儿童支气管哮喘急性发作临床特征及其年龄差异分析

Analysis of Clinical Features and Age Differences of Asthma Exacerbation in Children

目的探讨儿童支气管哮喘急性发作及不同年龄发作的特点,以预防及控制其发作。方法收集2013年1月~2015年12月笔者医院哮喘急性发作住院患儿395例,分成<5岁组和≥5岁组两组,对患儿的一般资料、流行病学、诱发因素、呼吸道感染及病原谱、过敏原、并发症进行比较分析。结果入组病例平均年龄4.25±2.51岁,男女性别比例为2.06∶1,住院高峰季节为秋季,合并呼吸道感染367例(92.91%),入院前已确诊哮喘113例(28.61%),长期规范治疗随访31例(7.85%)。与≥岁组比较,<5岁组易合并呼吸道感染(χ~2=9.856,P=0.007),且更易合并肺炎(χ~2=9.846,P=0.002)。<5岁组呼吸道合胞病毒检出率明显增高(χ~2=10.870,P=0.001),但支原体感染检出率两组之间比较,差异无统计学意义(χ~2=3.090,P=0.079)。并且<5岁组住院前诊断哮喘率(χ~2=16.742,P=0.000)、长期规范治疗随访率(χ~2=12.948,P=0.000)均明显低于≥5岁组。结论呼吸道感染、未早期规范诊治是儿童支气管哮喘急性发作主要诱因。<5岁幼儿哮喘急性发作更易并发呼吸道感染,易合并肺炎及呼吸合胞病毒感染,并且住院前诊断率及长期规范治疗依从性均较低。

Objective To understand the clinical features and the differences of age on children with asthma exacerbation. Methods Totally 395 inpatients with asthma exacerbation of our hospital were enrolled from January 2013 to December 2015. All the inpatients were divided into 2 groups： 〈 5 years of age group and ≥5 years of age group. The general data, epidemiology, predisposing factors, respira- tory tract infection and pathogenic spectrum of these children were compared and analyzed. Results Average age of all inpatients was 4. 25 ± 2.51 years old, the proportion of male and female was 2.06：1, and autumn was the epidemical season. 367 inpatients （92.91%） were complicated with respiratory tract infection. 113 inpatients （28.61%） had been diagnosed with asthma before hospitalization. 31 in- patients（7.89% ） were followed up with long term standardized treatment. Compared with ≥ 5 years of age group,inpatients of 〈 5 years of age group were more easily to be complicated with respiratory tract infection （χ2= 9. 856, P = 0. 007）, especially with pneumonia （χ2=9. 846,P = 0. 002）. The detection rate of respiratory syncytial virus in 〈 5 years of age group were higher than t〉 5 years of age group （χ2= 10. 870,P =0. 001 ）. But there were no significant difference between the two groups in the detection rate of mycoplasma. （χ2=3. 090,P = O. 079）. The diagnostic rate of asthma before hospitalization and rate of long term standardized follow -up treatment in 〈 5 years of age group were lower than ≥ 5 years of age group （χ2= 16. 742,P = 0. 000 ;χ2=12. 948 ,P = 0. 000）. Conclusion Respiratory tract infection, non - timely diagnosis and standard treatment were major predisposing factors for asthma exacerbation of children. 〈 5 years of age group were easily to be complicated with respiratory tract infection, especially with pneumonia and respiratory syncytial virus infection. The diagnostic rate of asthma before hospitalization and rate of long term standardized follow - up treatment were lower.