内蒙古呼和浩特地区儿童雷暴哮喘事件回顾性分析

Retrospective analysis of childhood thunderstorm asthma events in Hohhot,Inner Mongolia

目的:描述性分析2023年9月2日呼和浩特地区儿童雷暴天气哮喘事件的临床特征,为儿童雷暴哮喘防治提供参考。方法:通过内蒙古自治区人民医院病案信息系统查询及电话随访获取患儿病历资料,回顾性分析雷暴发生后13 h内急诊就诊量、就诊时间、主要症状、过敏性疾病史、既往哮喘病史等资料以及72 h内住院患儿呼出气一氧化氮(FeNO)、肺功能等特点,并对部分雷暴哮喘患儿进行追踪随访。结果:1.雷暴天气发生13 h内内蒙古自治区人民医院儿科急诊因哮喘急性发作就诊患儿为357例,雷暴天气开始0.5 h因哮喘就诊患儿增多,就诊高峰时间为雷暴天气开始后3~8 h。2.在13 h内急诊就诊患儿主要表现为胸闷350例(98.04%)、呼吸困难275例(77.03%)、喘息241例(67.51%),肺部可闻及肺部喘鸣音者301例(84.31%)。3.急诊患儿既往过敏性疾病史诊断为过敏性鼻炎者311例(87.11%),其中未预防性用药者216例(69.45%);诊断哮喘患儿47例(13.17%),未预防用药者34例(72.34%)。4.在72 h内累计住院患儿41例,当夜住院患儿26例(7.28%)。72 h内住院患儿哮喘急性发作病情重度及危重度10例(24.39%),外周血嗜酸性粒细胞百分比>0.05者41例(100%),血清特异性免疫球蛋白IgE>30 IU/mL者39例(95.12%),FeNO>35 ppb者24例(58.54%),肺功能为轻中度阻塞性通气功能异常29例(70.73%)。5.3个月随访到雷暴哮喘患儿199例,6个月随访到雷暴哮喘患儿151例。结论:呼和浩特地区雷暴天气开始0.5 h因哮喘就诊人数增多,高峰就诊时间为雷暴天气后3~8 h。急诊患儿以胸闷、呼吸困难及喘息为主要表现,有明显过敏性鼻炎病史,多数首次诊断为哮喘,既往诊断为鼻炎、哮喘患儿大多未规范用药。住院患儿的外周血嗜酸性粒细胞比值、FeNO、肺功能结果明显异常。需加强对雷暴哮喘患儿的长期管理。

Objective To describe and analyze the clinical characteristics of the childhood thunderstorm asthma event in Hohhot on September 2,2023,and to provide reference for the prevention and treatment of childhood thunderstorm asthma.Methods Through the medical record information system of Inner Mongolia Autonomous Region People′s Hospital and telephone follow-up,the patient′s medical records were obtained.Retrospective analysis was conducted on the emergency visits,visit time,main symptoms,history of allergic diseases,history of asthma,and the characteristics of fractional exhaled nitric oxide(FeNO)and lung function of hospitalized children within 72 hours after the occurrence of thunderstorms.Some children with thunderstorm asthma were followed up.Results(1)Within 13 hours after the thunderstorm,357 patients were admitted to the pediatric emergency department for an acute asthma attack,and the number of patients for asthma increased from 0.5 hours after the thunderstorm began,and the peak time was 3-8 hours after the thunderstorm began.(2)Within 13 hours of emergency treatment,the main manifestations of pediatric patients were chest tightness in 350 cases(98.04%),dyspnea in 275 cases(77.03%),wheezing in 241 cases(67.51%),and lung wheezing in 301 cases(84.31%).(3)Three hundred and eleven cases(87.11%)of emergency pediatric patients with a history of allergic diseases were diagnosed with allergic rhinitis,and 216 cases(69.45%)with a history of rhinitis were not treated with prophylactic medication.A total of 47 cases(13.17%)of previously diagnosed asthma patients,and 34 cases(72.34%)of them did not receive prophylactic medication.(4)Within 72 hours,a total of 41 patients were hospitalized,and 26 patients(7.28%)were hospitalized that night.Within 72 hours of hospitalization,there were 10 cases(24.39%)with severe or critical acute asthma attacks,41 cases(100%)with peripheral blood eosinophil ratio>0.05,39 cases(95.12%)with serum specific immunoglobulin IgE>30 IU/mL,24 cases(58.54%)with FeNO>35 ppb,and 29 cases(70.73%)with mild to moderate obstructive ventilation dysfunction.(5)There were 199 children with thunderstorm asthma were followed up for 3 months,and 151 children with thunderstorm asthma were followed up for 6 months.Conclusions The thunderstorm weather in Hohhot area started 0.5 hours ago due to an increase in the number of asthma patients,and the peak treatment time was 3-8 hours after the thunderstorm weather.The main symptoms of emergency children are chest tightness,difficulty breathing,and wheezing.Emergency children have a clear history of allergic rhinitis,and most of them are diagnosed with asthma for the first time.Emergency children who have previously been diagnosed with rhinitis and asthma often do not use standardized medication.The peripheral blood eosinophil ratio,FeNO,and lung function results of hospitalized children were significantly abnormal.Long term management of children with thunderstorm asthma needs to be strengthened.