目的 研究毛细支气管炎患儿痰液中creola小体与患儿病情严重程度、住院时间、过敏史的关系,并随诊患儿,探讨痰液creola小体在预测哮喘发生中的价值。方法 选取2012年9月-2015年3月住院治疗的114例毛细支气管炎患儿。观察creola小体评分与病情严重程度、住院时间、随访发生哮喘或不能缓解喘息例数的关系。结果 在毛细支气管炎患儿中,creola小体评分分别与病情程度、住院时间、过敏史相关。且不同程度病性、住院时间和是否有过敏史间的creola小体的评分比较,差异有统计学意义(P<0.05)。creola小体评分对不能缓解性喘息有较强的诊断价值:随着creola评分的升高,不能缓解性喘息患儿的敏感性、特异性、阳性预测值也不断升高。其中在creola评分5分组中,将来发展为哮喘的患儿的敏感性为38.88%,特异性为96.77%,阳性预测值为77.77%。结论 在毛细支气管炎患儿中,creola小体的大小和病情严重程度、住院时间、过敏史相关,将来发展为不能缓解喘息或者哮喘的儿童有较强的预测价值。
Abstract
Objective To investigate the relationship of creola body in sputum with the disease severity,hospital stay and allergy history in chidren with bronchiolitis,and to discuss the early predictive value of creola bodies for asthma. Methods A total of 114 infants with first wheezing were enrolled in this study from September 2012 to March 2015.The relationship between creola bodies score and the following conditions was evaluated,such as the severity of patient's condition,length of hospital stay and the number of children who developed asthma or unremitting wheezing. Results Creola body score was correlated with the severity of disease,hospital stays and allergy history (all P<0.05).Also,creola body score had a strong predictive value for unremitting asthma.With the increase of creola body score,the sensitivity,specficity and positive predictive value also increased.The sensitivity,specificity and positive predictive value of creola boby score 5 were 38.88%,96.77%,and 77.77% respectively. Conclusions The creola body has strong correlation with disease severity,hospital stays and allergy history.Creola body also has a strong predictive value for unremitting wheezing and asthma.
关键词
哮喘 /
creola小体 /
毛细支气管炎 /
婴幼儿
Key words
asthma /
creola body /
bronchiolitis /
infants
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参考文献
[1] Ralston SL,Lieberthal AS,Meissner HC,et al.Clinical practice guideline:the diagnosis,management,and prevention of bronchiolitis[J].Pediatrics,2014,134(5):e1474-e1502.
[2] Miller EK,Avila PC,Khan YW,et a1.Wheezing exacerbations in early childhood:evaluation,treatment,and recent advances relevant to the genesis of asthma[J].J Allergy Clin Immunol Pract,2014,2(5):537-543.
[3] Elliott M,Heltshe SL,Stamey DC,et al.Exhaled nitric oxide predicts persistence of wheezing,exacerbations,and decline in lung function in wheezy infants and toddlers[J].Clin Exp Allergy,2013,43(12):1351-1361.
[4] Zhang Y,Zhou C,Liu J,et al.A new index to identify risk of multi-trigger wheezing in infants with first episode of wheezing[J].J Asthma.2014;51(10):1043-1048.
[5] 胡亚美,江载芳.实用儿科学[M].7版.北京:人民卫生出社,2015:1251-1252.
[6] Eggink H,Brand P,Reimink R,Bekhof J,et al.Clinical scores for dyspnoea severity in children:A prospective validation study[J].PLoS One.2016,11(7):e0157724.
[7] 沙莉,刘传合.2014年全球哮喘防治创议委员会儿童支气管哮喘最新修订指南解读[J].中国医刊,2015,50(7):16-19.
[8] Castro-Rodriguez JA,Sardón O,Pérez-Yarza EG,et al.Young infants with recurrent wheezing and positive asthma predictive index have higher levels of exhaled nitric oxide[J].J Asthma,2013,50(2):162-165.
[9] Turunen R,Vuorinen T,Bochkov Y,et al.Clinical and virus surveillance after the first wheezing episode:special reference to rhinovirus A and C species[J].Pediatr Infect Dis J,2017,36(6):539-544.
[10] Yamada Y,Yoshihara S.Creola bodies in infancy with respiratory syncytial virus bronchiolitis predict the development of asthma[J].Allergol Int,2010,59(4):375-380.
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