摘要
目的探讨婴幼儿喘息的转归及影响预后的因素。方法将252例婴幼儿喘息患儿分为IgE+组与IgE-组,各组根据对治疗的依从性再分为依从组、非依从组和对照组[拒绝使用吸入糖皮质激素(ICS)],对比分析各组患儿的临床特点、药物疗效、转归及影响预后的因素。结果 (1)IgE+组在本人有湿疹史、家族有哮喘或过敏鼻炎史与IgE-组比较差异有统计学意义(P<0.05)。(2)治疗后追踪各组患儿喘息/咳嗽的发作频率、持续时间、全身使用激素等差异均有统计学意义(P<0.05)。(3)IgE+依从组ICS的时间[(18.3±3.8)个月]较IgE-依从组[(9.2±4.6)个月]长(P<0.05)。(4)至6岁时,IgE+组患儿65.7%可停药,各亚组间差异有统计学意义(P<0.05);IgE-组患儿95%以上可停药,各亚组间差异无统计学意义(P>0.05)。结论 IgE-和IgE+的喘息患儿早期ICS均能获益。IgE-患儿至学龄前期喘息基本停止发作,而IgE+患儿至学龄前期仍有1/3喘息反复发作,规范ICS能控制病情。早期检测IgE对婴幼儿喘息的治疗和预后判断有一定帮助。
Objective To investigate the outcome and influence factors of infant wheezing. Methods A total of 252 infant wheezing cases were divided into IgE^ ＋ group and IgE^- group, which were further divided into compliance sub-group, incompliance subgroup and control subgroup. The clinical characteristics, efficacy of ICS （inhaled corticosteroids） therapy, outcome and factors that influence the outcome were compared between the groups. Results Significantly morepatients with history of eczema and family members had asthma or anaphylactic rhinitis were observed in IgE^ ＋ group （ P 〈 0. 05 ）. There were significant differences in frequency and duration of wheezing/cough and the use of systematic cortico-steroid between the groups after ICS therapy （ P 〈 0. 05 ）. The length of ICS in IgE^ ＋ compliance subgroup was significantly longer than that of IgE^- compliance subgroup （P 〈 0. 05）. By the age of 6 years, 65.7% in IgE^ ＋ group and more than95% in IgEgroup withdrew ICS, with significant differences among IgE^ ＋ subgroups （P 〈 0. 05 ）, but no among IgE subgroups （ P 〉0. 05 ）. Conclusion Both IgE^ ＋ and IgE^- wheezing children benefit from ICS. By preschool age, wheezeremission generally presents in IgE group, while one third in IgE^ ＋ group still have relapsing wheeze. Regular ICS provides well control of clinical manifestations. Early IgE test helps both in therapy and outcome prediction.
出处
《广东医学》
CAS
CSCD
北大核心
2013年第4期534-537,共4页
Guangdong Medical Journal
