摘要
目的:探讨高渗盐水支气管激发试验联合诱导痰检查对儿童慢性咳嗽的病因诊断价值及不典型哮喘的诊断和治疗意义。方法:按照慢性咳嗽的诊断与治疗指南对96例慢性咳嗽患儿行高渗盐水支气管激发试验同时诱导痰检查。结果:96例慢性咳嗽患儿咳嗽变异性哮喘41例(41/96,43%),感染后咳嗽34例(34/96,35%),上气道咳嗽综合征12例(12/96,13%),心理性、精神性咳嗽9例(9/96,9%),高渗盐水激发试验阳性39例(41%),高渗盐水激发过程出现哮鸣音32例(33%)。高渗盐水激发试验同时进行诱导痰,标本合格者50例,痰嗜酸性粒细胞(EOS)增高32例占64%(32/50),平均(34.4±25.8)%。其中咳嗽变异性哮喘(CVA)患儿EOS平均(40.37±30.38)%,感染后咳嗽(PIC)患儿EOS平均(14.6±13.94)%,两组比较差异有显著性意义(t=3.136,P=0.004)。所有患者诱导痰过程中无明显不良反应发生。结论:高渗盐水激发试验反映气道高反应性特异性高,联合诱导痰检查可提高儿童咳嗽的病因学诊断,对儿童哮喘的诊断与鉴别诊断及治疗、预后均有重要的临床意义,高渗盐水支气管激发试验同时进行痰诱导检测可行性好、不良反应发生率低。
Objective：To discussion of bronchial provocation test with hypertonic saline combined with induced sputum examination of the causes of chronic cough in children and its value in diagnosis of atypical asthma diagnosis and treatment significance.Methods：According to the diagnosis and treatment of chronic cough in 96 cases of chronic cough in children with guide line of bronchial provocation test with hypertonic saline and induced sputum examination.Results：96 cases of chronic cough in patients with cough variant asthma 41 cases（41/96,43%）,34 cases of cough after infection（34/96,35%）,12 cases of upper airway cough syndrome（12/96,13%）,9 cases of psychological,spiritual cough（9/96,9%）,hypertonic saline provocation test positive in 39 cases（41%）,hypertonic saline process wheezing in 32 cases（33%）.Hypertonic saline test simultaneously induced sputum,a qualified specimen in 50 cases,sputum eosinophil（EOS） increased in 32 cases accounted for 64%（32/50）,an average of（34.4±25.8）%.The cough variability asthma（CVA） in patients with a mean of（40.37±30.38）%,cough after infection（PIC） in patients with a mean of（14.6±13.94）% EOS,there was significant difference between two groups（t=3.136,P=0.004）.All patients had sputum induction process has no obvious adverse reaction.Conclusion：Hypertonic saline provocation tests reflect the specific high airway hyperresponsiveness,induced sputum examination can improve children＇s cough etiology diagnosis,on children asthma diagnosis and differential diagnosis and treatment,the prognosis of clinical significance.Hypertonic saline induced sputum from bronchial provocation tests carried out feasibility testing,low incidence of adverse reactions.
出处
《医学理论与实践》
2012年第21期2611-2612,2615,共3页
The Journal of Medical Theory and Practice
关键词
慢性咳嗽
高渗盐水激发试验
诱导痰
Chronic cough
Hypertonic saline provocation test
Induced sputum
