To determine the response of nebulized magnesium sulfate on the lung function of children with bronchial hyperresponsiveness.

目的 观察硫酸镁雾化是否能改善乙酰胆碱激发后的哮喘患儿肺功能,并与单用沙丁胺醇雾化及二者联合雾化进行比较.方法 收集2011年11月至2012年3月重庆医科大学附属儿童医院复诊的哮喘患儿84例,随机分为3组,均进行肺功能激发,然后用不同药物行支气管舒张试验.(1)硫酸镁组:雾化吸入等渗硫酸镁溶液(7.5％,含硫酸镁150 mg)2 mL; (2)沙丁胺醇组:雾化吸入沙丁胺醇溶液(含沙丁胺醇2.5 mg)2 mL; (3)硫酸镁+沙丁胺醇组:雾化吸入硫酸镁+沙丁胺醇混合溶液(含硫酸镁150 mg+沙丁胺醇2.5 mg)2.5 mL.观察各组药物雾化吸入后10、20 min肺功能改变情况.结果 各组雾化吸入不同舒张药物后肺功能均有显著上升,比较各组舒张后的肺功能值差异无统计学意义(P＞0.05),但沙丁胺醇组分别与硫酸镁组、硫酸镁+沙丁胺醇组舒张试验后10 min第1秒用力呼气量(FEV1)及最大呼气峰流量(PEF)上升的百分比差异有统计学意义(P＜0.05);各组内不同时间段比较,硫酸镁组与沙丁胺醇组舒张试验后的肺功能较激发后的肺功能差异有统计学意义(P＜ 0.05),但与硫酸镁+沙丁胺醇组差异无统计学意义(P＞0.05).结论 单用硫酸镁雾化吸入有支气管扩张作用,雾化吸入后10 min内对肺功能改善效果不如单用沙丁胺醇好,但总体两者无明显差别.硫酸镁+沙丁胺醇联合雾化吸入虽有支气管扩张效应,但不能明确说明二者联合是否具有协同效应.

Objective: To investigate whether the budesonide/formoterol (Symbicort) has a quick effect on lung function in children with bronchial asthma, and alleviates the symptoms of acute attack. Methods:Twenty participants were selected according to the standard diagnosis criteria of asthma, and in the course of an acute attack. Five, fifteen and thirty minutes after inhalation of Symbicort in 2 puffs, pulmonary function was tested and wheezing condition over lung and its improvement was observed. Results:Thirty minutes after the inhalation therapy, lung function was improved, bronchial dilation test was positive, and the wheezing sound over lung was reduced in all the cases. Among 20 children, 15 cases showed their improvement only in 5 minutes, with their lung fimction test improved and bronchial dilation test positive. The other 5 cases showed their improvements in 15 minutes. Conclusions:The budesonide/formoterol can be used as maintenance and reliever inhalation therapy in children with acute exacerbations of bronchial asthma.

Objective:To measure the efficacy of salmeterol/fluticasone in children with asthma with spirometer.Methods:FEV1.0 and PEF were measured in 365 asthmatic patients of 4～18 years old.According to the status of illness,all patients were divided into mild group,moderate group and severe group.Salmeterol/fluticasone accuhaler(50 μg salmeterol and 100 μg fluticasone propionate) was administrated as 1 inhalation,2 inhalation or 3 inhalation per day and lung function was measured two months and six months after the first measurement.Results:There was significant improvement in both two indexes with FEV1.0(χ2 were 106.07 and 140.67,P0.05) and PEF(χ2 were 92.74 and 131.15,P0.05).There were significant differences.Conclusions:Salmeterol/fluticasone accuhaler is a long-acting,anti-inflammatory and spasmolytic complex,which has a rapid efficacy and fewer undesirable effects.Patients are easy to accept it and it's suitable for treatment of children asthma.

AIM:To evaluate the safety of the methacholine in the bronchial provocation test for infants. METHODS:Three groups of patients were enrolled,including 49 asthmatoid patients,53 patients with chronic cough,and 10 normal infants.Methacholine(Mch)was taken for the bronchial provocation test(BPT)and the indexes of respiration,heart rate,wheezing together with adverse reactions were recorded simultaneously. RESULTS:The positive rate of BPT for the forementioned 3 groups were 94%,79%,and 0%,respectively. The occurrences of transient expiratory wheezing and cough were 57% vs 42% and 24% vs 19%,in the 1st and 2nd group respectively.For all of the groups,there appeared to have only 4 patients with respiration fre- quency＞60·min~(-1),5 patients of heart rate＞140·min~(-1),and 3 patients of SaO_2＜0.80,and furthermore with more cyanotic complexion,respiratory embarrassment and severe asthmatic attack.CONCLUSION:BPT with Meh in infants possesses good tolerance and safety,clinically;without any severe adverse reactions.

Objective To evaluate bronchial provocation test (BPT) in diagnosis and differential diagnosis of chronic cough in infants. Methods Fifty infants with chronic cough, 23 wheezed infants and 10 controls were included. BPT was performed and the indexes including SaO2, Rrs, %T-PF, %V-PF and lung symptoms were recorded. Results Thirty-nine out of 50 infants with chronic cough were positive (78%) in BPT, while 21 out of 23 wheezed infants positive (91.3%); the controls were all negative (100%). Significant difference in SaO2, Rrs, %T-PF, %V-PF was found in the infants positive in BPT before and after BPT. And in the infants who were negative, only SaO2 and Rrs were of significant difference before and after BPT. Conclusion BPT is of high clinic value in auxiliary diagnosis and differential diagnosis of chronic cough in infants. To judge the BPT result with comprehensive index is more stable and reliable.

Objective To evaluate the clinical efficiency, mechanisms, and safety of Siqikang injection (BCG-PSN) combined with fluticasone propionate (FP) in treatment of infantile asthma. Methods Thirty-five children with asthma (treatment group) were administered with BCG-PSN (3 months) combined with FP (1 year). The other 30 children with asthma (control) were administered orally with ketotifen only. During the follow-up period for more than 1.5 years, the severity of asthma, frequency of asthma attack, pulmonary function, and immunologic function were investigated and evaluated. Results Compared with those in the control group, the pulmonary functions of the treated infants, such as PEF and FEV1, recovered from abnormality (P0.01). Compared with those indices before treatment, alleviated severity of asthma, decreased incidence of asthma attack, serum IgE, sIL-2R, and ratio of CD4/CD8, but increased CD3 T cells were found in children with asthma. The total clinical effective rate reached 91.43% (32/35). Conclusion BCG-PSN combined with FP is one of the effective methods for the treatment and prevention of infantile asthma.

目的观察丙酸氟替卡松(FP)吸入治疗哮喘的疗效和安全性.方法对57例哮喘患儿按病情轻、中、重度,分别吸入FP 125、250、375 μg治疗,疗程12周.治疗期间记录哮喘日记,定期随访日、晚间症状评分、肺部哮鸣音及沙丁胺醇气雾剂的应用.治疗前后检测肺功能1 s用力呼气量(FEV1)和最大呼气量(PEF),并观察有无不良反应.结果 57例哮喘患儿临床评分减少,症状明显改善(P＜0.001);吸入β2受体激动剂次数明显减少,其中35例已终止应用(P＜0.05);肺功能FEV1和PEF有明显改善(P＜0.05);总有效率为95 %,且均无不良反应.结论不同程度儿童哮喘予不同剂量FP吸入治疗确有临床疗效,且耐受性高,依从性高,优于其他吸入糖皮质激素.

目的探讨丙酸氟替卡松防治婴幼儿哮喘的临床疗效和安全性.方法对50例婴幼儿哮喘采用局部吸入丙酸氟替卡松(9个月～1年)治疗,临床随访哮喘发作次数、程度、时间(＞1年)及防治前后肺功能、骨密度变化;未用丙酸氟替卡松防治的30例婴幼儿哮喘作为对照组.结果与对照组比较,防治组婴幼儿肺功能各指标恢复良好(P＜0.01);骨密度无明显降低(P＞0.01);临床防治总有效率92.00%(46/50例).结论丙酸氟替卡松防治婴幼儿哮喘疗效显著,可作为临床医师综合防治婴幼儿哮喘的理想方法之一.

Objective To evaluate the efficiency of low dose of Becotide combined with ketotifen in decreasing the incidence of asthma following bronchiolitis.Methods 56 children with bronchiolitis received Becotide and ketotifen daily while other 32 subjects were not intervented as control.The intervention duration was 6 to 9 months,then followed up for more than 1 year.Pulmonary function and bone density were tested pre-and post-treatment.Results After following up over 1 year,only 3 cases in 52 patients with bronchiolitis receiving Becotide and KIF developed into asthma.However,14 cases in control group (14/32) developed into asthma.The incidence of asthma was 5.77% and 46.67% in two group,respectively.Furthermore,the pulmonary function injury persisted in control group but recovered to near normal in treatment group.There was no difference revealed in bone density between two groups.Conclusion Becotide combined with ketotifen may be an effective intervention to prevent the development of asthma after bronchiolitis.

Objective: To observe the degree of effect on lung function in childhood asthmatics treated with fluticasone propionate inhalation and BCG-PSN injection. Methods: To test lung function indicators with MasterScope spirometer before and after administration. Results: There exists significsnt difference betreen PEF, FEF25, FEF50 and FEF75 except FVC and FEV1.0 before and after administration in 20 patients. Conclusion: Good result can be attained in symptoms and lung function in asthmatics treated with fluticasone propionate and BCG-PSN.

目的:了解溴化异丙托品(爱喘乐)对婴幼儿哮喘肺功能的影响.方法:应用2600型婴儿肺功能仪对婴幼儿哮喘进行溴化异丙托品(爱喘乐)雾化治疗前后肺功能检测指标变化.结果:在受检7项指标中V50、V25、%T-PF、%V-PF、ME/ML雾化前后有明显统计学差异(P＜0.05).结论:溴化异丙托品(爱喘乐)对婴幼儿哮喘急性发作期肺功能有明显改善,主要表现在反映中小气道指标的改善.该药副作用小,可以将其用于哮喘急性发作期的解痉治疗,以改善患儿通气功能.

目的观察慢性咳嗽小儿吸入支气管扩张剂沙丁胺醇(万托林)后对肺功能的影响程度,探讨支气管舒张试验在咳嗽变异性哮喘中的诊断价值.方法应用2600型婴幼儿肺功能仪对小儿慢性咳嗽患儿进行万托林吸入前后肺功能各项指标测定.结果在受检20例患儿中,经万托林雾化前、后其肺功能指标(潮气量、PF、V50、V25)有显著性差异(P<0.05).结论支气管舒张试验在小儿慢性咳嗽中具诊断价值,沙丁胺醇对缓解症状和改善肺功能可收到良好效果.

目的对比观察万托林和爱喘乐雾化吸入后对哮喘患儿肺功能的影响程度.方法应用2600型婴幼儿肺功能仪对婴幼儿哮喘进行两种支气管扩张剂吸入前后肺功能指标测定.结果在受检7项指标中,经万托林和爱喘乐雾化吸入前后其肺功能指标均有明显改善,两种药物雾化后肺功能指标除潮气量(TV)外,其余各项指标改善程度无显著性差异.结论爱喘乐和万托林均可用于哮喘发作期的解痉治疗,对缓解症状和改善肺功能均能收到良好效果.

毛细支气管炎(毛支炎)是婴幼儿时期常见的下呼吸道感染性疾病,以咳嗽、喘憋、呼吸困难为临床症状,远期部分患儿存在气道高反应性[1].支气管扩张剂治疗是否有效存在分歧,现对毛支炎的婴儿喘乐宁溶液雾化吸入前后肺功能测定,报道如下.

我们于2000年对我市0-14岁儿童哮喘流行病学资料进行调查分析,阐明流行特征,哮喘危险因素对今后制定防治策略具有重要意义,现将调查研究报道如下.

目的观察安可来对哮喘患儿肺功能的影响.方法对56例12～18 a的哮喘病人,随机分为用药组和对照组,两组均按哮喘常规给予激素和β2激动剂治疗,用药组加服安可来,在服药前检测肺功能一次,服药4周后的同一时辰复查肺功能一次.结果用药组判断肺通气功能受损程度的指标FEV10、MVV用药前后有显著差异(t分别为1.85和2.15 P＜0.05),代表各级气道受损情况的肺功能指标:最大呼吸流量(PF)、75%肺活量最大呼气流量(V75)、50%肺活量最大呼气流量(V50)、25%肺活量最大呼气流量(V25)等均有明显提高(t分别为2.148、2.12、2.01和2.15,P＜0.05),明显优于对照组.结论安可来辅助激素和β2激动剂治疗儿童哮喘,可更好的改善其气道阻塞情况.

Objective: To evaluate the clinical efficiency and the Safety of Beclomethasone(Becotide, BCD)and special immuno -densensitization (SID) in the therapy with early and long - term course for infantile asthma. Methods: 82 cases with infantile asthma were administered BCD and injected SID together. The total course was at least one year and the average time of following up was 2. 5 years. There was follow - up of degree of severity of asthma, frequency of asthma attack and pulmonary function. 76 infantile asthma without treatment were as control groups. Results: Compared with the control: The indication of the pulmonary function of infants: PEF and FEV1 recovered from abnormality, alleviation of degree of severity and decreased number of attack, The clinical effects was 91. 46%. Conclusion: BCD and SID is the one of the effective treatment on preventing infantile asthma with early and long - time course.

目的 观察安可来治疗儿童哮喘的疗效.方法 31例哮喘患儿均口服安可来,每次20mg,每日2次,共用4周,观察哮喘评分变化及β2激动剂使用次数,同时观察肺功能变化.结果 显效12例,有效16例,无效3例.结论 安可来治疗儿童哮喘效果满意.

目的检测婴幼儿哮喘喘乐宁雾化吸入治疗前后的肺功能.方法应用婴幼儿肺功能呼吸流速仪,对28例急性婴幼儿哮喘喘乐宁雾化治疗前后进行睡眠时的潮式呼吸流量(TBFV)环和潮式呼吸压力容量(TBPV)曲线测定.结果雾化前后的TBFV环图形的改变能明显反映哮喘患儿的气道阻塞程度及改善状况,各项指标也有不同程度的改变,有显著性差异的有:TBFV环中的TV(t=1.847,P＜0.05)、%T-PF(t=3.366,P＜0.01)、V25/PF(t=4.394,P＜0.01)以及TBPV曲线中的Rrs(t=3.140,P＜0.01).结论该检测可以了解哮喘婴幼儿气道阻塞情况及气道可逆性,指导临床诊治与疗效判断.