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目的探讨儿童支气管哮喘反复发作的原因,分析其预后,为临床治疗及判断预后提供依据。方法对2005年8月至2014年7月儿科门诊、哮喘门诊诊疗的1 286例支气管哮喘患儿按生长发育特点及年龄进行分组,根据其起病情况、临床治疗效果,分析儿童哮喘的发病原因,及其自然病程及预后。结果 3岁以内婴幼儿哮喘212例,经按《支气管哮喘诊断与治疗指南》及GINA(全球哮喘防治战略)治疗方案治疗;绝大部分哮喘患儿症状得到有效控制,经随访,186例(87.74%)患儿在3岁以内未出现哮喘发作,3岁以后仍有发作者仅26例(12.26%)。3岁以上至12岁患儿共1 074例,经规范化治疗,临床症状控制率达90%以上。其中622例(57.91%)患儿在青春期后完全缓解;但452例(42.09%)儿童哮喘反复发作,部分发展为成人哮喘。其中,48例被诊断为难治性儿童哮喘中,26例(54.17%)Ig G、Ig A、Ig M总量低于4 g/L,特别是s Ig A含量明显降低。结论 3岁以内儿童哮喘与呼吸道及肺发育不全密切相关,预后良好,经规范治疗后很少发作。3~12岁儿童哮喘大部分免疫功能未成熟,反复发生呼吸道感染引发哮喘。小部分发展为成人哮喘。儿童哮喘针对性的预防措施十分重要。
Objective To investigate the causes of recurrent bronchial asthma in children and analyze their prognosis to provide evidence for clinical treatment and prognosis. Methods A total of 1 286 children with bronchial asthma from August 2005 to July 2014 were selected according to their growth and development characteristics and age. , And its natural history and prognosis. Results A total of 212 cases of asthma in infants and children aged less than 3 years were treated according to Guideline for Diagnosis and Treatment of Bronchial Asthma and GINA (global asthma prevention and treatment strategy). Most children with asthma were effectively controlled. After follow-up, 186 cases (87.74 %) Had no asthma attack within 3 years of age, and only 26 (12.26%) had hair loss after 3 years of age. A total of 1 074 cases of children over the age of 3 to 12 years old, after standardized treatment, clinical symptoms control rate of 90%. Among them, 622 (57.91%) children had complete remission after puberty; however, 452 (42.09%) children had recurrent asthma and partially developed asthma in adults. Of the 48 cases diagnosed as refractory childhood asthma, 26 (54.17%) of the total Ig G, Ig A and Ig M were less than 4 g / L, especially s Ig A was significantly decreased. Conclusion Children with asthma within 3 years of age are closely related to respiratory and pulmonary hypoplasia, with a good prognosis and few seizures after standard treatment. Most children aged 3 to 12 years with asthma immune function immature, recurrent respiratory tract infection caused by asthma. Small part of the development of adult asthma. Targeted precautions for childhood asthma are important.