6岁以下哮喘患儿长程规范治疗管理的控制稳定性分析  

Control stability analysis of long-term standardized treatment and management for children aged under 6 years with asthma

作　　者：赵莉 向莉[1] 皇惠杰 侯晓玲[1] Zhao Li;Xiang Li;Huang Huijie;Hou Xiaoling(Department of Allergy,National Center for Children′s Health,Beijing Children′s Hospital,Capital Medical University,Key Laboratory of Major Diseases in Children,Ministry of Education,China National Clinical Research Center for Respiratory Diseases,Beijing 100045,China)

机构地区：[1]国家儿童医学中心、首都医科大学附属北京儿童医院过敏反应科、儿科重大疾病研究教育部重点实验室、国家呼吸系统疾病临床医学研究中心,100045

出　　处：《国际儿科学杂志》2023年第3期210-215,共6页International Journal of Pediatrics

基　　金：国家呼吸系统疾病临床医学研究中心"呼吸专项"(HXZX-20210203,HXZX-20210204,HXZX-202107);北京市医院管理中心儿科学科协同发展中心专项经费资助项目(XTCX201818)。

摘　　要：目的评估长程规范治疗管理的6岁以下支气管哮喘(以下简称哮喘)患儿控制状态的转归情况及其控制稳定性,并分析影响控制稳定性的因素。方法采用病例登记研究,收集2014年1月至2020年12月在北京儿童医院过敏反应科进行规范治疗管理1~2年的共173例6岁以下哮喘患儿的病历资料,分别在治疗管理1年、2年时进行哮喘控制状态评价。根据患儿控制状态阶段性评价的变化对控制稳定性进行判定,分为控制稳定组和控制不稳定组,比较两组间在治疗1年、2年期的哮喘急性发作、反复呼吸道感染、肺炎、伴随疾病、致敏状态、肺功能、初始治疗级别、分娩方式、喂养方式和过敏性疾病家族史的差异性。结果共纳入173例患儿,首诊年龄3岁以下占17.9%(31/173),3~5岁占82.1%(142/173)。3岁以下患儿在治疗管理1年、2年时达到控制者分别为51.6%(16/31)、70.0%(21/30);3~5岁患儿在治疗管理1年、2年时达到控制者分别为74.6%(106/142)、76.7%(79/103)。173例患儿在治疗管理1年、2年期,控制稳定与不稳定者分别为28.9%(50/173)、71.1%(123/173)和26.3%(35/133)、73.7%(98/133)。治疗管理1年、2年期,控制稳定组哮喘急性发作者(28.0%、54.3%)均低于控制不稳定组(64.2%、72.4%),差异均有统计学意义(χ^(2)=18.768、3.889,均P<0.05)。治疗管理1年期,控制稳定组鸡蛋致敏检出率(53.1%)高于控制不稳定组(32.9%),差异有统计学意义(χ^(2)=3.921,P<0.05);控制稳定组采用2级、3级、4级初始治疗级别的比率分别为4.0%、22.0%、74.0%,控制不稳定组采用2级、3级、4级初始治疗级别的比率分别为20.3%、34.1%、45.5%,控制稳定组初始治疗级别高于控制不稳定组,差异有统计学意义(Z=-3.608,P<0.05)。治疗管理2年期,控制稳定组鸡蛋、牛奶致敏检出率(61.9%、42.9%)均高于控制不稳定组(26.2%、18.0%),差异均有统计学意义(χ^(2)=8.698、5.220,均P<0.05)。两组患儿在反复呼吸道�Objective To evaluate the outcome and stability of control statuses in children under 6 years old with bronchial asthma(abbreviated asthma)who were received long-term standardized treatment and management,and to analyze the factors affecting the control stability.Methods Using the case registration study,a total of 173 asthmatic children under 6 years old were selected from January 2014 to December 2020 in the department of allergy of Beijing Children′s Hospital.All the patients were received asthma long-term standardized treatment and management for 1 year to 2 years.Control statuses were evaluated at 1 year and 2 years follow up visits respectively.According to the changes of stage evaluations of control statuses,the control stabilities were decided,and patients were divided into stable control group and unstable control group.The parameters of exacerbation,repeated respiratory tract infection,pneumonia,concomitant diseases,allergen sensitization,pulmonary function,initial treatment level,delivery mode,feeding method and family history of allergic diseases were compared between the two groups at 1 year and 2 years respectively.Results Of the 173 patients included,17.9%(31/173)were younger than 3 years old and 82.1%(142/173)were 3 to 5 years old.After treatment and management for 1 year and 2 years,the proportions of asthma control levels assessed as good control were 51.6%(16/31)and 70.0%(21/30)respectively in the patients younger than 3 years old,and they were 74.6%(106/142)and 76.7%(79/103)respectively in the patients aged 3 to 5 years old.At 1 year and 2 years of treatment and management,the proportions of stable control and unstable control in 173 patients were 28.9%(50/173),71.1%(123/173)and 26.3%(35/133),73.7%(98/133),respectively.Asthma control stability status assessment and analysis showed that in the stable control group than that in the unstable control group,at 1 year and 2 years follow up visits,the percentages of exacerbations were lower(28.0%and 54.3%vs 64.2%and 72.4%),and the differences were

关 键 词：支气管哮喘 婴幼儿 控制 管理 

分 类 号：R725.6[医药卫生—儿科]