目的 分析腺样体肥大合并鼻炎患儿随访3年后的变应原谱变化特征.方法 纳入2017年7月～2017年10月就诊于首都儿科研究所附属儿童医院耳鼻咽喉头颈外科,诊断腺样体肥大伴鼻炎的患儿,观察随访至2021年3月.记录基线及随访时血清变应原特异性IgE(sIgE)结果,以及腺样体大小、改良Lund-Kennedy(MLK)鼻内镜评分结果.结果 共纳入36例诊断腺样体肥大合并鼻炎的患儿,9例(25％)为女性,27例(75％)为男性,平均年龄(7.8±2.5)岁,27例(75％)患儿合并变应性鼻炎.基线及随访3年后霉菌均为最主要的变应原,3年后合并尘螨过敏的患儿比例较入组时有下降趋势(37％vs 24％,P=0.28),蒿sIgE水平有上升趋势[4.2(1.7-23.2)vs 9.3(2.8-88.5)KU/L,P=0.35].分层分析发现在6岁以上患儿中屋尘螨sIgE水平较前明显下降[1.8(1.2-2.6)KU/L vs 0.1(0.0-0.7)KU/L,P<0.05].患儿经药物或手术治疗后,腺样体较前明显缩小,MLK鼻内镜评分较前显著下降(6.6±0.9 vs 4.3±1.6,P<0.05).结论 腺样体肥大合并鼻炎患儿中霉菌为最主要的变应原,3年后随访尘螨过敏比例呈下降趋势.药物或手术治疗后患儿腺样体大小及MLK评分均有显著下降.

目的 探讨阻塞性睡眠呼吸暂停低通气综合征(obstructive sleep apnea hypopnea syndrome,OSAHS)伴哮喘患儿睡眠监测的特点.方法 选取2010年1月至2012年10月首都儿科研究所附属儿童医院收治的96例OSAHS患儿,其中伴哮喘的OSAHS组和单纯OSAHS组各48例,对两组的睡眠监测结果进行回顾性分析.结果 OSAHS伴哮喘组在快速眼动睡眠期(rapid-eye movement,REM)的呼吸暂停低通气指数(apnea-hypopnea index,AHI)为(13.42±6.84)次/h,明显高于非哮喘组[(9.64±7.07)次/h],差异有统计学意义(P=0.010).两组的平均SpO2虽无明显变化,但伴哮喘的OSAHS组Sp02下降最大值[(13.96±4.36)％]明显高于单纯OSHAS组[(10.29±3.93)％],差异有统计学意义(P=0.000).REM期SpO2下降的最大值组间比较差异有统计学意义[(14.29±5.57)％比(10.63±4.47)％,P=0.000];在非快速眼动睡眠期(non-rapid-eye movement,NREM),两组的AHI、SpO2下降最大值组间比较,差异无统计学意义(P＞0.05).中重度OSAHS伴哮喘组比中重度单纯OSAHS组在REM期有更高的AHI[(19.70±8.10)次/h比(12.50±7.12)次/h,P=0.016],轻度OSHAS两组的REM期、NREM期的AHI的差异无统计学意义(P＞0.05).结论 伴哮喘的OSAHS患儿睡眠事件多发生在REM期,REM期有更高的AHI以及更显著的SpO2下降,使得伴哮喘的OSAHS患儿微觉醒和睡眠片段化增加,REM期睡眠减少,对患儿生长发育有更大危害,应主张积极手术.

目的 探讨鼻部疾病的干预对儿童急性喉炎预后的影响.方法 回顾性分析2016-01-01至2016-12-31在首都儿科研究所附属儿童医院耳鼻喉科门诊就诊的546例急性喉炎患儿的临床资料,并记录这些患儿伴发鼻部疾病的情况;对其中急性喉炎反复发作并伴发鼻部疾病的患儿同时进行鼻部疾病的积极干预并随访1年,分析干预前后患儿急性喉炎的发病情况.结果 本组中有183例(33.52％)患儿伴有鼻部疾病;急性喉炎反复发作的有31例,其中伴发鼻部疾病的患儿有21例(67.74％),显著高于非急性喉炎反复发作群体(P＜0.001).对21例急性喉炎反复发作患儿伴发的鼻部疾病进行鼻部症状干预后,急性喉炎反复发作的次数较前明显减少[由(4.4±1.4)次/年降至(1.6±0.9)次/年,P＜0.05],症状持续时间明显缩短[由(5.5±1.1)d降至(4.3±1.4)d,P＜0.05].结论 急性喉炎反复发作患儿中伴发鼻部疾病的比例较高,积极治疗鼻部疾病可减少急性喉炎发作次数,缩短症状持续时间.

Objectives: The aim of the study was to investigate upper airway cough syndrome (UACS) in children and to determine alternative methods to explore the relationships among TRPV1, TGF-beta 2, and UACS.Methods: In 2012, 104 children with adenoid hypertrophy aged 2-13 years who were admitted to the otolaryngology department, Capital Institute of Pediatrics-affiliated children's hospital, were included in this study. Enzyme-linked immunosorbent assay (ELISA) and immunohistochemical (IHC) studies for TRPV1 and TGF-beta 2 were performed to understand the relationship between the two inflammatory factors, and the correlations among the indices and UACS. The research was divided into three stages. In stage 1,72 children (24 UACS and 48 controls) were enrolled in the study, and ELISAs for TRPV1 and TGF-beta 2 were performed. In stage 2, 32 children (16 UACS and 16 controls) were enrolled in the study and both ELISA and IHC for TRPV1 and TGF-beta 2 were performed. In stage 3,41 children were enrolled in this research who had thick mucus secretions in the posterior nasal apertures in stage 1 and 2 (23 cases with chief complaint (or history) of chronic cough and 18 cases without). The difference between the TRPV1 and TGF-beta 2 serum values and the clinical factors was determined.Results: The levels of TRPV1 and TGF-beta 2 were significantly increased in the UACS cases. OSAHS and thick mucus secretions correlated with a diagnosis of UACS. A history of asthma and thick mucus secretions correlated with elevation of the two inflammatory factors. There was no statistical correlation between ELISA and IHC testing. Among the children with thick mucus secretions, some had a higher possibility of chronic coughing including those who had higher levels of the two indices, larger tonsils and a history of chronic tonsillitis.Conclusion: The detections of TRPV1 and TGF-beta 2 from serum and adenoid body specimens are valuable for UACS auxiliary diagnosis. Tonsil hypertrophy and chronic tonsillitis history are independent risk factors of UACS. (C) 2013 Elsevier Ireland Ltd. All rights reserved.

Objective To observe the treatment effect of Biyan Qing oral liquid on children with acute nasosinusitis. Methods Sixty cases of children with acute nasosinusitis were randomly divided into treatment group and control group(30 cases in each group).Children in both groups were treated with antibiotics and fluticasone propionate nasal spray.Additionally,children in the treatment group was given Biyan Qing oral liquid therapy.Then,the treatment efficacy was evaluated.Results After 14 days treatment,the efficiency of nasal congestion,purulent nasal discharge flow of individual symptom in the treatment group was significantly higher than that of the control group( P0.05);The total effective rate was 73.3% in treatment group,which was higher than 63.3% of the control group,but the difference was not significant(P0.05).After 14 days treatment,the individual point and total score was significantly lower than that before treatment(P0.05),and the treatment group improved more significantly compared with that of the control group( P0.05). There was no adverse reactions found in the two groups.Conclution Biyan Qing oral liquid combined with conventional therapy for nasosinusitis in children is effective and safety,especially to children with symptoms of rhinobyon and pus nasal discharge.This therapy might be worth to widely applied in clinic.