98例儿童难治性哮喘临床特点分析.docVIP

精品论文 参考文献 98例儿童难治性哮喘临床特点分析 刘京涛 乔波涛 马春英 张冬梅 张君平（河南省三门峡市中心医院儿科 472000） 【中图分类号】R725.6【文献标识码】A【文章编号】1672-5085（2012）13-0066-03 【摘要】目的 探讨儿童难治性哮喘的临床特点。方法回顾性分析我院2007年1月-2010年12月诊断的难治性哮喘98例患儿进行分析。结果 98例患儿（男56例，女43例）确诊年龄最小1岁4个月，最大13岁，其中小于3岁17例（17.3%），3-5岁31例（31.6%），大于5岁50例（50.0%）。发生难治性哮喘的危险因素依次为：反复接触过敏原32例（32.7%）、治疗依从性差31例（31.6%）、反复呼吸道感染30例（30.6%）、上气道综合征15例（15.3%）、胃食管反流6例（6.1%），＜5岁儿童以治疗依从性差及反复呼吸道感染为主，＞5岁以反复接触过敏原及上气道综合征为主。42例5岁以上儿童中FEV1或PEFge;正常预期值的80%者8例（19.0%），60%-79%者18例（42.9%），＜60%者16例（38.1%）。28例患儿进行皮肤点刺过敏原检测中尘螨过敏15例（53.6%），花粉过敏10例（35.7%），食物过敏3例（10.7%）。临床表现为激素依赖型70例（71.4%）、脆性哮喘20例（20.4%）、致死性哮喘8例（8.2%）；63例（64.3%）需增加吸入激素用量，18例（18.4%）给予口服激素，17例给予静脉应用激素（17.3%）；8例发作时常伴有高碳酸血症和需要使用机械通气治疗。经规范化治疗2-4周72例（73.5%）达到控制，21例（21.4%）部分控制，5例（5.1%）未控制。结论儿童难治性哮喘由多种危险因素引起，糖皮质激素仍为DA的主要治疗手段，部分患儿发作时肺功能严重受到影响，治疗难度较大 【关键词】儿童 难治性哮喘 临床特点 Clinical characteristics of difficult-to-treat asthma in 98 cases of children LIU Jingtao QAO Botao MA Chunying ZAHNG Dongmei ZHANG Junping Department of pediatrics, Sanmenxia Central Hospital, Henan, Sanmenxia 472000, China 【Abstract】 To analysis clinical characteristics of difficult-to-treat asthma in children. Method A retrospective analysis was performed based on the clinical records，laboratory data and treatment effects which were collected from 98 difficult-to-treat asthma（DA） cases from January，2007 to December，2010. Result Of the 98 cases，56 were male and 43 female，aged from 1 year and 4 months to 13 years. The risk factors most often associated with difficult-to-control asthma were environmental exposure repeatedly（32.7%），noncompliance with treatment (31.6%), respiratory infection repeatedly(30.6%), upper airway cough syndrome (15.3%)，gastroesophageal reflux disease（6.1%）. The major risk factor were noncompliance with treatment and respiratory infection repeatedly among the cases which younger than 5 years old，and environmental exposure repeatedly and upper airway cough syndrome in which older than 5 years old. There distribution of the forced expirator