Duiverman E J, Jöbsis Q, van Essen-Zandvliet E E, van Aalderen W M, de Jongste J C
Academisch Ziekenhuis, Beatrix Kinderkliniek, afd. Kindergeneeskunde, sectie Kinderlongziekten, Postbus 30.001, 9700 RB Groningen.
Ned Tijdschr Geneeskd. 2003 Sep 27;147(39):1905-8.
The case history and physical examination form the corner-stones for asthma diagnosis. Establishing the correct diagnosis may be difficult in infants and preschool children; in such cases the progression of the symptoms over time is important. Routine laboratory and radiological investigations are advised against. Allergy testing may be useful in children under the age of 4 years. Lung function investigations can be used from the age of 5 to 6 years onwards. Non-invasive investigations into the degree of bronchial inflammation can be performed by measuring the fraction nitric oxide in exhaled air. House dust mite reduction is a useful measure for preventing asthma if sensitisation has been demonstrated. Breast-feeding during the first 4 to 6 months of life can be considered as a preventive measure in infants with an increased risk of developing asthma and allergy.
病史和体格检查是哮喘诊断的基石。对于婴幼儿和学龄前儿童，确立正确诊断可能存在困难；在这种情况下，症状随时间的进展很重要。不建议进行常规实验室和影像学检查。过敏测试对4岁以下儿童可能有用。肺功能检查从5至6岁起即可采用。通过测量呼出气体中的一氧化氮分数，可以对支气管炎症程度进行无创检查。如果已证实存在致敏现象，减少屋尘螨是预防哮喘的一项有效措施。对于有较高哮喘和过敏发病风险的婴儿，可将出生后头4至6个月进行母乳喂养视为一种预防措施。
