿身高与对照组儿童身高差异无统计学意义(P>0.05),然而未控制组患儿身高明显落后于对照组儿童身高(P<0.05)。结论不规律用药导致哮喘控制不良,引起气道高反应性及通气功能障碍,同时也是影响儿童身高的重要因素。

关键词: 哮喘, 身高, 肺通气功能, 呼出气一氧化氮

CLC Number:

R722

WU Hua-jie, SHI Zhao-ling, LI Jing-xian, WU Shi-yu, LI Cong-cong, SUN Xin. Clinical observation on the changes of pulmonary ventilation function and height in children with uncontrolled asthma[J]. journal1, 2018, 26(12): 1380-1383.

吴华杰, 石曌玲, 李静娴, 吴世瑜, 李聪聪, 孙新. 支气管哮喘未控制患儿身高及肺通气功能变化临床观察研究[J]. 中国儿童保健杂志, 2018, 26(12): 1380-1383.

References

[1] 中华医学会儿科学分会呼吸学组,《中华儿科杂志》编辑委员会.儿童支气管哮喘诊断与防治指南(2016年版)[J].中华儿科杂志,2016,54(3):167-181.
[2] 全国儿科哮喘防治协作组.中国城区儿童哮喘患病率调查[J].中华儿科杂志,2003,41(2):123-127.
[3] 全国儿科哮喘协作组,第三次全国城市儿童哮喘流行病学调查[J]. 中华儿科杂志,2013,51(10):729-735.
[4] Wong GW, Kwon N, Hong JG et al.Pediatric asthma control in Asia: phase 2 of the Asthma Insights and Reality in Asia-Pacific (AIRIAP 2) survey [J]. Allergy,2013,68(4):524-530.
[5] 中国哮喘儿童家长知信行调查项目组.中国大陆29个城市哮喘患儿病情控制状况及影响因素[J].中华儿科杂志,2013,51(2):90-95.
[6] 张皓, 邬宇芬, 黄剑峰,等.儿童肺功能检测及评估专家共识[J]. 临床儿科杂志,2014,32(2):104-114
[7] Pruteanu AI,Chauhan BF,Zhang L,et al.Inhaled corticosteroids in children with persistent asthma:is there a dose response impact on growth? An overview of Cochrane reviews [J]. Paediatr Respir Rev,2015,16(1):51-52.
[8] Allen DB.Inhaled corticosteroids and growth:still an issue after all these years[J].J Pediatr,2015,166(2):463-469.
[9] Zhang L, Prietsch SOM, Ducharme FM. Inhaled corticosteroids in children with persistent asthma: effects on growth[J]. Evid Based Child Health,2014, 9(4):829-930.
[10] Giannini C, Mohn A,Chiarelli F.Growth abnormalities in children with type 1 diabetes, juvenile chronic arthritis, and asthma[J].Int J Endocrinol, 2014,2014(1):140-158.
[11] 吴华杰, 丁翠玲, 石曌玲,等. 低剂量吸入性糖皮质激素对轻中度哮喘儿童身高的影响[J]. 发育医学电子杂志, 2017,5(4):224-228.
[12] Global Initiative for Asthma. Global strategy for asthma management and prevention[EB/OL].[2017-12-20]. http://www.ginasthma.org.
[13] 贾宵宵,张维溪.哮喘患儿长期吸入糖皮质激素对身高的影响[J].国际儿科学杂志,2016,43 (12 ):931-934.
[14] 李淑群.长期吸入糖皮质激素对婴幼儿哮喘患儿血Ca²⁺ 、P³⁺ 、胰岛素样生长因子的影响[J].检验医学与临床杂志,2016,13(16):2309-2310.
[15] Tan DJ,Walters EH,Perret JL,et al.Clinical and functional differences between early-onset and late-onset adult asthma: a population-based Tasmanian Longitudinal Health Study[J].Thorax.2016,71(11):981-987
[16] Rao DR,Phipatanakul W.An overview of fractional exhaled nitric oxide and children with asthma[J].Expert Rev Clin Immu,2016,12(5):521-530.
[17] Sadeghi MH, Wright CE, Hart S, et al. Does FeNO predict clinical characteristics in chronic cough?[J]. Lung, 2018, 196(1):59-64.