哮喘联盟

   摘要
   目的：以往我们曾经研究过气道高反应性（AHR）与特应质之间的关联性，但目前仍有若干问题亟待解决。本研究旨在评估气道对甘露醇的高反应性与哮喘患儿特应质之间的关联。
   方法：我们总共纳入了44例哮喘患儿，年龄为6岁～16岁。对其进行皮肤点刺试验（SPTs），检测其血清中总IgE及特异性IgE的水平，同时实施甘露醇激发试验（MCT）。
   结果：气道对对甘露醇的高反应性与血清中尘螨特异性IgE水平之间存在较好的相关性（r= -0.66, p<0.001），但是其与血清中狗毛皮屑特异性IgE水平（r= -0.33, p=0.01）以及烟曲霉菌特异性IgE水平（r= -0.23, p=0.02）之间的关联性较弱。此外，我们发现气道对对甘露醇的高反应性与血清总IgE水平（r= -0.30; p=0.03）、气源性过敏原特异性IgE水平（r= -0.37, p= 0.01）以及阳性皮肤点刺试验数量（r= -0.31, p=0.02）之间也存在较弱的关联性。
   结论：用甘露醇激发试验检测气道高反应性可能为哮喘患儿特应质程度的准确评估提供较好的手段。特应质程度较高的患者对甘露醇的反应性也明显增强。在临床实践中，对于特应质程度较高的哮喘患儿，可能需要采取强化治疗方案以减弱其气道高反应性。本文章受版权保护，并保留所有解释权。
 

（杨冬 审校）
Acta Paediatr. 2015 Feb 5. doi: 10.1111/apa.12968. [Epub ahead of print]


 

Airway hyperresponsiveness to mannitol provides a good evaluation of atopy in childhood asthma.
 

Attanasi M1, Rapino D, Marcovecchio ML, Consilvio NP, Scaparrotta A, Cingolani A, Di Pillo S, Chiarelli F.
 

ABSTRACT
AIM: The relationship between airway hyperresponsiveness (AHR) andatopy has been previously investigated, but there are still some issues to be clarified. The aim of this study was to assess the link between AHRand mannitol and atopy in asthmatic children.
METHODS: We evaluated 44 children with asthma, agedsix to 16-years-of-age,using skin prick tests (SPTs), serum total and specific immunoglobulin E (IgE)levels and the mannitol challenge test (MCT).
RESULTS: We found agood correlation between AHR to mannitol and specific IgE against Dermatophagoidespteronissinus (r= -0.66, p<0.001) and a weak correlation with specific IgE against dog dander (r= -0.33, p=0.01) and Aspergillusfumigatus(r= -0.23, p=0.02).Furthermore,we found a weak correlation between AHR to mannitol and serum total IgE (r= -0.30; p=0.03), the sum of specific IgE to aeroallergens (r= -0.37, p= 0.01) and the number of positive SPTs (r= -0.31, p=0.02).
CONCLUSION: Measuring AHR with MCT might provide an accurate evaluation of the degree of atopy in children. The patients with a higher degree of atopy were significantly more reactive to mannitol.In clinical practice these results indicate that children with asthma who are more atopic may require more intensive treatment strategies to reduce AHR. This article is protected by copyright. All rights reserved.

Acta Paediatr. 2015 Feb 5. doi: 10.1111/apa.12968. [Epub ahead of print]