Abstract
Giriş ve Amaç: Astım-benzeri yakınmaları olan ancak solunum fonksiyon testlerinde reverzibilite bulgusu olmayan hastalarda egzersiz provokasyon testi tanıda kullanılabilir. Ancak bu test zaman alıcıdır ve her zaman pratik değildir. Bu nedenle bu çalışmada, astım-benzeri yakınması olan hastalarda pozitif egzersiz provokasyon testinin pozitif olmasınıöngörecek değişkenlerin belirlenmesi amaçlanmıştır.Gereç ve Yöntemler: Çalışmada, Kasım-2009- Haziran 2012 tarihleri arasında polikliniğimize astım-benzeri yakınmaları olan ve solunum fonksiyon testlerinde (SFT) reversibilitesi olmayıp egzersiz provokasyon testi (EPT) yapılan hastaların dosyaları geriye dönük olarak incelendi. Klinik özellikleri ve laboratuvar sonuçları tek değişkenli ve çok değişkenli regresyon analizi ile değerlendirildi.Bulgular: Yaşları 7-17 yıl arasında değişen toplam 145 hastanın dosyası incelendi. Olguların 76’sı (%52.4) kızdı ve ortanca yaş 11 yıl (çeyrekler arası aralık (ÇAA): 10-14) idi. 50 hastada (%34.5) egzersiz provokasyon testi pozitif saptandı. Egzersiz provokasyon testi pozitif saptanan olguların 14’ü (%28,7) obezdi. Çok değişkenli logistik regresyon analizinde yaş, cinsiyet, atopi, ailevi alerjik hastalık, sigara maruziyeti, periferik kan eozinofil sayısının 500 /mm³’ün üstünde olması, FEV1, FEV1/FVC değişkenlerine göre düzeltildiğinde obezite varlığı (odds retro (OR):4,188; %95 GA:1,512-11,604; p:0.006) ve FEF25-75 düşüklüğü (OR:1,030; %95 GA:1,050-1,012; p:0,01) egzersiz provokasyon test pozitifliği için risk faktörü olarak bulundu.Sonuç: Astım-benzeri yakınmaları olan ancak solunum fonksiyon testlerinde reverzibilite bulgusu olmayan hastalarda obezitenin olması ve FEF25-75 değerlerinin düşük saptanması egzersiz provokasyon testinin pozitifliği için risk faktörü olduğu söylenebilir.
Keywords
References
- National Asthma Education and Prevention Program. Expert Panel Report 3 (EPR-3): Guidelines for the Diagnosis and Management of Asthma-Summary Report 2007. J Allergy Clin Immunol 2007;120:S94-138.
- Crapo RO, Casaburi R, Coates AL, Enright PL, Hankinson JL, Irvin CG, et al. Guidelines for methacholine and exercise challenge testing-1999. This official statement of the American Thoracic Society was adopted by the ATS Board of Directors, July 1999. Am J Respir Crit Care Med 2000;161:309-29.
- Neyzi O, Günöz H, Furman A, Bundak R, Gökçay G, Darendeliler F. Türk çocuklarında vücut ağırlığı, boy uzunluğu, baş çevresi ve vücut kitle indeksi referans değerleri. Çocuk Sağlığı ve Hastalıkları Dergisi 2008;51:1-14.
- Katial RK, Covar RA. Bronchoprovocation testing in asthma. Immunol Allergy Clin North Am 2012;32:413-31.
- Teoh OH, Trachsel D, Mei-Zahav M, Selvadurai H. Exercise testing in children with lung diseases. Paediatr Respir Rev 2009;10: 99-104.
- Weiler JM, Anderson SD, Randolph C, Bonini S, Craig TJ, Pearlman DS, et al. Pathogenesis, prevalence, diagnosis, and management of exercise-induced bronchoconstriction: A practice parameter. Ann Allergy Asthma Immunol 2010;105:S1-47.
- Busquets RM, Anto JM, Sunyer J, Sancho N,Vall O. Prevalence of asthma-related symptoms and bronchial responsiveness to exercise in children aged 13-14 yrs in Barcelona, Spain. Eur Respir J 1996;9:2094-8.
Predictive Risk Factors for Airway Hyperresponsiveness in Children with Exercise-Induced Respiratory Symptoms
Abstract
Objective: The exercise challenge test can be used to diagnose asthma in patients with asthma-like symptoms but without reversibility on spirometry. However, the test is time-consuming and is not always practical. The aim of this study was to determine the potential factors that may predict the presence of a positive exercise challenge test in children with asthma-like symptoms but without reversibility on spirometry.Material and Methods: All patients who presented at our outpatient clinic between November 2009-June 2012 with asthma-like symptoms but did not have reversibility on spirometry and on whom an exercise challenge test was done were analyzed retrospectively. The clinical features and laboratory results were analyzed with univariate and multivariate regression analysis.results: A total of 145 children between 7 and 17 years of age were analyzed. 76 out of 145 patients (52.4%) were female and their median age was 11 (Interquartile Range (IQR): 10-14) years of age. The exercise provocation test was positive in 50 (34.5%) patients. Fourteen patients with a positive exercise challenge test (28.7%) were obese. Multivariate logistic regression analysis revealed that obesity (odds ratio [OR]: 4.188, 95% confidence interval (CI): 1.512-11.60, p=0.006) and low basal FEF25-75 (OR:1.030, 95% CI:1.050-1.012, p=0.006) were risk factors for the presence of positive exercise challenge test when adjusted for the variables age, sex, atopy, familial allergic disease, passive smoking, peripheral blood eosinophil count greater than 500/mm³ and FEV1, FEV1/FVC parameters.conclusion: For patients with asthma-ike symptoms but without reversibility on spirometry, obesity and low FEF25-75 can be considered as the significant risk factors for the presence of a positive exercise challenge test
Keywords
References
- National Asthma Education and Prevention Program. Expert Panel Report 3 (EPR-3): Guidelines for the Diagnosis and Management of Asthma-Summary Report 2007. J Allergy Clin Immunol 2007;120:S94-138.
- Crapo RO, Casaburi R, Coates AL, Enright PL, Hankinson JL, Irvin CG, et al. Guidelines for methacholine and exercise challenge testing-1999. This official statement of the American Thoracic Society was adopted by the ATS Board of Directors, July 1999. Am J Respir Crit Care Med 2000;161:309-29.
- Neyzi O, Günöz H, Furman A, Bundak R, Gökçay G, Darendeliler F. Türk çocuklarında vücut ağırlığı, boy uzunluğu, baş çevresi ve vücut kitle indeksi referans değerleri. Çocuk Sağlığı ve Hastalıkları Dergisi 2008;51:1-14.
- Katial RK, Covar RA. Bronchoprovocation testing in asthma. Immunol Allergy Clin North Am 2012;32:413-31.
- Teoh OH, Trachsel D, Mei-Zahav M, Selvadurai H. Exercise testing in children with lung diseases. Paediatr Respir Rev 2009;10: 99-104.
- Weiler JM, Anderson SD, Randolph C, Bonini S, Craig TJ, Pearlman DS, et al. Pathogenesis, prevalence, diagnosis, and management of exercise-induced bronchoconstriction: A practice parameter. Ann Allergy Asthma Immunol 2010;105:S1-47.
- Busquets RM, Anto JM, Sunyer J, Sancho N,Vall O. Prevalence of asthma-related symptoms and bronchial responsiveness to exercise in children aged 13-14 yrs in Barcelona, Spain. Eur Respir J 1996;9:2094-8.
Details
| Other ID | JA55TG46AK |
|---|---|
| Journal Section | Research Article |
| Authors | |
| Publication Date | August 1, 2013 |
| Submission Date | August 1, 2013 |
| Published in Issue | Year 2013 Volume: 7 Issue: 2 |
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