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目的 探讨无症状气道高反应性发展为症状性哮喘的一些有关因素。方法 随访了1997年气道反应性普查的 4 1例无症状气道高反应性学生和对照组 31例正常气道反应性学生。结果可随访的无症状气道高反应性学生有 18% (7 38)出现哮喘 ,与对照组 (0 % ,0 30 )比较差异有显著性(P <0 .0 5 )。在可随访的 38例无症状气道高反应性学生中 ,有哮喘家族史发病率 (5 4 .5 % ,6 11)与无哮喘家族史发病率 (3% ,1 2 7)比较差异有显著性 (P <0 .0 1) ,发病者一秒钟用力呼气容积降低 2 0 %所需组胺累积量 =(1.4± 0 .72 ) μmol (HisPD2 0 FEV1=1.4± 0 .72 μmol) ,sIgEQ值 (2 8.1± 13.2 5 ) ,与无发病者HisPD2 0 FEV1(5 .6 3± 2 .5 8) μmol,sIgEQ值 (12 .1± 11.5 3)比较 ,差异有显著性 (P <0 .0 5 ,P <0 .0 5 )。发病者ECP值 (6 4 .5 2± 75 .11) μg L与无发病者ECP值 (40 .32± 5 9.93) μg L比较差异无显著性。结论 部分无症状气道高反应性者在一定时间内可发展为症状性哮喘 ,特别是有哮喘家族史 ,sIgEQ值较高 ,ECP阳性 ,HisPD2 0 FEV1≤ 1.96 μmol的无症状气道高反应性者 ,是发展为症状性哮喘的“高危人群” ,对他们进行预防性治疗有一定的临床价值
Objective To investigate some factors related to the development of asymptomatic airway hyperresponsiveness to symptomatic asthma. Methods A total of 41 asymptomatic airway hyperresponsiveness students and 31 normal airway responsive students were enrolled in the 1997 Airway Reactivity Inventory. Results Asymptomatic airway hyperresponsiveness follow-up showed asthma in 18% (7 38%) of patients with asymptomatic airway hyperresponsiveness compared with the control group (0%, 0 30) (P <0.05). Among the 38 patients with asymptomatic airway hyperresponsiveness, there was a significant difference in the incidence of family history of asthma (54.5%, 6/11) and non-family history of asthma (3%, 127) (P <0.01). The cumulative cumulative amount of histamine required to reduce 20% of forced expiratory volume in one second was (1.4 ± 0.72) μmol (HisPD2 0 FEV1 = 1.4 ± 0.72 μmol ), sIgEQ (2 8.1 ± 13.2 5), there was significant difference compared with non-morbid HisPD2 0 FEV1 (5.36 ± 2.58) μmol, sIgEQ (12.1 ± 11.5 3) <0 .0 5, P <0. 0 5). There was no significant difference in the ECP value (64.52 ± 75.11) μg L between the onset and the non-onset ECP (40.32 ± 59.93) μg L. Conclusions Some patients with asymptomatic airway hyperresponsiveness may develop symptomatic asthma within a certain period of time, especially with family history of asthma, high sIgEQ value, positive ECP, and asymptomatic airway hyperresponsiveness to HisPD20 FEV1≤1.96 μmol Who develop “high risk groups” of symptomatic asthma and have some clinical value in their prophylactic treatment