儿童支气管哮喘的诊断进展——2008 PRACTALL解读

The new progress of early diagnosis of asthma in infants and children:interpretation of 2008 PRACTALL

5岁及以下儿童哮喘的诊断极为困难,因为诊断只能依靠临床判断、症状评价和体征分析。PRACTALL共识报告特别针对儿童哮喘制定,在诊断中强调了儿童哮喘的自然病史和病理生理特点、儿童喘息的不同类型、儿童哮喘的不同临床表型等,并推荐了不同年龄儿童哮喘的诊断、临床管理及监测的方法;强调诊断需要综合考虑,包括反复喘息的类型、特异体质病史、哮喘危险因素、长期随访、广泛鉴别诊断和观察对支气管舒张剂及抗炎治疗的反应。

Particular difficulties were presented when diagnosis of asthma in children under 5 was made.Diagnosis of asthma in early childhood is a big challenge and has been based largely on clinical justification and assessment of symptoms and physical signs.The PRACTALL consensus report focus exclusively on pediatric asthma,such as natural history and pathophysiology of pediatric asthma,different patterns of recurrent wheeze in pediatric patients,different phenotypes of asthma in children,and provides recommendations for diagnosis,practical management and monitoring.More factors should be considered for diagnosis of asthma in children under 5,including the patterns of recurrent wheeze,history of atopy,risk factor of asthma,long-term follow-up,extensive differential diagnoses,response to bronchodilator and/or anti-inflammatory treatment and so on.