| Objective:Bronchial asthma is one of the most common chronic respiratory diseases in childhood.It is a heterogeneous disease with multi-gene genetic and environmental factors.It is a chronic inflammatory disease of airway involving multiple cells and cell components.The data of the third epidemiological survey of asthma in urban children in China show that the incidence of asthma in urban children is as high as 3.02%from September 2009 to August 2010,and the prevalence rate of asthma in the past two years is 2.32%,which is close to the level of developed countries.Acute attack of asthma will lead to emergency treatment and hospitalization of children,and even threaten the life and health of children.This study retrospectively analyzed the clinical characteristics of acute attacks of bronchial asthma in hospitalized children from 2020-2022,and summarized the clinical characteristics of children with acute attacks of bronchial asthma in Affiliated Hospital of Yan’an University,providing theoretical basis for the prevention and treatment of acute attacks of bronchial asthma in children.Methods:Clinical data of 339 hospitalized children diagnosed with acute attack of bronchial asthma admitted to the Department of Pediatrics,Affiliated Hospital of Yan’an University from January 2020 to December 2022 were retrospectively analyzed.Clinical data were collected,including the general situation of the child(age,gender,place of residence),the severity of the disease at the time of treatment,whether the family members had allergic diseases,the month and season of onset,clinical symptoms,signs,auxiliary examination,treatment and the course of the disease.SPSS25.0 statistical software was used for analysis,and the measurement data were represented by mean±standard deviation(X?S)and ANOVA.Statistical data were represented by X ~2 test and Fisher exact probability method,with P<0.05 indicating statistically significant difference.Results:This study included 339 hospitalized children with acute bronchial asthma in Yan’an from January 2020 to December 2022,including 231 males and 108 females,with a male-to-female ratio of 2.14.The youngest was 0.5 years old,the oldest was 14years old,74 cases were infantile(≤3 years old),108 cases were preschool(4-6 years old),110 cases were school age(7-10 years old)and 47 cases were puberty(11-14 years old).The cases of preschool,preschool and puberty all reached the peak in September(10.91%,8.85%,4.72%),and the number of infantile cases reached the peak in November(4.72%).And the number of cases in infancy,preschool,school-age and puberty groups was higher in autumn than in the other three seasons(8.26%,13.27%,17.60%,7.96%).The results of etiological detection in children of different ages showed that the detection rate of influenza virus in preschool and puberty was higher than that in school age,and the detection rate of mycoplasma pneumoniae infection in school age was significantly higher than that in infants(P<0.05).There was no significant difference in adenovirus,rhinovirus,mixed virus,mixed virus+Mycoplasma pneumoniae infection among different age groups(P>0.05).The results of allergen analysis in children of different ages showed that the detection rate of allergies of Artemisia artemisia+dust mites in school age was higher than that in infancy,and the detection rate of protein(milk,beef and mutton,freshwater fish,seafood)in infant was higher than that in preschool and school age.the difference was statistically significant(P<0.05).There was no significant difference in Artemisia argyi+dust,tree combination+pollen and animal fur among different age groups(P>0.05).The difference of exhaled nitricoxide(fractional exhaled nitric oxide,Fe NO)in different age groups of children with acute attack of bronchial asthma showed significant difference,and the average value of Fe NO in children after school age was higher than that before school age.There was no significant difference in Fe NO among children with acute attack of bronchial asthma of different severity.The results of comparison of complications in different age groups showed that there were significant differences in myocardial damage,non-mycoplasma infective pneumonia and mycoplasma infective pneumonia(P<0.05),and the myocardial damage in infantile group was higher than that in preschool group.Infant complicated with mycoplasma infectious pneumonia is higher than school age,pre-school age with mycoplasma infectious pneumonia is higher than school age and puberty.The incidence of mycoplasma infection pneumonia in school age was higher than that in preschool age,and there were significant differences among the five results(P<0.05).There was no significant difference in specific constitution(anaphylactic shock,allergic rhinitis,urticaria),acute upper respiratory tract infection and acute bronchitis among different age groups(P>0.05).The results showed that there were significant differences in oral Montestana chewing tablets,inhaled salbutamol sulfate aerosol and inhaled fluticasone propionate aerosol(P<0.05).The number of patients in the mild group was higher than that in the moderate and severe groups.There was no significant difference in the number of users of terbutaline sulfate atomized solution,budesonide atomized suspension and budesonide formoterol inhalation among different disease degree groups(P>0.05).The results showed that there was significant difference in the course of hospitalization and acute attack of bronchial asthma in different age groups(P<0.05).There was no significant difference between the acute attack of bronchial asthma and the course of hospitalization in children with different degrees of bronchial asthma(P>0.05).Conclusion:According to the clinical characteristics of children with acute bronchial asthma attack in the Affiliated Hospitals of Yan’an University,the following conclusions were drawn:1.Male>female(2.14:1);September and November were the peak of the incidence,and the incidence season was mainly in autumn.2.The infection of mixed virus(mainly respiratory syncytial virus)+mycoplasma pneumoniae was the main infection in infants,and the infection of mycoplasma pneumoniae was the main infection in children of early school age and after;Infants and young children are mainly allergic to protein(milk,beef and mutton,freshwater fish,seafood),and children in early school age and later are mainly allergic to mugwort,mugwort+dust mites.The results of Fe NO were correlated with age,and had no significant difference with the severity of the disease.3.The children in the infant group and the pre-school age group were mainly complicated with myocardial damage and non-mycoplasma infection,and the school age children were mainly complicated with mycoplasma pneumonia.The duration of hospitalization in children was related to age,and the duration of hospitalization in young children was longer than that in young children. |
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