| Objective:To review and analyze the relationship between erythrocyte index(MCV,MCH,MCHC)with initial diagnosis of bronchial asthma and the basic situation of children,auxiliary examination indexes,pulse concussion pulmonary function before and after treatment,and Child-asthma Control Test(C-ACT)score before and after treatment in preschool children,so as to provide basis for better condition evaluation and treatment of children with bronchial asthma,and to provide certain guidance value for clinicians.Methods:A total of 200 children with complete clinical data were collected from January 2021to January 2022 in Shandong Province Rizhao people’s hospital due to bronchial asthma,including name,age,sex,height,weight,main symptoms,signs,peripheral blood routine,pulse concussion pulmonary function results(before and after treatment),C-ACT score(before and after treatment),and the number of respiratory tract infections and acute asthma attacks within half a year after treatment.1.The children were divided into three groups according to whether the hemoglobin was normal and the erythrocyte index was normal or not,including 80 cases in group A(normal erythrocyte index),47 cases in group B(single abnormal erythrocyte index),and 73 cases in group C(multiple abnormal erythrocyte index).The clinical data of the three groups were analyzed to find the differences between the indicators.2.The differences in pulse concussion pulmonary function indexes before and after treatment were compared between the groups.3.The differences in the C-ACT scores of children over 4 years old before and after treatment were compared between the groups.4.To explore the relationships between erythrocyte index and lung function,C-ACT scores etc.Results:1.General information:(1)According to the inclusion and exclusion criteria,200children met the inclusion criteria and were included in the study,118(59%)were male,82(41%)were female,and the ratio of male to female was 1.44:1.There were 48 children(24%)in the 36 to 48 month old group,123 children(61.5%)in the 48 to 60 month old group,and 29 children(14.5%)in the 60 to 72 month old group.The children aged 48 to60 months were significantly higher than those aged 36 to 48 months and 60 to 72 months(P<0.05).Among 200 children,80(40%)in group A,47(23.5%)in group B and 73(36.5%)in group C.The number of children in group(B+C)was significantly higher than that in group A(X~2=8.000a,P=0.005).There were 44 males and 36 females in Group A,with an average age of(52.11±7.76)months;There were 25 males and 22 females in group B,with an average age of(52.70±7.46)months;There were 49 males and 24 females in Group C,with an average age of(52.23±5.10)months.There was no significant difference in age,sex and weight among the three groups(P>0.05).(2)There was no correlation between the erythrocyte index and age,peripheral blood leukocyte(WBC)count,eosinophil(EOS)count(P>0.05).There was no significant difference in peripheral blood leukocyte(WBC)count and eosinophil(EOS)count among groups A,B and C(P>0.05).(3)The height of group C was the lowest,significantly lower than that of group A and group B(P<0.05),and there was no significant difference between group A and group B(P>0.05).2.Correlation between RBC index and pulmonary function before treatment:MCV had a negative correlation with R5 and X5 of pulmonary function of pulse concussion before treatment(r was-0.140,-0.154,respectively,P<0.05).There was no correlation between MCV and pulmonary function R20(P>0.05).There was a negative correlation between MCH and pulmonary function R5(r=-0.176,P=0.013),but there was no correlation between MCH and pulmonary function R20,X5(P>0.05).There was no correlation between MCHC and lung function R5,R20,X5(r was-0.044,-0.064,0.014,respectively,P>0.05).3.Changes of pulmonary function before treatment in different groups:Before treatment,the pulmonary function R5 of pulse concussion was statistically significant(P<0.05).There was no significant difference in pulmonary function R20 among groups A,B and C(P>0.05).The difference of pulmonary function X5 between groups A and C was statistically significant(P<0.05).4.Correlation between RBC index and C-ACT score before treatment:There was no correlation between MCV,MCH,MCHC and C-ACT score at the beginning of treatment(r=-0.009,-0.029,-0.042,P>0.05).There was no significant difference in C-ACT scores among groups A,B and C at the beginning of treatment(P>0.05).5.Correlation between RBC index and pulmonary function after treatment:MCV was correlated with R5 and X5 of pulse concussion pulmonary function half a year after treatment(r=-0.143,-0.150,P<0.05),but not with R20(r=-0.031,P=0.664).MCH was correlated with pulmonary function R5 and X5 after treatment(r=-0.230,-0.155,P<0.05),but not with R20(P>0.05).MCHC was correlated with pulmonary function R5 after treatment(r=-0.147,P=0.037),but not with R20 and X5(P>0.05).6.Changes of pulmonary function in different groups after treatment:R5 after treatment was statistically significant(P<0.05)among groups A,B and C and between groups A and C.There was no significant difference in R20 among groups A,B and C(P>0.05).The difference of X5 among group A,B and C and between group B,C and group A was statistically significant(P<0.05),and the value of group C was the largest.7.Correlation between RBC index and C-ACT score after treatment:MCV,MCH,MCHC and C-ACT were statistically significant(r=0.175,0.267,0.251,P<0.05).There were statistically significant differences among the three groups A,B and C,and between the two groups A and C(P<0.05).There was no difference between the two groups A,C and B(Z=-1.284,-1.849,P>0.05).8.The number of respiratory tract infections in half a year after treatment:The number of infections in Group C was significantly higher than that in Group A and Group B,with a statistically significant difference(P<0.05).There was no difference between Group A and Group B(Z=-1.198,P=0.231).9.The number of acute asthma attacks within half a year after treatment:The number of asthma attacks in Group A was significantly less than that in Group B and Group C,with a statistically significant difference(P<0.05).There was no significant difference between Group B and Group C(Z=-0.029,P=0.977).10.After treatment,the RBC index of children in each group had no significant change compared with that before treatment(P>0.05).The pulmonary function of children in each group was significantly improved after treatment compared with that before treatment(P<0.05).The C-ACT score of children in each group was significantly improved after treatment compared with that before treatment(P<0.05).11.The comparison of asthma control level within half a year after systematic treatment:the asthma control rate among group A,B and C,and between group A and group C were statistically significant(P<0.05),and the control rate of group C was the lowest.Conclusion:1.The incidence rate of decreased red blood cell index is high in preschool children with bronchial asthma,decreased red blood cell index may affect the height of pediatric patients.2.The pediatric patients with multiple decreased RBC index have the poor pulse concussion pulmonary function,the decrease of RBC index may be related to the increase of peripheral respiratory resistance and peripheral elastic resistance.3.The decrease of RBC index may be a risk factor for respiratory tract infection and asthma attack in preschool children with bronchial asthma.4.Children with multiple decreased erythrocyte index indicates that there is iron deficiency in red blood cells.The asthma control is still not ideal even if systematically standardized anti-asthma treatment is given half a year later,suggesting that the reason should be found and intervened,in order to better control asthma. |
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