南方医科大学学报

南方医科大学学报 ›› 2016, Vol. 36 ›› Issue (12): 1723-.

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性别对肥胖哮喘患儿吸入糖皮质激素后肺功能的影响

叶泽慧，黄英   

  • 出版日期:2016-12-20 发布日期:2016-12-20

Association between gender and lung function in obese asthmatic children after inhaling corticosteroids

  • Online:2016-12-20 Published:2016-12-20

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摘要： 目的研究性别对肥胖哮喘患儿吸入糖皮质激素（ICS）治疗前后肺功能的影响。方法190例哮喘患儿根据性别分为男性 组（102例，正常体质量组/肥胖组57/45）、女性组（88例正常体质量组/肥胖组46/42），检测所有患儿治疗前及规范化ICS治疗1 年后肺功能，包括第1秒时间肺活量（FEV1）、用力肺活量（FVC）、用力呼气50%流量（MEF50）、用力呼气25%流量（MEF25）。结 果治疗前各组肺功能男女性比较无统计学差异（均P>0.05）。ICS治疗1年后，正常体质量男女性组FVC%、FEV1%较治疗前 均明显升高（P<0.05）；肥胖男性组FVC%、FEV1%较治疗前明显升高（P<0.05），而肥胖女性组仅FVC%较治疗前升高（P< 0.05）。结论ICS治疗能够改善哮喘大气道通气功能，性别对哮喘ICS治疗大气道通气功能的改善依赖于体质量指数，表现为 性别对正常体质量哮喘患儿ICS治疗影响作用较小，而女性肥胖哮喘患儿肺功能改善程度明显低于男性肥胖哮喘患儿。

Abstract: Objective To study the association between gender and lung function in obese asthmatic children before and after inhaling corticosteroids (ICS). Methods A total of 102 asthmatic boys (including 57 normal-weight and 45 obese boys) and 88 asthmatic girls (including 46 normal-weight and 42 obese girls) received ICS treatment for one year. Pulmonary functions were evaluated before and after the treatment for forced expiratory volume in one second (FEV1), forced vital capacity (FVC), maximal expiratory flow 25 (MEF25) and maximal expiratory flow 50 (MEF50). Results The asthmatic children in the 4 subgroups showed similar pulmonary functions before the treatment. After inhalation of methacholine, FVC% and FEV1% were improved in both normal-weight boys and normal-weight girls; FVC% and FEV1% in obese boys were improved after the treatment, but the obese girls showed improvement only in FVC%. Conclusion Inhalation of methacholine can improve large airway function in asthmatic children, and gender affects the improvement to a lesser extent in normal-weight children. In obese asthmatic children, methacholine inhalation better improves lung functions in boys than in girls.