asthmatic bronchitis
Introduction
Introduction to asthmatic bronchitis Asthmatoid bronchitis, also known as asthmatic bronchitis, is an allergic disease that is often associated with respiratory infections. Patients often have a history of eczema and other allergies, especially in obese people, with a longer course of disease and a history of recurrent episodes. The trachea and bronchus of infants and young children are relatively narrow, and the surrounding elastic fibers are well developed. Therefore, the mucosa is susceptible to infection or other irritation and swelling and congestion, causing the tube to be narrow, and the secretions are sticky and difficult to cough up, thereby producing wheezing sound. basic knowledge The proportion of illness: the incidence rate is about 0.004% - 0.008% Susceptible people: no specific people Mode of infection: non-infectious Complications: bronchial asthma
Cause
Cause of asthmatic bronchitis
Infection (25%):
Factors can be caused by a variety of viral and bacterial infections, more common are syncytial virus, parainfluenza virus, influenza virus, adenovirus, rhinovirus and Mycoplasma pneumoniae. In most cases, bacterial infection can be caused on the basis of viral infection.
Anatomical features (15%):
The trachea and bronchus of infants and young children are relatively narrow, and the surrounding elastic fibers are well developed. Therefore, the mucosa is susceptible to infection or other irritation and swelling and congestion, causing the tube to be narrow, and the secretions are sticky and difficult to cough up, thereby producing wheezing sound.
Allergic constitution (20%):
Factors Infants and young children with viral infections are very many, only a small number of children with asthmatic bronchitis, suggesting that the different pathophysiological changes and clinical manifestations of the same virus in different individuals, closely related to the factors in the body, such as In recent years, it has been found that children with asthmatic bronchitis caused by syncytial virus have specific IgE antibodies. The concentration of histamine in nasopharyngeal secretions is significantly higher than that of children with the same infection without wheezing. The relatives often have allergic rhinitis. A history of allergic diseases such as measles and asthma, about 30% of children have had eczema, and serum SIgE levels are often increased.
Prevention
Breathing bronchitis prevention
According to the above section, for children with asthmatic bronchitis, attention should be paid to family and children's own allergic history, eosinophilia examination, serum IgE level, etc. If there is suspicious bronchial asthma, early prevention and treatment of asthma should be given. .
Complication
Complications of asthmatic bronchitis Complications, bronchial asthma
Complications may include bronchial asthma and the like.
Symptom
Wheezing-like bronchitis symptoms Common symptoms Cough with wheezing wheezing wheezing chemical bronchitis Allergic coughing Chronic cough in winter... Ciliated epithelial cell damage shed shrug
1, the age of onset is small, more common in children 1 to 3 years old.
2, often secondary to upper respiratory tract infection, the condition is mostly not heavy, there are low or moderate fever, only a small number of sick children appear high fever, prolonged expiration time, accompanied by wheezing sound and coarse wet rales, wheezing no obvious Paroxysmal.
3. After treatment, the above symptoms are alleviated on the 5th to 7th day.
4. Most cases of recurrence are related to infection.
5, the short-term prognosis is mostly good, the number of relapses will gradually recover by the age of 3 to 4 years old, but some cases develop into bronchial asthma after long-term development.
Examine
Asthma-like bronchitis examination
The X-ray shows various forms of infiltrates in the lungs, showing a segmental distribution, which is more common in the lungs, and some extend from the vicinity of the hilum. The lesions often dissipate after 3 to 4 weeks, and some patients have a small amount. Pleural effusion, the total number of white blood cells is normal or slightly increased, mainly neutrophils, 2 weeks after onset, about 2 / a patient positive test of condensation, titer greater than 1:32, if the titer is gradually increased At the time, it is more diagnostic. About half of the patients have positive MG agglutination test. The agglutination test is a traditional experimental method for diagnosing Mycoplasma pneumoniae infection, but its sensitivity and specificity are not ideal. Determination of serum Mycoplasma IgM antibody (enzyme-linked immunosorbent assay) The adsorption test is the most sensitive, the immunofluorescence method is strong, and the indirect hemagglutination method is more practical. It can further confirm the diagnosis and directly detect the Mycoplasma pneumoniae antigen in the specimen. It can be used for rapid clinical diagnosis, monoclonal antibody immunoblotting, nucleic acid hybridization and PCR. Technology, such as high efficiency, specific and sensitive, easy to promote, has important value for the diagnosis of Mycoplasma pneumoniae infection.
Diagnosis
Diagnostic identification of asthmatic bronchitis
Diagnostic criteria for infant asthma (scoring method), the principle of scoring by repeated authors of age <3 years old:
1, infants with bronchiolitis or wheezing-like bronchitis after repeated wheezing episodes 3 times 2 points.
2. 2 points for the wheezing in the lungs.
3, a sudden onset of wheezing symptoms 1 point.
4, the child has a history of other allergies 1 point.
5, 1 or 2 relatives have a history of eczema, dermatitis or asthma 1 point.
The above total score of >5 points to diagnose asthmatic asthmatic attacks in infants and young children, only 2 times or a total score of 4 points, the initial diagnosis of asthmatic bronchitis, and continue to follow the observation.
