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Asthma in children

最后审阅: 19 Aug 2025
最后更新: 31 Jul 2025

小结

定义

病史和体格检查

关键诊断因素

  • wheezing episode triggers
  • increased work of breathing
  • features of atopic disease
  • history of response to treatment within appropriate time frame
  • family history of asthma
  • history of passive or active tobacco smoking
完整详情

其他诊断因素

  • age >3 years
  • dry nighttime cough
  • dyspnea on exertion
  • expiratory wheezing
  • chest wall deformity
完整详情

危险因素

  • allergic sensitization
  • atopic disease
  • respiratory tract infections in early life
  • serum eosinophilia
  • family history of asthma or atopy
  • gene polymorphisms and epigenetics
  • passive or active cigarette smoking
  • vaping
  • maternal smoking in pregnancy
  • abnormal lung function and airway hyperresponsiveness
  • indoor and outdoor air pollution
  • low socioeconomic status
  • pesticide exposure
  • male sex
  • obesity
  • gastroesophageal reflux disease (GERD)
  • obstructive sleep apnea (OSA)
  • assisted reproductive technologies
  • cesarean section
  • intestinal microbiota
  • acid-suppressive drug use in pregnancy and childhood
  • acetaminophen use in pregnancy
  • antibiotic use in pregnancy
完整详情

诊断性检查

首要检查

  • spirometry
  • peak expiratory flow (PEF)
  • response to bronchodilator
完整详情

需考虑的检查

  • fractional expired nitric oxide (FeNO)
  • airway challenge tests
  • exercise challenge test
  • CBC
  • sweat test
  • sputum culture
  • skin prick testing
  • chest x-ray
  • electron micrograph ciliary studies
  • chest CT
  • sinus CT
  • bronchoscopy
完整详情

新兴检查

  • bronchoalveolar lavage

治疗流程

持续性治疗

age 0 to 5 years

age 6 to 11 years

撰稿人

作者

Paul D. Robinson, MBChB, MRCPCH, FRACP, PhD, ATSF

Respiratory and Sleep Physician

Queensland Children's Hospital

Conjoint Professor

Child Health Research Centre

University of Queensland

Brisbane

Queensland

Australia

利益声明

PDR declares that he has no competing interests.

Anne Chang, MBBS, FRACP, MPHTM, PhD, FAPSR, FThorSoc, FAHMS

Professor

Respiratory and Sleep Physician

Queensland Children's Hospital

Queensland University of Technology

Brisbane

Menzies School of Health Research

Charles Darwin University

Darwin

Australia

利益声明

AC is an author of a number of references cited in this topic.

同行评议者

Kenan Haver, MD

Associate Professor of Pediatrics, Harvard Medical School

Boston Children's Hospital

Division of Pulmonary Medicine

Boston

MA

利益声明

KH receives royalties from UpToDate.

Peter Griffiths, MBChB

General Practitioner

Harborne Medical Practice

Birmingham

UK

利益声明

PG declares that he has no competing interests.

Peer reviewer acknowledgements

BMJ Best Practice topics are updated on a rolling basis in line with developments in evidence and guidance. The peer reviewers listed here have reviewed the content at least once during the history of the topic.

Disclosures

Peer reviewer affiliations and disclosures pertain to the time of the review.

参考文献

Our in-house evidence and editorial teams collaborate with international expert contributors and peer reviewers to ensure that we provide access to the most clinically relevant information possible.

关键文献

Global Initiative for Asthma. 2024 Global strategy for asthma management and prevention. May 2024 [internet publication].全文

National Institute for Health and Care Excellence. Asthma: diagnosis, monitoring and chronic asthma management (BTS, NICE, SIGN). Nov 2024 [internet publication].全文

National Institute for Health and Care Excellence. Asthma pathway (BTS, NICE, SIGN). Nov 2024 [internet publication].全文

National Heart, Lung, and Blood Institute; National Asthma Education and Prevention Program. Guidelines for the diagnosis and management of asthma. Aug 2007 [internet publication].全文

Expert Panel Working Group of the National Heart, Lung, and Blood Institute (NHLBI) administered and coordinated National Asthma Education and Prevention Program Coordinating Committee (NAEPPCC), Cloutier MM, Baptist AP, et al. 2020 focused updates to the asthma management guidelines: a report from the National Asthma Education and Prevention Program Coordinating Committee Expert Panel Working Group. J Allergy Clin Immunol. 2020 Dec;146(6):1217-70.全文  摘要

参考文献

A full list of sources referenced in this topic is available to users with access to all of BMJ Best Practice.
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