临床儿科杂志 ›› 2018, Vol. 36 ›› Issue (10): 729-.doi: 10.3969/j.issn.1000-3606.2018.10.001

• 营养消化系统专栏 •    下一篇

肥胖对轻中度过敏和非过敏性哮喘儿童肺功能的影响

梁樊梅, 黄英, 张学莉, 徐晓雯, 王建, 彭佳瑜   

  1. 重庆医科大学附属儿童医院呼吸中心 儿童发育疾病研究省部共建教育部重点实验室 儿童发育重大 疾病国家国际科技基地 儿科学重庆市重点实验室(重庆 400014)
  • 收稿日期:2018-10-15 出版日期:2018-10-15 发布日期:2018-10-15
  • 通讯作者: 黄英  E-mail:huangying62@126.com
  • 基金资助:
    重庆医科大学附属儿童医院科研项目(No.lcyj2014-5)

Effects of obesity on lung function in mild-to-moderate allergic and nonallergic asthmatic children

LIANG Fanmei, HUANG Ying, ZHANG Xueli, XU Xiaowen, WANG Jian, PENG Jiayu   

  1. Department of Respiratory Medicine, Children's Hospital of Chongqing Medical University, Chongqing 400014, China
  • Received:2018-10-15 Online:2018-10-15 Published:2018-10-15

摘要:  目的 比较肥胖对轻中度过敏及非过敏性哮喘患儿基础肺功能、气道高反应性(AHR)的影响。方法 选择 230例初诊、非急性发作轻中度哮喘患儿,根据皮肤点刺试验(SPT)分为过敏组和非过敏组,再根据不同体质指数(BMI) Z 评分分为过敏体质量正常组、过敏超重组、过敏肥胖组、非过敏体质量正常组、非过敏超重组、非过敏肥胖组;检测各组患 儿的肺功能及支气管激发试验并进行比较。结果 各组轻中度哮喘患儿的呼气流速峰(PEF)、用力呼气75%流量(MEF75)、 MEF50、MEF25、最大呼气中段流量(MMEF)的差异有统计学意义(P<0.05),均以非过敏肥胖组最低,非过敏超重组次低。 过敏哮喘患儿各指标与BMI-Z评分不相关(P>0.05),非过敏哮喘患儿肺功能指标PEF、MEF75、MEF50、MEF25、MMEF与 BMI-Z 值呈负相关(r=-0.314~-0.273, P均<0.01)。 各组间不同等级AHR发生率的差异无统计学意义(P>0.05)。 支 气管激发试验后,各组患儿间PEF、MEF75、MEF25、MMEF下降率的差异有统计学意义(P<0.05),均以非过敏肥胖组的下 降率为最低。 结论 肥胖对非过敏哮喘儿童肺功能影响更大,且主要影响通气功能。

Abstract:  Objective To explore the effects of obesity on basic lung function and airway hyperresponsiveness (AHR) in children with mild-to-moderate allergic and non-allergic asthma. Methods According to the skin prick test (SPT), 230 children with mild-to-moderate asthma were divided into allergic group and non-allergic group. Furthermore, based on different body mass index (BMI) Z score, they were also divided into allergic normal body mass group, allergic overweight group, allergic obese group, nonallergic normal body mass group, nonallergic overweight group and nonallergic obese group. The lung function and bronchial provocation test of each group were detected and compared. Results There were significant differences in peak expiratory flow (PEF), maximal expiratory flows at the 75% of vital capacity (MEF75), MEF50, MEF25, and maximal midexpiratory flow (MMEF) among different groups of mild-to-moderate asthmatic children, and the levels of all above markers were the lowest in nonallergic obese group, followed by nonallergic overweight group (P<0.05). There was no correlation between the BMI-Z score and the indexes of allergic asthma (P>0.05). The pulmonary function indexes (PEF, MEF75, MEF50, MEF25 and MMEF) of nonallergic asthma children were negatively correlated with BMI-Z score (r=-0.314~-0.273, P all <0.01). There was no significant difference in the incidence rate of different grades of AHR among different groups (P>0.05). After bronchial provocation test, the rates of decrease in PEF, MEF75, MEF25 and MMEF were significantly different among the groups (P<0.05), and the lowest rate was found in the nonallergic obese group. Conclusion Obesity has a greater impact on lung function in nonallergic asthma children, and mainly affects ventilation function.