Abstract：
Oral breathing is considered to increase hyper-responsiveness of the airways. Data on the need for nose clip (NC) during exercise challenge test (ECT) in children and adolescents is scarce. Ouraim was to evaluate the role of NC during ECT in children and adolescents.
A prospective, cohort study; children referred for ECT were evaluated on two separate visits, with and without a NC. Demographic, clinical data and measurements of lung functions were recorded. Allergy and asthma control were evaluated by Total Nasal Symptoms Score (TNSS) and Asthma Control Test (ACT) questionnaires.
Sixty children and adolescents (mean age 16.7 ± 1.1 years, 38% Female,) performed ECT with NC and 48 (80%) completed visit 2 (ECT without NC), 8.7 ± 7.9 days after visit 1. Following exercise, 29/48 patients (60.4%) with NC had a decline of ≥12% in forced expiratory volume in the first second (FEV1 ) (positive ECT) compared to only 16/48 (33.3%) positive tests without NC (p = 0.0008). Test result was changed in 14 patients from positive ECT (with NC) to negative ECT (no NC) and in only one patient from negative to positive. The use of NC resulted in greater FEV1 decline (median 16.3% predicted, IQR 6.0-19.1% predicted vs. median 4.5% predicted, IQR 1.6-18.4% predicted, p = 0.0001), and better FEV1 increase after bronchodil at or inhalation compared to ECT without NC. Higher TNSS scores did not predict higher probability to positive ECT.
The use of NC during ECT increases detection rate of exercise induced bronchoconstriction during ECT in the pediatric population. These findings strengthen the recommendation of nasal blockage during ECT in children and adolescents.
A prospective, cohort study; children referred for ECT were evaluated on two separate visits, with and without a NC. Demographic, clinical data and measurements of lung functions were recorded. Allergy and asthma control were evaluated by Total Nasal Symptoms Score (TNSS) and Asthma Control Test (ACT) questionnaires.
Sixty children and adolescents (mean age 16.7 ± 1.1 years, 38% Female,) performed ECT with NC and 48 (80%) completed visit 2 (ECT without NC), 8.7 ± 7.9 days after visit 1. Following exercise, 29/48 patients (60.4%) with NC had a decline of ≥12% in forced expiratory volume in the first second (FEV1 ) (positive ECT) compared to only 16/48 (33.3%) positive tests without NC (p = 0.0008). Test result was changed in 14 patients from positive ECT (with NC) to negative ECT (no NC) and in only one patient from negative to positive. The use of NC resulted in greater FEV1 decline (median 16.3% predicted, IQR 6.0-19.1% predicted vs. median 4.5% predicted, IQR 1.6-18.4% predicted, p = 0.0001), and better FEV1 increase after bronchodil at or inhalation compared to ECT without NC. Higher TNSS scores did not predict higher probability to positive ECT.
The use of NC during ECT increases detection rate of exercise induced bronchoconstriction during ECT in the pediatric population. These findings strengthen the recommendation of nasal blockage during ECT in children and adolescents.
摘要：
背景：口腔呼吸被认为会增加气道的高反应性。关于儿童和青少年在运动挑战测试（ECT）期间需要鼻夹（NC）的数据很少。Ouraim旨在评估NC在儿童和青少年ECT中的作用。
方法：前瞻性，队列研究；接受ECT转诊的儿童在两次单独就诊时进行评估，有和没有NC。人口统计,记录肺功能的临床数据和测量结果.通过总鼻症状评分（TNSS）和哮喘控制测试（ACT）问卷评估过敏和哮喘控制。
结果：60名儿童和青少年（平均年龄16.7±1.1岁，38%女性,)用NC进行ECT，48次(80%)完成2次就诊(无NC的ECT)，访视1后8.7±7.9天。练习后，29/48例（60.4％）的NC患者在第一秒（FEV1）（阳性ECT）的用力呼气量下降≥12％，而没有NC的试验只有16/48（33.3％）（p=0.0008）。14例患者的测试结果从ECT阳性（有NC）变为ECT阴性（无NC），只有1例患者的测试结果从阴性变为阳性。使用NC导致FEV1下降幅度更大(预测中位数为16.3%，IQR6.0-19.1%预测与预测中位数为4.5%，IQR预测1.6-18.4%，p=0.0001),与不使用NC的ECT相比，吸入或吸入支气管地尔后FEV1增加更好。较高的TNSS评分并不能预测ECT阳性的可能性较高。
结论：在ECT期间使用NC可提高ECT期间运动诱发的支气管收缩在儿科人群中的检出率。这些发现加强了儿童和青少年ECT期间鼻塞的建议。
方法：前瞻性，队列研究；接受ECT转诊的儿童在两次单独就诊时进行评估，有和没有NC。人口统计,记录肺功能的临床数据和测量结果.通过总鼻症状评分（TNSS）和哮喘控制测试（ACT）问卷评估过敏和哮喘控制。
结果：60名儿童和青少年（平均年龄16.7±1.1岁，38%女性,)用NC进行ECT，48次(80%)完成2次就诊(无NC的ECT)，访视1后8.7±7.9天。练习后，29/48例（60.4％）的NC患者在第一秒（FEV1）（阳性ECT）的用力呼气量下降≥12％，而没有NC的试验只有16/48（33.3％）（p=0.0008）。14例患者的测试结果从ECT阳性（有NC）变为ECT阴性（无NC），只有1例患者的测试结果从阴性变为阳性。使用NC导致FEV1下降幅度更大(预测中位数为16.3%，IQR6.0-19.1%预测与预测中位数为4.5%，IQR预测1.6-18.4%，p=0.0001),与不使用NC的ECT相比，吸入或吸入支气管地尔后FEV1增加更好。较高的TNSS评分并不能预测ECT阳性的可能性较高。
结论：在ECT期间使用NC可提高ECT期间运动诱发的支气管收缩在儿科人群中的检出率。这些发现加强了儿童和青少年ECT期间鼻塞的建议。
