反复喘息患儿1035例随访分析

Follow-up study of 1035 children with recurrent wheezing

目的：探讨反复喘息患儿的转归及吸入激素的治疗效果。方法回顾性分析1035例反复喘息患儿4年以上的临床随访资料。结果1035例反复喘息患儿中，751例（72.56%）喘息已停止发作，284例（27.44%）近2年内仍有发作。首次喘息发作年龄≤3岁542例（52.37%），~7岁386例（37.29%），~12岁107例（10.34%），不同喘息首发年龄之间临床控制率的差异有统计学意义（χ2=45.27，P〈0.001），其中~12岁的临床控制率较低。吸入糖皮质激素持续1年以上的患儿有429例，其中343例（79.95%）哮喘未再发作，而未吸入治疗的606例中仅408例（67.33%）未再发作，两者的临床控制率差异有统计学意义（P〈0.01）。结论89.66%的反复喘息儿童哮喘第1次喘息发生在7岁以内，大多数可以临床控制；较长期激素吸入治疗可减少反复喘息患儿发展为成人哮喘的风险。

Objective To investigate the long-term outcome of children with recurrent wheeze and to determine the effectiveness of inhaled hormone therapy. Methods One thousand and thirty-five children with recurrent wheezing were followed up for more than 4 years and the data were retrospectively evaluated. Results Of 1035 cases, 751 （72.56%） patients outgrew their wheeze during the follow-up period, whereas the other 284 （27.44%） patients had recurrence wheeze during the last two years. The age of wheezing onset was〈3 years in 542 （52.37%） cases, from 3 to 7 years in 386 （37.29%） cases, and from 7 to 12 years in 107 （10.34%） cases. There was significant difference in clinical control rate among groups with different wheezing ages onset （χ2=45.27, P〈0.001）. Children with wheezing age onset from 7 to 12 years had the lowest clinical control rate. Among 1035 wheeze children, 343 （79.95%） children in 429 cases who received inhaled hormone therapy for more than one year outgrew their wheeze. Whereas 408 （67.35%） in 606 cases who did not receive inhaled hormone therapy outgrew their wheeze. There was significant difference of clinical control rate between inhaled group and non-inhaled group （P〈0.01）. Conclusions The age of wheezing onset is〈7 years in 89.66%of children with recurrent wheeze. Most of them can be clinicalycontrolled. The long term inhaled hoemone therapy for children with recurrent wheeze can reduce the risk of developing adulthood asthma.