Analysis of clinical characteristics and risk factors of chest tightness variant asthma in children
10.3760/cma.j.cn112150-20240129-00097
- VernacularTitle:儿童胸闷变异性哮喘的临床特征及危险因素分析
- Author:
Jialing CHEN
1
;
Xin SONG
;
Wenjing ZHU
;
Shuo LI
;
Chuanhe LIU
;
Li SHA
Author Information
1. 首都儿科研究所附属儿童医院变态反应科，北京 100020
- Keywords:
Asthma;
Children;
Respiratory function tests;
Risk factors;
Chest tightness
- From:
Chinese Journal of Preventive Medicine
2024;58(6):815-822
- CountryChina
- Language:Chinese
-
Abstract:
Objective:To analyze the clinical features and risk factors of chest tightness variant asthma (CTVA) in children, so as to provide basis for the prevention and management of the disease.Methods:A cross-sectional study was conducted to analyze 178 children aged 6-17 years old who were admitted to the Department of Allergy, Capital Institute of Pediatrics Affiliated Children′s Hospital from January 2021 to January 2023 due to chest tightness. The age was 8.83(7.50, 11.58) years old, with 89 males (50%) and 89 females (50%). According to the diagnosis of CTVA, 130 cases were divided into CTVA group and 48 non-CTVA cases were divided into control group. Demographic data, personal history, family history, clinical features, auxiliary examination results and other data were collected. The clinical characteristics, allergens, FeNO level and pulmonary function parameters of the two groups were analyzed. Logistic regression analysis was used to explore the risk factors of the disease.Results:The proportion of school-age children (6-11 years old) in CTVA group was higher than that of adolescent children (≥12 years old) [(113/130,86.9%) vs (26/48,54.2%), Z=21.985, P<0.01]. The proportion of CTVA combined with eczema [(74/130,56.9%) vs (19/48,39.6%), χ2=4.225, P<0.05] and rhinitis symptoms [(98/130,75.4%) vs (27/48,56.2%), χ2=6.138, P<0.05] was higher. The positive rates of mold sensitization [(52/130,40.0%) vs (11/48,22.9%), χ2=4.474, P<0.05] and multiple sensitization [(71/130,54.6%) vs (18/48,37.5%), χ2=4.108, P<0.05] in inhaled allergens were significantly higher than those of control group. The proportion of elevated FeNO (>20 ppb) in CTVA children was 20.8% (27/130), which was significantly higher than that in control group 4.2%(2/48)( χ2=7.086 ,P<0.01). There were no statistical differences in spirometry parameters FEV 1 and FVC between CTVA group and control group ( P both>0.05). FEV 1/FVC, PEF, FEF 25, FEF 50, FEF 75 and MMEF were significantly lower than those in control group ( P all<0.05). Logistic regression analysis showed that rhinitis symptoms ( OR=2.351, 95% CI 1.105-5.002, P=0.026), multiple sensitizations ( OR=2.184, 95% CI 1.046-4.557, P=0.038), tIgE>60 kU/L( OR=3.080, 95% CI 1.239-7.654, P=0.015), FeNO>20 ppb ( OR=6.734, 95% CI 1.473-30.796, P=0.014) and small airway dysfunction ( OR=3.164, 95% CI 1.089-9.194, P=0.034) were risk factors for chest tightness variant asthma. FeNO combined with FEF 50 has the largest area under the curve ( Z=2.744, P<0.01) in diagnosing CTVA. Conclusion:CTVA is more common in school-age children than in adolescent children. Rhinitis symptoms, multiple sensitization, tIgE>60 kU/L, FeNO>20 ppb and small airway dysfunction are risk factors for chest tightness variant asthma. FeNO combined with small airway indexes can improve the diagnostic value of CTVA.
