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目的对比分析肥胖对哮喘规范化药物治疗过程中肺功能变化的影响,以指导临床治疗哮喘。方法纳入2013年11月-2014年11月该院收治的68例哮喘患儿,均接受规范化药物治疗,按体质量指数(BMI)划分为肥胖组31例及非肥胖组37例,对比2组治疗前、治疗1年后肺功能指标及哮喘控制测试(ACT)量表得分。结果 1治疗前肥胖组FVC明显高于非肥胖组,差异有统计学意义(P<0.05);非肥胖组治疗1年后1 s用力呼气容积(FEV1)、用力肺活量(FVC)明显提升,差异均有统计学意义(P<0.05);肥胖组治疗后仅FVC明显升高,差异有统计学意义(P<0.05);治疗后非肥胖组FEV1明显高于肥胖组,差异有统计学意义(P<0.05)。22组治疗后用力呼气25%流量(MEF25)、用力呼气50%流量(MEF50)均无明显变化。3治疗后非肥胖组ACT评分明显高于肥胖组,差异有统计学意义(P<0.05)。结论哮喘不伴有肥胖患儿接受规范化药物治疗后,大气道通气功能可得到明显改善,但小气道通气功能基本无变化;肥胖可进一步抑制规范化药物治疗对患儿大气道通气功能的改善;改善肥胖症状有助于提升患儿疗效。
Objective To compare and analyze the effect of obesity on the changes of pulmonary function in the course of standardized asthma medication to guide the clinical treatment of asthma. Methods Sixty-eight children with asthma admitted to our hospital from November 2013 to November 2014 were enrolled in this study. All patients underwent standardized medical therapy. According to body mass index (BMI), 31 children with obesity and 37 non-obese children were enrolled in this study. Before treatment, 1 year after treatment of lung function indicators and asthma control test (ACT) scale score. Results 1 The FVC of obesity group before treatment was significantly higher than that of non-obesity group (P <0.05). The FEV1 and FVC of non-obese group were significantly increased after 1 year of treatment, (P <0.05). Only FVC in obese group was significantly increased after treatment (P <0.05), FEV1 in non-obese group was significantly higher than that in obese group after treatment, the difference was statistically significant (P <0.05). Twenty-two groups forced exhaled 25% of the flow (MEF25), forced expiratory 50% of the flow (MEF50) showed no significant change. 3 After treatment, ACT scores of non-obese group were significantly higher than those of obese group, the difference was statistically significant (P <0.05). CONCLUSIONS: The ventilatory function of airway can be significantly improved in children with asthma without obesity, but the function of small airway ventilation is basically unchanged. Obese can further inhibit the improvement of airway function in children with obesity by standard medical treatment. Obesity symptoms help to improve the efficacy of children.