儿童迁延性细菌性支气管炎诊疗现状  

Current status of diagnosis and treatment of protracted bacterial bronchitis in children

作　　者：李娟[1] 代继宏[1] LI Juan;DAI Jihong(Department of Pneumology,Children’s Hospital of Chongqing Medical University,National Clinical Research Center for Child Health and Disorders,Ministry of Education Key Laboratory of Child Development and Disorders,Chongqing Key Laboratory of Pediatrics,Chongqing 400014,China)

机构地区：[1]重庆医科大学附属儿童医院呼吸科、国家儿童健康与疾病临床医学研究中心、儿童发育疾病研究教育部重点实验室、儿科学重庆市重点实验室,重庆400014

出　　处：《临床儿科杂志》2024年第4期373-378,共6页Journal of Clinical Pediatrics

摘　　要：迁延性细菌性支气管炎(PBB)是由细菌引起的支气管内膜持续感染性疾病。PBB是国内外儿童慢性咳嗽的主要病因。目前已有多个国家将其纳入慢性咳嗽指南并加以完善及更新。PBB的诊断包括基于临床和基于微生物学的诊断标准。现国际上推荐阿莫西林-克拉维酸钾作为治疗PBB的首选药物,当患儿对青霉素过敏或对阿莫西林-克拉维酸钾耐药时,可选择头孢类或大环内酯类抗生素。尽管2周合适抗生素治疗后咳嗽缓解是诊断PBB的关键部分,但目前最佳的抗生素疗程暂未统一。PBB的预后整体较好,但频繁复发和反复使用抗生素的情况比较常见。同时,若PBB反复发作及合并流感嗜血杆菌感染则有进展为支气管扩张的风险。目前国内对于PBB的认识起步相对较晚,在诊断及治疗方面仍有不足。因此本文主要介绍PBB的诊断及治疗现状,指出目前这一领域存在的问题,使PBB的诊治更加规范。Protracted bacterial bronchitis(PBB)is a persistent infectious disease of the bronchial intima caused by bacteria.PBB is the leading cause of chronic cough in children at home and abroad.At present,it has been included in the guidelines for chronic cough in many countries and has been improved and updated.The diagnosis of PBB includes clinical diagnostic criteria and microbiology-based diagnostic criteria.Currently,amoxicillin-clavulanate potassium is recommended as the first choice for the treatment of PBB.When children are allergic to penicillin or resistant to amoxicillin-clavulanate potassium,cephalosporins or macrolides can be selected.Although cough relief after 2 weeks of appropriate antibiotic treatment is a critical part of the diagnosis of PBB,there is currently no consensus on the optimal course of antibiotics treatment.The prognosis of PBB is generally good,but frequent recurrence and repeated antibiotic use are common.There is also a risk of progression to bronchiectasis if PBB is recurrent and associated with Haemophilus influenzae infection.Up to now,the understanding of PBB in China started relatively late,and there are still deficiencies in diagnosis and treatment.In order to standardize PBB diagnosis and therapy,this article primarily presents the current state of PBB diagnosis and treatment and highlights issues that still need to be resolved in this area.

关 键 词：迁延性细菌性支气管炎 慢性咳嗽 诊治 儿童 

分 类 号：R725.6[医药卫生—儿科]