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目的了解支气管哮喘(哮喘)患儿青春期前后病情缓解基本状况。方法对501例8～26岁的哮喘患者进行有关青春期前后病情缓解基本状况的问卷调查。结果 501例哮喘患者青春期后病情缓解率为67.5%(338/501例)。男性患者(66.0%)与女性患者(69.9%)缓解率比较差异无统计学意义。在青春期病情未缓解的哮喘患者哮喘首次发作年龄及末次发作年龄与缓解组比较有统计学差异(t=5.82、9.90,Pa=0.00)。8岁后哮喘发作仍频繁者(年最多发作6次以上)的病情在青春期后缓解的概率更小,与年发作<6次的患者比较差异有统计学意义(χ2=20.69,P=0.00)。变应性鼻炎症状越严重(中-重度)的哮喘患者,青春期前后的缓解率越低,与轻度或无明显鼻炎患者比较,差异有统计学意义(χ2=8.25,P=0.02)。个人高发季节在春夏秋季者在青春期前后哮喘病情缓解率更低,与高发季节在冬季的患者比较差异有统计学意义(χ2=7.71,P=0.04)。血总IgE水平越高的哮喘患者,青春期后哮喘病情缓解率越低(t=2.16,P=0.03)。规范化吸入激素联合特异性免疫治疗的哮喘患者在青春期前后缓解率较高,与吸入激素组及未规范治疗组比较,差异有统计学意义(χ2=10.25,P=0.01)。经常运动健身的哮喘患者在青春期前后缓解率更高,达75.3%,与不常运动健身的哮喘患者比较,差异有统计学意义(χ2=8.76,P=0.00)。结论青春期前后哮喘患者病情缓解率较高,哮喘首次发作年龄越大、8岁后哮喘急性发作仍频繁、并变应性鼻炎越严重以及血总IgE越高,其在青春期前后的哮喘病情越不易缓解。给予积极的干预治疗措施如特异性免疫治疗及运动健身等,能使青春期前后哮喘的缓解率提高。
Objective To understand the basic condition of pre-puberty patients with bronchial asthma (asthma). Methods A total of 501 asthmatic patients aged 8 to 26 years were asked about the basic condition of their condition before and after puberty. Results 501 patients with asthma post-puberty remission rate was 67.5% (338/501 cases). There was no significant difference in remission rates between male patients (66.0%) and female patients (69.9%). There was a significant difference in asthma asthma patients with early onset of asthma and the age of the last attack when compared with the remission group (t = 5.82, 9.90, Pa = 0.00). Patients with frequent asthma attacks after 8 years of age (with at most 6 episodes per year) had a lower chance of remission after puberty than those with <6 episodes of annual seizure (χ2 = 20.69, P = 0.00) . The more severe (moderate-severe) asthma patients with allergic rhinitis, the lower the rate of remission before and after puberty, with or without significant rhinitis patients, the difference was statistically significant (χ2 = 8.25, P = 0.02). The individual high incidence season had a lower rate of asthma exacerbation before and after puberty in spring, summer and autumn, and a statistically significant difference compared with the high season in winter (χ2 = 7.71, P = 0.04). Asthmatics with a higher serum total IgE level had a lower remission rate of asthma after puberty (t = 2.16, P = 0.03). The standardized rate of remission was higher in pre-and post-puberty asthmatic patients with asthma combined with specific immunotherapy, which was significantly different from that of inhaled hormone group and non-standard treatment group (χ2 = 10.25, P = 0.01). The rate of remission of asthma patients who exercised regularly was higher than that of adolescent children (75.3%), which was significantly different from asthmatics who did not exercise regularly (χ2 = 8.76, P = 0.00). Conclusion The pre-and post-adolescent asthma patients have a higher rate of remission, the older the first attack of asthma, the more acute asthma attack after 8 years old. The more serious the allergic rhinitis and the higher the total IgE of blood are, the harder it is to treat asthma before and after puberty ease. Given active interventions and treatments such as specific immunotherapy and exercise and fitness, can improve the rate of remission of asthma before and after puberty.