2018年榆林地区56例儿童雷暴哮喘回顾性分析

Retrospective analysis on 56 children with thunderstorm asthma in Yulin,2018

目的对榆林地区56例雷暴哮喘患儿发病特征进行回顾性分析,为今后本地区小儿雷暴哮喘的预防、诊治等提供参考。方法回顾性分析2018年9月榆林市儿童医院收治的56例雷暴哮喘患儿,分析其年龄、发病季节、家族史、过敏史、血清特异性免疫球蛋白IgE、外周血嗜酸性粒细胞、肺功能及呼出气一氧化氮(FeNO)的特点。结果56例患者中,男女比例6:1,中位年龄89月;首次发病者占51.79%;有过敏性疾病史48例(85.71%),有过敏性疾病家族史14例(25.00%);血清特异性免疫球蛋白IgE阳性者49例(87.50%),过敏原为艾蒿(78.57%)、尘螨(55.36%)、霉菌(50.00%)、柏榆(35.71%)、葎草(30.36)、狗皮屑(23.21)、桑树(23.21)、矮豚草(21.43);外周血嗜酸性粒细胞百分比明显增高,其中大于5%的患儿53例(94.64%);肺功能以中、重度异常为主,且表现形式多样;FeNO明显升高,中位数为36 ppb,大于35 ppb的患儿28例(53.85%);年龄≥6岁患儿的病情重症率明显高于<6岁患儿(P<0.05)。结论雷暴哮喘发病前的雷暴天气为其诱因,年长儿多见,约半数病例为首次发作,患者有明显过敏性疾病家族史,通常病情急、症状重,呈明显群体性发病,肺功能、呼出气一氧化氮及外周血嗜酸性粒细胞明显异常。

Objective The characteristics of 56 children with thunderstorm asthma in Yulin were retrospectively analyzed,to provide evidence for prevention and treatment in this area in the future.Methods The data of 56 children with thunderstorm asthma were retrospectively analyzed,who were admitted into Yulin Children’s Hospital in September 2018.The characteristics of age,season of attack,family history,allergy history,serum specific immunoglobulin IgE(sIgE)level,peripheral blood eosinophils,lung function,and exhaled nitric oxide(FeNO)level were summarized.Results The male female ratio was 6∶1,the median age was 89 months and about 51.79%of patients underwent first attack.History of allergic diseases was shown among 48(85.71%)cases,while family history of allergic diseases was shown among 14(25.00%)cases.Positive results of sIgE were shown among 49(87.5%)cases.Allergenic allergens included Artemisia argyi pollen(50.00%),dust mites(55.36%),molds(78.57%),Cypress elm pollen(35.71%),Humulus scandens pollen(30.36%),dog dander(23.21%),Morus alba(23.21%),and Ambrosia artemisiifolia pollen(21.43%).The percentage of eosinophils of peripheral blood was significantly increased,in which 53(94.64%)cases were higher than 5%.Moderate and severe abnormal pulmonary function with varied manifestations were observed.FeNO levels were significantly increased,whose median was 36.00 ppb,while 28(53.85%)cases were higher than 35 ppb.The serious illness rate of children over 6 years-old was significantly higher than that of children under 6 years-old(P<0.05).Conclusions Attack of thunderstorm asthma can be triggered by thunderstorm weather.It is more common among older children.About half cases undergo first attack.Patients with thunderstorm asthma usually have family history of allergic diseases.The characteristics of thunderstorm asthma are sudden onset,severe symptom,and mass attacks.Pulmonary function,FeNO,and peripheral blood eosinophils are markedly abnormal.