Clinical Features Of 24 Children Asthma With Protracted Bacterial Bronchitis In Children By Follow-up Study

Objective:To analyze the clinical characteristics of asthma with protracted bacterial bronchitis(PBB)in children.Methods:The clinical data of asthma with PBB diagnosed from June 2015 to December 2019 were analyzed retrospectively.And the patients were followde up to record cough relapse.Results:Asthma with PBB in 24 patients,the ratio of boy and girl was 7:5,the median age were 4 years and 2 months(2 years and 10 months,5 years and 11 months),most of them were preschoolers.50.0%(12/24)had wheezing,50.0%(12/24)could hear wheezing and rough wet rales.40.0%(2/5)Chest X ray/19.0%(4/21)chest CT showed increased and thickened lung texture,airway remodeling showed tracheobronchial type in 6.7%(1/15).Sinusitis and allergic rhinitis were seen in 79.2%(19/24).The pulmonary function mainly showed obstructive airway dysfunction,and bronchodilation test was positive in all patients,Bronchoscopy showed a chronic bronchitis accompanied with superior secretions in all patients,in which 62.5%(15/24)showed a purulent bronchitis,4.2%(1/24)were considered tracheobronchial type.BALF routine showed that neutrophils increased significantly,and the proportion of phagocytes decreased.The order of bacterial detection in BALF was as follows:There were 11 cases Haemophilus influenzae,9 cases Streptococcus pneumoniae,2 case Moraxella catarrhalis,2 case Pseudomonas aeruginosa,and 1 case Burkholderia cepacia.All patients had cough remission after 20.5(16,31.5)days of antibiotics therapy.2 case had a recurrent PBB,and 1 patient improved to irreversible bronchiectasis by 1 year and 3 months to 5 year and 9 months follow-up.Conclusions:Asthma with PBB in children,which is more common in preschool children.Persistent wet cough is the main feature and patients may be accompanied by wheezing.Bronchoscopy can detect chronic bronchitis with superior secretions,which is often be purulent.On the basis of anti-asthma treatment,appropriate anti-infection treatment is effective,but some patients may experience recurrent PBB,which even make progress to bronchiectasis.