212例儿童哮喘预后的5年随访研究

Prognosis of 212 children with asthma: a 5-year follow-up study

摘要:

目的：探讨儿童哮喘转归和影响发病与预后的因素。方法：对随访5年以上的212例哮喘儿童资料进行回顾性分析。 结果：5年随访中，哮喘停止发作121例（57.1%），哮喘持续91例（42.9%）。哮喘急性发作的主要诱因为呼吸道感染（71.7%），其次是过敏原吸入（17.0%）。由呼吸道感染诱发的哮喘患儿（61.2%）较由过敏原（41.7%)或运动（26.3%）诱发者缓解率高（P＜0.05）。湿疹合并过敏性鼻炎、父母哮喘、过敏原诱发的喘息是发展成持续性哮喘的3个危险因素。结论：5年以上的随访中大部分哮喘患儿停止发作。呼吸道感染是儿童哮喘急性发作的主要诱因。由呼吸道感染诱发的哮喘转归较好。特应质及有特应质遗传背景的患儿更有可能发展成持续性哮喘。

Abstract:

OBJECTIVE: To study the prognosis of childhood asthma and the factors influencing asthmatic attacks and prognosis. METHODS: The medical data of 212 children with asthma who were followed up for more than 5 years were retrospectively studied. RESULTS: During the 5-year follow up, asthmatic attacks termination was found in 121 cases (57.1%) and asthma persistence was observed in 91 cases. Respiratory tract infections were found as the major factors inducing asthmatic attacks (71.7%), followed by inhaled allergens (17.0%).The children with asthma induced by respiratory tract infections had a higher remission rate of asthmatic attacks (61.2%) than those induced by allergens (41.7%) or exercises (26.3%). Three risk factors for asthma persistence were identified: concurrent allergic rhinitis and eczema, parental asthma and allergy-induced wheezing. CONCLUSIONS: The 5-year follow-up study demonstrated that asthmatic attacks stopped in the majority of children with asthma. Respiratory tract infections may be the major factors inducing acute asthma attacks. The children with asthma induced by respiratory infections may experience a better outcome. Atopic children or children with the genetic background of atopy are at high risks for the development of persistent asthma.