婴幼儿喘息诊治进展被引量：74

Diagnosis and treatment of infant wheezing

在线阅读下载PDF

导出

摘要婴幼儿喘息是一种异质性疾病,可分为婴幼儿暂时性喘息、非过敏性持续性喘息和过敏性喘息(即哮喘)。婴幼儿暂时性喘息主要与先天性支气管肺发育不良等因素有关,非过敏性持续性喘息主要与病毒感染引起的炎症有关,这一炎症参与的细胞主要是嗜中性粒细胞和淋巴细胞,而哮喘参与的细胞主要是嗜酸性粒细胞。婴幼儿期喘息的发作次数不是诊断哮喘的理想指标,婴幼儿期哮喘的诊断应重视过敏性疾病的遗传背景、个人过敏性疾病史、实验室过敏指标的检查及对支气管扩张剂治疗的反应。在不能明确婴幼儿喘息类型的情况下,联合应用激素、2β肾上腺素能受体激动剂、白三烯受体调节剂和组织胺H1受体阻断剂治疗是一个有效的选择。 Infant wheezing is a highly heterogeneous disease and can be divided into infant intermittent wheezing, non-allergic persistent wheezing, and allergic wheezing （so called asthma）. Infant intermittent wheezing is closely related with congenital dysplasia of bronchi or lung. Non-allergic persistent wheezing is associated with inflammation in viral infection, and neutrophils and lymphocytes are the primary cells involved in the inflammation. In asthma primary cells involved are eosinophils. Frequency of wheezing episode is not considered as an ideal index for diagnosis of asthma. Genetic background, individual medical record of allergic disease, and laboratory results are important factors in the diagnosis. When the type of wheezing is not identified, combination of eorticosteroids, β2-adrenergie receptor exeitomotor, leukotriene receptor regulator, and histamine H1 receptor blocking agent may be an effective treatment.

作者鲍一笑

机构地区上海交通大学医学院附属新华医院儿科

出处《临床儿科杂志》 CAS CSCD 北大核心 2008年第1期1-4,共4页 Journal of Clinical Pediatrics

关键词婴幼儿喘息诊断治疗 infant wheezing diagnosis treatment

分类号 R725.6 [医药卫生—儿科]

引文网络
相关文献

参考文献16

1Smith PK,Wang SZ,Dowling KD,et al.Leucocyte populations in respiratory syncytial virus-induced bronchiolitis[J].J Paediatr Child Health,2001,37(2):146-151.
2Wang SZ,Smith PK,Lovejoy M,et al.The apoptosis of neutrophils is accelerated in respiratory syncytial virus(RSV)-induced bronchiolitis[J].Clin Exp Immunol,1998,114(1):49-54.
3Bont L,Kavelaars A,Heijnen CJ,et al.Monocyte interleukin-12 production is inversely related to duration of respiratory failure in respiratory syncytial virus bronchiolitis[J].J Infect Dis,2000,181(5):1772-1775.
4Phaybouth V,Wang SZ,Hutt JA,et al.Cigarette smoke suppresses Th1 cytokine production and increases RSV expression in a neonatal model[J].Am J Physiol Lung Cell Mol Physiol,2006,290(2):L222-L231.
5Wang SZ,Rosenberger CL,Bao YX,et al.Clara cell secretory protein modulates lung inflammatory and immune responses to respiratory syncytial virus infection[J].J Immunol,2003,171 (2):1051-1060.
6Choi EH,Lee HJ,Yoo T,et al.A common haplotype of interleukin-4 gene IL4 is associated with severe respiratory syncytial virus disease in Korean children[J].J Infect Dis,2002,186(9):1207-1211.
7Taussig LM,Wright AL,Holberg CJ,et al.Tucson Children's Respiratory Study:1980 to present[J].J Allergy Clin Immunol,2003,111 (4):661-675.
8Stein RT,Martinez FD.Asthma phenotypes in childhood:lessons from an epidemiological approach[J].Paediatr Respir Rev,2004,5 (2):155-161.
9Martinez FD.Development of wheezing disorders and asthma in preschool children[J].Pediatrics,2002,109 (2 Suppl):362-367.
10Kajosaari M,Syvanen P,Forars M,et al.Inhaled corticosteroids during and after respiratory syncytial virusbronchiolitis may decrease subsequent asthma[J].Pediatr Allergy Immunol,2000,11 (3):198-202.