| Objective:To investigate the incidence of recurrent acute exacerbation and the effects of pulmonary function,exhaled nitric oxide(FeNO)and allergic rhinitis on the duration of asthma remission in children with asthma,in order to reduce the incidence of recurrent acute exacerbation in asthma remission period.It provides guidance for the management and treatment of children with asthma during clinical remission.Methods: A total of 126 asthmatic children aged 4-18 years who had recurrence of asthma after the asthma remission period from June 2012 to June 2018 in the pediatric department of Dalian Children’s Hospital were selected.Using retrospective analysis methods,grouping according to different time of remission(Asthma Remission Group 1means 3 months remission,Asthma Remission Group 2 means 6 months remission,Asthma Remission Group 3 means 12 months remission,Asthma Remission Group 4 means 18 months remission),comparing whether there was any difference in lung function abnormality rate,lung function index and expiratory nitric oxide abnormal rate in each group of children in the asthma remission period,according to whether alone with Allergic rhinitis,the children was divided into groups to compare the length of remission time between the two groups,and to analyze the causes of recurrent acute asthma attack.Result:1.Among the 126 children with asthma,the minimum age was 4 years,the maximum age was 14.5 years old,and the average age was 7.21±1.72 years old.There are 44 patients in Asthma Remission Group 1,the average age was 5.06±1.12 years old;There are 29 patients in Asthma Remission Group 2,the average age was 7.08±1.62 years old;There are 29 patients in Asthma Remission Group 3,the average age was7.66±1.98 years old;There are 24 patients in Asthma Remission Group 4,the averageage was 9.02±2.17 years old;2.Among the 126 children with asthma,In Asthma Remission Group 1,5 cases of pulmonary ventilatory dysfunction,accounting for 11.4%,30 cases of small airway dysfunction,accounting for 68.2%;Asthma Remission Group 2,3 cases of pulmonary ventilatory dysfunction,accounting for 10.3%,10 cases of small airway dysfunction,accounting for 34.5%;In Asthma Remission Group 3,2 cases of pulmonary ventilatory dysfunction,accounting for 6.9%,3 cases of small airway dysfunction,accounting for10.3%;In Asthma Remission Group 4,2 cases of pulmonary ventilatory dysfunction,accounting for 8.3%,3 cases of small airway dysfunction,accounting for12.5%.Compared the abnormal rate of pulmonary ventilation function between the four groups,the difference was not statistically significant;Compared the abnormal rate of small airway function between the four groups.The rate of small airway dysfunction in Group 1 was higher than that in the other three groups,the difference was statistically significant.Compared with the indexes of lung function among the four groups,the FEF50%,FEF75% and MMEF of the Asthma Remission Group 1 were lower than the other three groups,and the difference was statistically significant;the FEV1 and FEV1/FVC of the Asthma Remission Group 1 were lower than Group 3 and Group4,and the difference was statistically significant,Group 1 compared with Group 2,the difference was not statistically significant;Comparison of FVC,PEF and FEF 25%between the four groups,the difference was not statistically significant.3.Among the 126 children with asthma,In Asthma Remission Group 1,30 cases of abnormal FeNO,accounting for 68.2%;In Asthma Remission Group 2,5 cases of abnormal FeNO,accounting for 17.2%;In Asthma Remission Group 3,4 cases of abnormal FeNO,accounting for 13.8%;In Asthma Remission Group 4,8 cases of abnormal FeNO,accounting for 33.3%;The abnormal rate of FeNO between the four groups was compared,the abnormal rate of FeNO in Asthma Remission Group 1 was higher than the other three groups,and the difference was statistically significant.4.Among the 126 children with asthma,there are 66 cases in the only asthma group,accounting for 52.4%,and 60 cases in the combined rhinitis group,accounting for47.6%;The asthma remission time in the only asthma group was longer than that in the combined rhinitis group,and the difference was statistically significant.5.Among the 126 cases of recurrent acute exacerbation of asthma,70 cases of respiratory infections,accounting for 55.6%,20 cases of self-discontinuation,accounting for 15.9%,17 cases were exposed to allergens,accounting for 13.5%,11 cases without obvious incentives,accounting for 8.7%,6 cases were affected by cold air,physical and chemical stimulation,accounting for 4.8%,2 cases of hyperventilation such as exercise,accounting for 1.6%.6.Among the 126 children with asthma,there were 44 cases in the Asthma Remission Group 1,and the recurrence rate was 34.9%;there were 29 cases in the Asthma Remission Group 2,and the recurrence rate was 23.0%;there were 29 cases in the Asthma Remission Group 3,and the recurrence rate was 23.0%;there were 24 cases in the Asthma Remission Group 4,and the recurrence rate was 19.0%;Correlation analysis between different remission time and re-acute asthma attack,the longer the asthma remission time,the fewer the number of recurrent asthma attacks,and the asthma remission time is negatively correlated with the recurrence rate of asthma.The difference was significant.Conclusion:1.The shorter the duration of remission in asthmatic children,the greater the chance of re-acute episodes,especially in the 3 months of asthma remission,the most significant chance of re-acute episodes.And the smaller the airway function and the worse FeNO in asthmatic children when they reach asthma remission,the easier it is to have a recurrence of asthma in a short period of time.2.About 50% of children with asthma remission suffer from allergic rhinitis and influence their remission time.3.The main cause of re-acute episodes in children with asthma after clinical remission is respiratory tract infection,self-discontinuation,and exposure to allergens.Parents and clinicians pay more attention to the above factors in the asthma remission period,and more standardized and individualized management to achieve better control of asthma. |
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