RESUMEN
Asthma is a common chronic airway inflammatory disease in children.In recent decades, the global prevalence of asthma in children has been increasing significantly.As a heterogeneous disease, asthma presents multiple phenotypes, with the type 2(eosinophilic)airway inflammation predominating in children.Currently, fractional exhaled nitric oxide(FeNO)is an internationally recognized marker of eosinophilic airway inflammation, and its value in the diagnosis and treatment of asthma in children has been gradually recognized.This article reviews the sources, detection methods, possible influencing factors of FeNO and its role in the diagnosis and treatment of asthma in children.
RESUMEN
Objective:To investigate the distribution and characteristics of serum allergen specific IgE (sIgE) in children in Tianjin from June 2015 to April 2019.Methods:The fluorescence enzyme linked immunosorbent assay results (obtained by UniCAP system) of serum allergen sIgE of 5 823 children aged 1-14 in Tianjin area were analyzed.The distribution of serum allergen sIgE and its correlation with the gender, disease type, age and season were discussed.Results:(1) Among the 5 823 cases, 3 602 cases (61.86%) were positive for serum allergen sIgE, including 1 556 cases (43.20%) positive for single airborne allergens, 779 cases (21.63%) positive for single food allergens, 1 267 cases (35.17%) positive for both food and airborne allergens.(2) The top 5 airborne allergens were moulds (33.02%), dermatophagoides farinae (27.21%), dermatophagoides pteronyssinus (24.28%), mugwort (21.64%) and ragweed (17.32%). (3) Food allergens were mainly egg white, milk and wheat, whose positive rates were 27.06%, 25.59% and 20.00%, respectively.(4) The positive rate of serum allergen sIgE in boys (64.02%) was significantly higher than that in girls (57.93%) ( χ2=20.94, P<0.05). (5) The positive rate of serum allergen sIgE in children with asthma (73.18%) was significantly higher than that in children with allergic rhinitis (59.82%)( χ2=64.51, P<0.05) and eczema (51.60%) ( χ2=40.04, P<0.05). The main airborne allergens in children with asthma included moulds, dermatophagoides farinae, dermatophagoides pteronyssinus, wheat and peanut.The main allergens in children with allergic rhinitis were moulds, egg white, wheat, mugwort and dermatophagoides farinae.The main allergens in children with eczema were egg white, milk, moulds, dermatophagoides farinae and dermatophagoides ptero-nyssinus.(6) With the increase of age, the positive rate of airborne allergens increased gradually.In food allergens, the positive rate of milk and egg white decreased gradually while that of wheat and peanut increased gradually with the increasing age.(7) In different seasons, the positive rate of allergen sIgE was varied.The overall positive rate was highest in summer(66.59%), followed by autumn(64.15%), spring(62.07%), and winter(54.63%) successively( χ2=49.38, P<0.05). Among the airborne allergens, the positive rates of dermatophagoides farinae and dermatophagoides pteronyssinus were the highest in summer and autumn[dermatophagoides farinae(32.25%, 30.17%); dermatophagoides pteronyssinus(30.40%, 27.54%)]. The positive rate of moulds was the highest in summer(45.41%), followed by autumn(36.19%). The positive rate of blattella germanica was the highest in summer(5.52%). The positive rates of cat dander, animal dander combination, artemisia argyi and weeds pollen combination were higher in autumn(33.33%, 13.94%, 24.84%, 19.88%). Conclusions:Moulds, dermatophagoides farinae, dermatophagoides pteronyssinus, egg white and milk are the most common allergens in children in Tianjin.The distribution of allergens is correlated with the gender, disease type, age and season.
RESUMEN
Objective To study the influence of minocycline combined with azithromycin on serum CRP, D-Dimer and lung function in the children with refractory mycoplasma. Methods From April 2015 to August 2016, 42 children with refractory mycoplasma pneumonia were enrolled in the second hospital in Tianjing. The patients were divided into the observation group and the control group according to the order of admission. The control group was treated with azithromycin sequential therapy, the observation group were given minocycline combined with azithromycin to complete the treatment. The levels of serum CRP, D-D, lung function, clinical symptoms and signs, and the adverse effects were observed. Results After treatment, the total effective rate of the observation group was significantly higher than that in the control group (P<0.05). The levels of CRP and D-D in the observation group were significantly lower than those in the control group (P<0.05). The highest expiratory flow velocity (PEE), first-second forced expiratory volume (FEV1), forced vital capacity (FVC) and forced expiratory 25% flow rate (MEF25) in the observation group were significantly higher than those in the control group (P<0.05). The time of X-ray recovery time, the time of fever, the time of cough and the disappearance of lung rales were significantly shorter than those in the control group (P<0.05). Compared with the control group, there were no significant differences in diarrhea, abdominal pain, nausea, vomiting, pleural effusion, otitis media, mild anemia and rash adverse reaction rate in the observation group. Conclusion Minocycline combined with azithromycin in the treatment of severe Mycoplasma pneumoniae pneumonia can effectively reduce serum levels of CRP and D-D, improve pulmonary function and clinical symptoms, and have good clinical efficacy.
RESUMEN
Objective To observe the effect Azithromycin injection in the treatment of mycoplasma pneumoniae pneumonia ( MPP) in children. Methods Forty-four children of mycoplasma pneumoniae pneumonia were randomly divided into two groups, the Azithromycin group ( treat by Azithromycin, made by Pfizer) and the control group (treat by domestic Azithromycin) respectively. Improvement in symptoms and signs between the two groups were observed and compared. Results There were 25 cases in the Azithromycin group, of which,after a week, 17 cases cured,2 cases got better significantly and 6 cases got better. The effective ratio was 76. 00% ( 19/25 ). There were 19 cases in the control group, of which 5 cases cured, 9 cases got better significantly ,4 cases got better and 1 case no change. The effective ratio was 73. 68% (14/19). There was no statistical significance in the effective ratio between the two groups ( x2 = 0. 03, P > 0. 05). However, the Azithromycin group was superior to the control group both in the one week cure rate (t = 7.50,P< 0.05) and on defervescence time (t = 34. 05, P < 0. 05 ) and rales disappearance (t = 2. 39, P < 0. 05 ). Conclusion Azithromycin injection is more effective than domestic Azithromycin in the treatment of mycoplasma pneumoniae pneumonia,especially in the aspect of improving symptoms.