结核与肺部疾病杂志 ›› 2025, Vol. 6 ›› Issue (6): 659-665.doi: 10.19983/j.issn.2096-8493.20250116

• 论著 • 上一篇    下一篇

诊断延迟对儿童支气管哮喘确诊时肺功能及相关指标的影响

魏小玲1,2,3,4, 薛敏2,3,4, 刘艳芹2, 刘苗2, 张赟2, 程璐2, 马香2,3,4()   

  1. 1山东大学附属儿童医院(济南市儿童医院)健康医疗大数据应用管理科,济南 250022
    2山东大学附属儿童医院(济南市儿童医院)呼吸科,济南 250022
    3济南市儿童呼吸病重点实验室,山东大学附属儿童医院(济南市儿童医院),济南 250022
    4山东省儿童健康与疾病研究中心,济南市儿童医院,济南 250022
  • 收稿日期:2025-07-30 出版日期:2025-12-20 发布日期:2025-12-08
  • 通信作者: 马香,Email:maxiang0176@163.com
  • 基金资助:
    济南市卫生健康委员会大数据科技计划项目(2023-YBD-1-06)

Effect of diagnosis delay on pulmonary function and related indicators in children with bronchial asthma

Wei Xiaoling1,2,3,4, Xue Min2,3,4, Liu Yanqin2, Liu Miao2, Zhang Yun2, Cheng Lu2, Ma Xiang2,3,4()   

  1. 1Department of Health Data Application and Management,Children’s Hospital Affiliated to Shandong University (Jinan Children’s Hospital), Ji’nan 250022,China
    2Department of Respiratory, Children’s Hospital Affiliated to Shandong University (Jinan Children’s Hospital), Ji’nan 250022,China
    3Key Laboratory of Respiratory Disease for Children,Children’s Hospital Affiliated to Shandong University (Jinan Children’s Hospital), Ji’nan 250022,China
    4Shandong Provincial Clinical Research Center for Children’s Health and Disease, Children’s Hospital Affiliated to Shandong University (Jinan Children’s Hospital), Ji’nan 250022,China
  • Received:2025-07-30 Online:2025-12-20 Published:2025-12-08
  • Contact: Ma Xiang, Email:maxiang0176@163.com
  • Supported by:
    Big Data Technology Plan Project of Jinan Municipal Health Commission(2023-YBD-1-06)

摘要:

目的: 探讨支气管哮喘(简称“哮喘”)患儿首次喘息至诊断时间对肺功能、呼出气一氧化氮(fractional exhaled nitric oxide, FeNO)、嗜酸性细胞(eosinophils, EOS)、免疫球蛋白E (immunoglobulin E, IgE)的影响。方法: 分析2012年1月至2022年12月山东大学附属儿童医院随访治疗哮喘患儿的临床资料,按照患儿首次喘息至诊断时间0年(发作当次诊断)、(0~1]年、(1~2]年、(2~4]年、>4年分为5组,比较各组首次确诊哮喘时的呼吸功能测试(特指肺功能测试)指标、FeNO、EOS、IgE的差异。通过多元线性回归分析发病年龄、性别、首次喘息至诊断时间、鼻炎、湿疹对肺功能指标、FeNO、EOS、IgE的影响。结果: 单纯哮喘组首次喘息至诊断中位时间为22.98(4.28,42.88)个月,哮喘并发鼻炎组首次喘息至诊断的中位时间为12.25 (4.03,34.49)个月,两组差异无统计学意义(Z=-0.18,P=0.860);女性患儿组首次喘息至诊断时间短于男性患儿组(Z=-2.61,P=0.009),发病≤3岁组首次喘息至诊断时间长于起病年龄>3岁组,差异有统计学意义(Z=-17.07,P=0.000)。结论: 首次喘息至哮喘诊断时间越长,肺功能损害越严重且对FeNO、EOS、IgE均有影响,掌握哮喘诊断标准、及时诊断、积极规范治疗哮喘,对促进患儿的身心健康、减少哮喘伤残具有重大意义。

关键词: 哮喘, 呼吸功能测试, 呼出气一氧化氮, 嗜酸性细胞, 免疫球蛋白E, 儿童

Abstract:

Objective: To investigate the effect of diagnosis delay (from first onset to diagnosis) on respiratory function, fractional exhaled nitric oxide (FeNO), eosinophils (EOS), immunoglobulin E (IgE) in children with bronchial asthma. Methods: We analyzed data of asthma children treated in Children’s Hospital Affiliated to Shandong University from January 1, 2012, to December 31, 2022. All of the children were divided into 5 groups according to their diagnosis delay: immediate diagnosis, delayed for (0-1] year, (1-2] years, (2-4] years, and >4 years. The differences of lung function, FeNO, EOS, IgE at patients’ first diagnosis of asthma in different groups were compared. Multiple linear regression analysis was done to investigate the effects of various factors on lung function, FeNO, EOS, and IgE. Results: The median (quartile) diagnosis delay was 22.98(4.28,42.88) months in asthmatic children without rhinitis and 12.25 (4.03,34.49) months in children with asthma and rhinitis (Z=-0.18,P=0.860). The diagnosis delay was shorter among female than male (Z=-2.61,P=0.009). The children whose first asthma onset age was ≤3 years had a longer diagnosis delay than those whose first onset age was >3 years (Z=-17.07,P=0.000). Conclusion: The longer the diagnosis delay, the more severe the damage to lung function and FeNO, EOS, IgE. Therefore, diagnosing asthma according to its diagnostic criteria and providing standardized treatment in time, will contribute greatly to advancing physical and mental health of children with asthma and reducing damage and disability brought by asthma.

Key words: Asthma, Respiratory function tests (pulmonary function tests), Fractional exhaled nitric oxide, Eosinophils, Immunoglobulin E, Children

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