【作者】 刘燕；

【导师】 林荣军；

【作者基本信息】 青岛大学 ， 儿科学， 2017， 硕士

【摘要】 目的:通过检测毛细支气管炎患儿过敏原特异性免疫球蛋白E(Specific immunoglobulin E,s Ig E)、血清总Ig E、外周血嗜酸性粒细胞(Eosinophils,EOS)计数、呼出气一氧化氮(Fraction exhaled nitric oxide,Fe NO)及日后反复喘息和哮喘的发生率,探讨Fe NO测定在毛细支气管炎患儿远期转归中的临床意义。方法:将符合毛细支气管炎入选标准的患儿,根据有无特应性体质分为特应性体质组和非特应性体质组。分别检测并记录两组患儿在急性期、治疗后1个月、3个月Fe NO、外周血EOS、血清总Ig E及随访6个月、12个月反复喘息和哮喘的发生率。结果:(1)无论是急性期、治疗后1个月及3个月的Fe NO、血清总Ig E及EOS特应性体质组均较非特应性体质组高,差异有统计学意义(P<0.05)。(2)特应性体质组Fe NO、Ig E及EOS在治疗后1个月及3个月后与急性期相比,逐渐下降,差异有统计学意义(P<0.05)。(3)非特应性体质组患儿的Fe NO、Ig E及EOS在治疗1月及3个月后与急性期相比,逐渐下降,差异有统计学意义(P<0.05)。(4)在6个月、12个月的随访中,特应性体质组患儿在喘息次数及哮喘发生率均高于非特应性体质组,差异有统计学意义(P<0.05)。(5)特应性体质组急性期Fe NO与6个月及12个月随访喘息次数成显著正相关(P<0.01)。结论:(1)特应性体质组的毛细支气管炎患儿急性期、治疗后1个月及3个月的Fe NO、血清总Ig E及EOS均较非特应性体质组高,并且特应性体质组后期反复喘息的次数和发展为哮喘的可能性高于非特应性体质组,以上提示特应性体质是毛细支气管炎患儿日后反复喘息及发展为哮喘的高危因素。(2)Fe NO并不是在所有的毛细支气管炎患儿中都升高,特应性体质的毛细支气管炎患儿Fe NO与后期随访反复喘息次数成正相关,提示Fe NO可能成为预测毛细支气管炎患儿日后反复喘息和发展为哮喘的指标。更多还原

【Abstract】 Objective Observe specific immunoglobulin E(s Ig E),serum Ig E,peripheral blood eosinophilia(EOS),fraction exhaled nitric oxide(Fe NO)and the incidence of wheeze and asthma in the future to investigate the clinical significance of Fe NO in longterm outcomes of infants with bronchiolitis.Methods According to the inclusion criteria,we selected 100 Children of bronchiolitis from December 2015 to February 2016 in our hospital,divided the bronchiolitis patients into atopic and non-atopic groups,each group has 50 cases.Both groups were given Fe NO,serum Ig E,peripheral blood EOS detected and analyzed in the acute phase,1 month and 3 months after treatment.We both compared the incidence of wheeze and asthma of two groups.Results(1)The Fe NO,serum Ig E and EOS of atopic group were higher than those in non-atopic group(P <0.05),whether in the acute stage or 1 month and 3 months after treatment.(2)The Fe NO,as well as the Ig E and EOS of the atopy group in 1 month and 3 months were significantly lower than that in the acute stage(all P<0.05).(3)The Fe NO,as well as the Ig E and EOS of the non-atopic group after treatment in 1 month and 3 months decreased gradually compared with the acute phase.The differences were statistically significant(all P<0.05).(4)During the follow-up period of 6 and 12 months,the frequency of wheezing episode and asthma of the atopic group were higher than those of non-physical group,and the differences were statistically significant(P < 0.05).(5)There was a significantly positive correlationship between the Fe NO of the atopic group and the number of wheezing episode in the follow-up period of 6 and 12 months.Conclusion(1)The Fe NO,serum Ig E and EOS of atopic group were higher than those in non-atopic group in the acute stage,1 month and 3 months after treatment.The incidence of wheeze and asthma in atopic group were higher than those of non-physical group.It may suggest that the atopic constitution is a high risk factor for the development of bronchiolitis to asthma.(2)The incidence of wheeze and asthma of the atopic group were higher than the non-atopic group,which were correlated to Fe NO.It may suggest that higher level of Fe NO could be predicte recurrent wheezing and development to asthma of the bronchiolitis children.更多还原