儿童支气管哮喘诊断的几点思考

支气管哮喘（以下简称哮喘）是小儿常见的慢性气道疾病。5岁及以下儿童哮喘的诊断极为困难，是富有挑战性的；因为诊断只能依靠临床判断、症状评价和体征分析。病毒感染所至的喘息在婴幼儿期很常见，与哮喘鉴别较困难。目前还没有诊断婴幼儿期哮喘的特异检测手段和方法，因此诊断需要综合考虑，包括反复喘息的类型、特异体质病史、哮喘危险因素、长期随访、广泛鉴别诊断和观察对支气管舒张剂及抗炎治疗的反应。

The Strategy of Early Diagnosis of Asthma in Infants and Children

Bronchial asthma is one of the most common chronic disorders in airways for childhood. Diagnosis of asthma in children 5 years and younger presents a particularly difficult problem. The diagnosis of asthma in early childhood is challenging and has to be based largely on clinical judgment and an assessment of symptoms and physical findings. Wheezing in infants and children is extremely common, most episodes occur following viral infections especially in younger children.There are no specific diagnostic tools or surrogate markers for detecting asthma in infancy, therefore, many factors should consider, include the patterns of recurrent wheeze, history of atopy, risk factor of asthma,long-term follow-up, consideration of the extensive differential diagnoses, observing the child’s response to bronchodilator and/or anti-inflammatory treatment.