长期治疗的哮喘患者急性发作特征
2009/07/09
背景：目前未见基于日本儿童支气管哮喘治疗指南（JPGL，2005）的有关哮喘长期治疗有效性的评估报道。
方法：对2006年1月～2008年6月间因哮喘发作入院治疗的350名哮喘患儿的临床资料进行回顾性研究。根据指南要求，其中治疗超过3个月的149名患儿为长期治疗组，201名为非长期治疗组。将患儿分为3个年龄段：婴儿（100名）、初学走路的儿童（159名）和学龄儿童（91名）。
结果：初学走路儿童和上学儿童中，长期治疗组患儿的发病年龄早于非长期治疗组。学龄儿童非长期治疗组的WBC计数和CRP水平较高，显示存在某种程度的感染并发症。所有年龄段的长期治疗组患儿的哮喘严重程度大于非长期治疗组。然而，3个年龄段患儿在入院时哮喘发作的严重程度方面，长期治疗组与非长期治疗组之间未见显著差异。
结论：上述结果显示，较严重的哮喘患儿倾向于长期治疗，根据JPGL 2005对哮喘患儿进行的长期治疗能降低哮喘发作的严重程度，因为长期治疗患儿的哮喘病情严重程度与哮喘发作时的严重程度相关。
（陈欣 审校）
Pediatr Int. 2009 Mar 20. [Epub ahead of print]
Characteristics of asthma attack with long-term management for bronchial asthma
Kawahara N, Hasegawa S, Hashimoto K, Matsubara T, Ichiyama T, Furukawa S.
Background: There have been no reports on the evaluation of the usefulness of long-term asthma management based on the Japanese Pediatric Guideline for the Treatment and Management of Bronchial Asthma 2005 (JPGL 2005).
Methods: We retrospectively investigated the records of 350 patients admitted to our hospital who had asthma attacks from January 2006 to June 2008. There were 149 patients who were treated for more than 3 months in accordance with the guideline (long-term management group) and 201 who were not (non-long-term management group). We divided the patients into three age groups: 100 infants, 159 toddlers, and 91 schoolchildren.
Results: The onset age of asthma in the long-term management group was earlier than that in the non-long-term management group in toddlers and schoolchildren. The WBC counts and CRP levels were higher in the non-long-term management group in schoolchildren, suggesting the complication of some infections. The severity of asthma in the long-term management group was greater than that in the non-long-term management group among all three age groups. However there were no significant differences in the severity of asthma attack at admission between the long-term and non-long-term management groups in the three age groups.
Conclusion: These results elucidated that patients who had severe asthma tended to be treated with long-term management, and further suggest that the possibility that long-term asthma management according to JPGL 2005 may reduce the severity of asthma attack at admission, since the severity of asthma in patients undergoing long-term management correlates with the severity of asthma attack.
