婴幼儿喘息的分类和小儿哮喘的鉴别诊断

喘息是小儿时期常见的症状，尤其是婴幼儿。婴幼儿喘息分为三种类型：一过性的早期喘息，只发生在3岁以前的喘息。无家族的哮喘病史，与过敏原的致敏无关，与父母吸烟有关。持续性的早发的喘息，即非过敏的喘息，与病毒感染诱发有关。晚发的喘息/哮喘，即过敏性的喘息， 有湿疹和哮喘的气道病理特点。在诊断支气管哮喘前，还必须排除以下疾病：先天性气道和肺的发育异常，先天性心、血管异常，异物吸入，胃食管返流，支气管结核，纤毛不动综合征，免疫缺陷病等。

The Phenotype of Wheezing in the Younger Children and the Differential Diagnosis of the Asthma in Children

Wheeze is common in the children 5 years younger, three phenotype of wheezing has been described in the younger children. Transient early wheezing, which is often outgrown in the first 3 years,？？is often associated with prematurity and parental smoking. Children of persistent early-onset wheezing have recurrent episodes of wheezing associated with acute viral respiratory infections, and have no evidence of atopy. Those children of late-onset wheezing/asthma has asthma,which often persists throughout childhood and into adult life, and they often have an atopy background. Before the diagnosis of the asthma has been determined, the other cause of the wheezing must be excluded. These include congenital malformation causing narrowing of the intrathoracic airways, congenital heart and vascular disease, foreign body aspiration, gastroesophageal reflux, tuberculosis, primary ciliary dyskinesia,？？immune deficiency, et al.