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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 Women's Health cen tre of Bc 4480O ak Street Vancouver BC V6H 3V4 Canada Dr.

Background: Limited access to exercise testing facilitiesmeans that the diagno sis of exercise induced asthma (EIA) is mainly based on self-reported respirato ry symptoms. This is open to error since the correlation between exercise relate d symptoms and subsequent exercise testing has been shown to be poor. Aim: To st udy the accuracy of clinically diagnosed EIA among Vancouver schoolchildren. Met hods: Fifty two children referred for investigation of poorly controlled EIA wer e studied. Following a careful history and physical examination, children perfor med pulmonary function tests before, then 5 and 15 minutes after a standardised treadmill exercise test. Based on overall assessment, a diagnostic explanation f or each child’s respiratory complaints was provided as far as possible. Results : Only eight children (15.4%) fulfilled diagnostic criteria for EIA (fall in FE V1 ≥10%). Of the remainder: 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 abnormalities on clinical or laboratory testing, so were given no diagnosis. Initial reported symptoms of wheeze or cough often changed significantly followi ng a careful history, particularly among the eight elite athletes. The final com plaint was sometimes not respiratory, and, in a few cases, was not even associat ed with exercise. conclusions: The clinical diagnosis of EIA is inaccurate among Vancouver schoolchildren, principally due to the unreliability of their initial exercise related complaints. Symptom exaggeration, familiarity with medical jar gon, and psychogenic complaints are all common. A careful history is essential i n this population before basing any diagnosis on self-reported respiratory symp toms.

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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