126例儿童支气管哮喘急性发作特点分析

Clinical Characteristics of 126 Children with Acute Attack of Bronchial Asthma

目的调查分析不同年龄支气管哮喘急性发作患儿的临床特点。方法选取某院2018年1月-2018年12月支气管哮喘急性发作患儿126例,按年龄分为3组:婴幼儿组(1岁～2岁)、学龄前组(3岁～5岁)及学龄组(6岁～14岁),比较3组患儿发病季节、过敏原检测、发病程度、过敏及特应性疾病情况、合并症发生情况的临床特点。结果哮喘程度比较,婴幼儿组重度哮喘患儿比例最高,占29.41%;合并上呼吸道感染学龄组比例最高,占44.44%;合并支气管炎及支原体感染率学龄前组最高,分别为35.38%、52.31%,差异均无统计学意义(P>0.05);婴幼儿组合并肺炎比例最高,占50.00%,学龄前组占26.15%。学龄组占25.92%,随年龄增长逐渐降低,差异有统计学意义(P<0.05);随着年龄的增加食物性过敏原逐渐减少,吸入性过敏原逐渐增多;院前诊断哮喘率随着年龄的增长逐渐增加,但差异无统计学意义(P>0.05)、而长期规范治疗学龄前组最低,婴幼儿组占44.11%,学龄组占70.37%,差异有统计学意义(P>0.05)。结论儿童支气管哮喘急性发作不同年龄临床特点不同,婴幼儿支气管哮喘急性发作程度重、合并肺炎的比例高;学龄前儿童肺炎支原体感染率高、长期规范治疗率低,应根据不同特点,早期制定治疗方案。

Objective To investigate the characteristics of acute attack of bronchial asthma in children of different ages. Methods 126 children with acute attack of bronchial asthma in our hospital between January 2018 and December 2018 were retrospectively analyzed. These patients were classified into infant group(<3 years old), preschool group(3-5 years old), and school-age group(6-14 years old) to compare the incidence season, allergen detection, severity, allergic and idiopathic diseases and complications of the three groups. Results Comparing the degree of asthma, the proportion of children with severe asthma in infant group was the highest(21.54% in preschool group, 18.52% in school age group), 44.44% in school age group with upper respiratory tract infection(23.53% in infant group, 38.46% in preschool group), 35.38% and 52.31% in preschool age group with bronchitis and mycoplasma infection(26.47% and 35.29% in infant group, respectively). The school age was 29.63% and 48.15% respectively, with no significant difference(P> 0.05);the highest proportion of infants combined with pneumonia was 50.00%(26.15% in preschool group and 25.92% in school age group), which gradually decreased with age(P<0.05);food allergens gradually decreased with age, inhalation allergens gradually increased;pre-hospital diagnosis of wheezing. The asthma rate increased with age(44.12% in infant group, 61.54% in preschool group and 66.67% in school age group), but there was no significant difference(P>0.05), while the lowest rate was found in long-term normative treatment group(44.11% in infant group and 70.37% in school age group). The difference was statistically significant(P>0.05). Conclusions The clinical characteristics of acute attack of bronchial asthma in children of different ages were different, the degree of acute attack of bronchial asthma in infants and young children was serious, and the proportion of pneumonia was high;the infection rate of Mycoplasma pneumoniae in preschool children was high, and the long-term standard treatment rate was low, so the early treatment plan should be formulated according to different characteristics.