12岁以下儿童的哮喘:定义、流行病学和病理生理学
- Authors
- Gregory Sawicki, MD, MPH
Gregory Sawicki, MD, MPH
- Assistant Professor of Pediatrics
- Harvard Medical School
- Kenan Haver, MD
Kenan Haver, MD
- Assistant Professor of Pediatrics
- Harvard Medical School
- Section Editors
- Robert A Wood, MD
Robert A Wood, MD
- Editor-in-Chief — Allergy and Immunology
- Section Editor — Pediatric Allergy
- Professor of Pediatrics
- Johns Hopkins University School of Medicine
- Gregory Redding, MD
Gregory Redding, MD
- Section Editor — Pediatric Pulmonology
- Professor of Pediatrics
- University of Washington School of Medicine
- Deputy Editor
- Elizabeth TePas, MD, MS
Elizabeth TePas, MD, MS
- Senior Deputy Editor — UpToDate
- Deputy Editor — Allergy and Immunology
- Deputy Editor — Pediatrics
- Instructor in Medicine
- Harvard Medical School
- Translators
- 董琳, 主任医师
董琳, 主任医师
- 温州医科大学附属第二医院儿童呼吸科
引言
本专题对儿童期慢性哮喘的流行病学及病理生理学进行了概述。儿童期慢性哮喘的评估及治疗将单独讨论。 (参见“12岁以下儿童的哮喘:初始评估和诊断”和“12岁以下儿童哮喘:急性症状的急救治疗”和“12岁以下儿童的哮喘:使用控制药物治疗持续哮喘”)
定义
哮喘是一种慢性炎症性肺部疾病,其特点如下[1]:
●存在咳嗽、喘鸣、呼吸困难和胸闷等症状,通常与特定促发事件相关
●气道狭窄部分或完全可逆
●对多种刺激的气道反应性增高
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To continue reading this article, you must log in with your personal, hospital, or group practice subscription. For more information or to purchase a personal subscription, click below on the option that best describes you:Literature review current through: 2017-07 . | This topic last updated: 2016-10-11.The content on the UpToDate website is not intended nor recommended as a substitute for medical advice, diagnosis, or treatment. Always seek the advice of your own physician or other qualified health care professional regarding any medical questions or conditions. The use of this website is governed by the UpToDate Terms of Use ©2017 UpToDate, Inc.References- National Asthma Education and Prevention Program: Expert panel report III: Guidelines for the diagnosis and management of asthma. Bethesda, MD: National Heart, Lung, and Blood Institute, 2007. (NIH publication no. 08-4051). www.nhlbi.nih.gov/guidelines/asthma/asthgdln.htm (Accessed on December 31, 2008).
- Lai CK, Beasley R, Crane J, et al. Global variation in the prevalence and severity of asthma symptoms: phase three of the International Study of Asthma and Allergies in Childhood (ISAAC). Thorax 2009; 64:476.
- Bisgaard H, Szefler S. Prevalence of asthma-like symptoms in young children. Pediatr Pulmonol 2007; 42:723.
- American Lung Association: Trends in asthma morbidity and mortality. http://www.lung.org/finding-cures/our-research/trend-reports/asthma-trend-report.pdf.
- Akinbami LJ, Moorman JE, Liu X. Asthma prevalence, health care use, and mortality: United States, 2005-2009. National Health Statistics Reports 2011; 32:1. www.cdc.gov/nchs/data/nhsr/nhsr032.pdf.
- Asthma Attack Prevalence Percents among those with Current Asthma by Age, United States: National Health Interview Survey, 2012. http://www.cdc.gov/asthma/nhis/2012/table6-1.htm.
- Anthracopoulos MB, Pandiora A, Fouzas S, et al. Sex-specific trends in prevalence of childhood asthma over 30 years in Patras, Greece. Acta Paediatr 2011; 100:1000.
- Zilmer M, Steen NP, Zachariassen G, et al. Prevalence of asthma and bronchial hyperreactivity in Danish schoolchildren: no change over 10 years. Acta Paediatr 2011; 100:385.
- Wennergren G, Ekerljung L, Alm B, et al. Asthma in late adolescence--farm childhood is protective and the prevalence increase has levelled off. Pediatr Allergy Immunol 2010; 21:806.
- Zöllner IK, Weiland SK, Piechotowski I, et al. No increase in the prevalence of asthma, allergies, and atopic sensitisation among children in Germany: 1992-2001. Thorax 2005; 60:545.
- Osman M, Tagiyeva N, Wassall HJ, et al. Changing trends in sex specific prevalence rates for childhood asthma, eczema, and hay fever. Pediatr Pulmonol 2007; 42:60.
- Warner JO. The hygiene hypothesis. Pediatr Allergy Immunol 2003; 14:145.
- Gern JE. Viral respiratory infection and the link to asthma. Pediatr Infect Dis J 2008; 27:S97.
- Martinez FD, Morgan WJ, Wright AL, et al. Diminished lung function as a predisposing factor for wheezing respiratory illness in infants. N Engl J Med 1988; 319:1112.
- Turyk ME, Hernandez E, Wright RJ, et al. Stressful life events and asthma in adolescents. Pediatr Allergy Immunol 2008; 19:255.
- Data from National Health Interview Survey, 2006. National Center for Health Statistics. U.S. Department of Health and Human Services. Centers for Disease Control and Prevention. www.cdc.gov/asthma/NHIS/06/Data.htm (Accessed on December 16, 2008).
- Bloom B, Jones LI, Freeman G. Summary health statistics for U.S. children: National Health Interview Survey, 2012. Vital Health Stat 10 2013; :1.
- Gergen PJ, Mullally DI, Evans R 3rd. National survey of prevalence of asthma among children in the United States, 1976 to 1980. Pediatrics 1988; 81:1.
- Lipstein EA, Perrin JM, Kuhlthau KA. School absenteeism, health status, and health care utilization among children with asthma: associations with parental chronic disease. Pediatrics 2009; 123:e60.
- Weiss KB, Gergen PJ, Hodgson TA. An economic evaluation of asthma in the United States. N Engl J Med 1992; 326:862.
- Barnett SB, Nurmagambetov TA. Costs of asthma in the United States: 2002-2007. J Allergy Clin Immunol 2011; 127:145.
- Coultas DB, Samet JM. Epidemiology and natural history of childhood asthma. In: Childhood asthma: Pathophysiology and treatment, Tinkelman DG, Naspitz CK (Eds), Marcel Dekker, New York 1993. p.71.
- Clark D, Gollub R, Green WF, et al. Asthma in Jemez Pueblo schoolchildren. Am J Respir Crit Care Med 1995; 151:1625.
- Carter-Pokras OD, Gergen PJ. Reported asthma among Puerto Rican, Mexican-American, and Cuban children, 1982 through 1984. Am J Public Health 1993; 83:580.
- Gottlieb DJ, Beiser AS, O'Connor GT. Poverty, race, and medication use are correlates of asthma hospitalization rates. A small area analysis in Boston. Chest 1995; 108:28.
- Ferguson AC. Persisting airway obstruction in asymptomatic children with asthma with normal peak expiratory flow rates. J Allergy Clin Immunol 1988; 82:19.
- Akhter J, Gaspar MM, Newcomb RW. Persistent peripheral airway obstruction in children with severe asthma. Ann Allergy 1989; 63:53.
- Brown PJ, Greville HW, Finucane KE. Asthma and irreversible airflow obstruction. Thorax 1984; 39:131.
- Godfrey SG. Childhood asthma. In: Asthma, 3rd ed, Clark TJH, Godfrey SG, Lee TH (Eds), Chapman & Hall Medical, London 1992. p.551.
- Cropp GJ. Special features of asthma in children. Chest 1985; 87:55S.
- Vance VJ, Taylor WF. The financial cost of chronic childhood asthma. Ann Allergy 1971; 29:455.
- Fanta CH. Asthma. N Engl J Med 2009; 360:1002.
- Hegele RG, Hogg JC. The pathology of asthma: An inflammatory disorder. In: Severe asthma: Pathogenesis and clinical management, Szefler S, Leung DYM (Eds), Marcel Dekker, New York 1996. p.61.
- Laitinen LA, Heino M, Laitinen A, et al. Damage of the airway epithelium and bronchial reactivity in patients with asthma. Am Rev Respir Dis 1985; 131:599.
- Sobonya RE. Quantitative structural alterations in long-standing allergic asthma. Am Rev Respir Dis 1984; 130:289.
- Beasley R, Roche WR, Roberts JA, Holgate ST. Cellular events in the bronchi in mild asthma and after bronchial provocation. Am Rev Respir Dis 1989; 139:806.
- Djukanović R, Roche WR, Wilson JW, et al. Mucosal inflammation in asthma. Am Rev Respir Dis 1990; 142:434.
- Fahy JV, Liu J, Wong H, Boushey HA. Cellular and biochemical analysis of induced sputum from asthmatic and from healthy subjects. Am Rev Respir Dis 1993; 147:1126.
- Busse WW, Lemanske RF Jr. Asthma. N Engl J Med 2001; 344:350.
- Fitzpatrick AM, Teague WG, Holguin F, et al. Airway glutathione homeostasis is altered in children with severe asthma: evidence for oxidant stress. J Allergy Clin Immunol 2009; 123:146.
- Barnes PJ. The cytokine network in asthma and chronic obstructive pulmonary disease. J Clin Invest 2008; 118:3546.
- Larsen GL, Cherniack RM, Irvin CG. Pulmonary physiology of severe asthma in children and adults. In: Severe asthma: Pathogenesis and clinical management, Szefler SJ, Leung DY (Eds), Marcel Dekker, New York 1995. p.77.
- Joseph-Bowen J, de Klerk NH, Firth MJ, et al. Lung function, bronchial responsiveness, and asthma in a community cohort of 6-year-old children. Am J Respir Crit Care Med 2004; 169:850.
- Avital A, Noviski N, Bar-Yishay E, et al. Nonspecific bronchial reactivity in asthmatic children depends on severity but not on age. Am Rev Respir Dis 1991; 144:36.
- Tepper RS. Airway reactivity in infants: a positive response to methacholine and metaproterenol. J Appl Physiol (1985) 1987; 62:1155.
- Montgomery GL, Tepper RS. Changes in airway reactivity with age in normal infants and young children. Am Rev Respir Dis 1990; 142:1372.
- Tepper RS. Airway reactivity in early childhood asthma: What are the questions. Am J Respir Crit Care Med 1995; 151:S19.
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