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世界核心医学期刊文摘（儿科学分册） 2006年第1期2卷 10-11页

作者： seear m. Wensley D. West N. 李开 Children's and Wom.n's Health Cen tre of BC 4480O ak Street Vancouver BC V6H 3V4 Canada Dr.

Background: Lim.ted access to exercise testing facilitiesm.ans that the diagno sis of exercise induced asthm. (EIA) is m.inly based on self-reported respirato ry sym.tom.. This is open to error since the correlation between exercise relate d sym.tom. and subsequent exercise testing has been shown to be poor. Aim. To st udy the accuracy of clinically diagnosed EIA am.ng Vancouver schoolchildren. m.t hods: Fifty two children referred for investigation of poorly controlled EIA wer e studied. Following a careful history and physical exam.nation, children perfor m.d pulm.nary function tests before, then 5 and 15 m.nutes after a standardised treadm.ll exercise test. Based on overall assessm.nt, a diagnostic explanation f or each child’s respiratory com.laints was provided as far as possible. Results : Only eight children (15.4%) fulfilled diagnostic criteria for EIA (fall in FE V1 ≥10%). Of the rem.inder: 12 (23.1%) were un-fit, 14 (26.9%) had vocal co rd dysfunction/sigh dyspnoea, 7 (13.5%) had a habit cough, and 11 (21.1%) had no abnorm.lities on clinical or laboratory testing, so were given no diagnosis. Initial reported sym.tom. of wheeze or cough often changed significantly followi ng a careful history, particularly am.ng the eight elite athletes. The final com.plaint was som.tim.s not respiratory, and, in a few cases, was not even associat ed with exercise. Conclusions: The clinical diagnosis of EIA is inaccurate am.ng Vancouver schoolchildren, principally due to the unreliability of their initial exercise related com.laints. Sym.tom.exaggeration, fam.liarity with m.dical jar gon, and psychogenic com.laints are all com.on. A careful history is essential i n this population before basing any diagnosis on self-reported respiratory sym. tom..

关键词：运动诱发性哮喘哮喘症状呼吸系统症状咳嗽症状叹息样呼吸喘鸣病史记录平板运动试验试验间

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