| Objective: The clinical characteristics and risk factors of 438 children hospitalized with acute bronchial asthma attacks in Gansu Provincial Maternal and Child Health Hospital were analyzed to provide clinical guidance for timely control of asthma attacks and mitigation of recurrent attacks.Methods: The clinical data of children hospitalized for acute bronchial asthma exacerbation in Gansu Provincial Maternal and Child Health Hospital from 01 January 2017 to31 December 2021 were retrospectively collected.They were divided into infant group(0<age<3 years),preschool group(3≤age<6 years)and school age group(6≤age<14 years)according to age,and clinical characteristics such as respiratory pathogens and distribution of serum allergens in different age groups were analyzed.Children<6 years of age were divided into 2 groups of mild and severe according to their severity,and children≥6 years of age were divided into 4 groups of mild,moderate,severe and critical,to analyse the risk factors for acute asthma attacks of different severity in different age groups.Results:(1)A total of 438 children were included in this study,including 314 males and124 females,96 infants,190 preschoolers and 152 school-age groups.The preschoolers accounted for the highest proportion,43.38%.(2)The highest incidence of acute asthma attack occurred in autumn(185 cases(42.24%),followed by summer(128 cases(29.22%),spring(79cases(18.04%),and winter(at least 46 cases(10.50%),with the peak in September.(3)The virus detection rate decreased with the increase of age,and the difference between groups was statistically significant(P<0.05).Mycoplasma was the main pathogen detected in the three groups,and there was no statistical significance between the groups.The detection rate of RSV and influenza virus in spring was significantly higher than that in other seasons,and the difference was statistically significant(P<0.05).(4)Among the inhalant allergens,the positive rates of house dust,cat dander,mugwort,mold,brassweed/pigweed,tree combination and humulus scandens increased with age,and the differences among age groups were statistically significant(P<0.05).In ingestion allergens,the positive rate of milk,beef and egg in infant group and preschool group was higher than that in school age group,and the difference was statistically significant(P < 0.05).The positive rate of house dust was statistically significant between different sex groups(P<0.05),but there was no statistically significant difference between other allergen groups(P > 0.05).(5)With the increase of age,the proportion of children with acute asthma attack with respiratory tract infection gradually decreased,and the proportion of self-dose reduction/drug withdrawal and history of allergy gradually increased,with statistical significance among different age groups(P<0.05).In children <6 years old,combined respiratory tract infection,allergic history,and self-dose reduction/withdrawal were associated with severe asthma attack(P<0.05).Children ≥6 years old with respiratory tract infection and self-dose reduction/withdrawal were associated with more severe acute asthma attacks(P<0.05).(6)The duration of hospitalization in the group with respiratory tract infection was higher than that in the group with acute attack of asthma alone(P<0.05).The length of hospital stay of patients treated with antibiotics in acute asthma attack group was higher than that in group without antibiotics,and the difference was statistically significant(P<0.05).Conclusions:1.Autumn is the season with the highest incidence of acute asthma attacks,with the peak in September.2.The infants and preschoolers mainly had ingestion allergens such as milk,beef and eggs,while the school-age group mainly had ingestion allergens such as mugwort and tree combination.3.Respiratory infections are the leading cause of acute asthma attacks in children of all ages.Children with asthma<6 years old should pay attention to avoid respiratory tract infection,and children with asthma≥6 years old should pay attention to the effect of irregular use of asthma control drugs on acute asthma attack.4.Irrational use of antibiotics can prolong hospital stays. |
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