Fainardi Valentina, Santoro Angelica, Caffarelli Carlo
Clinica Pediatrica, Department of Medicine and Surgery, University of Parma, Parma, Italy.
Front Pediatr. 2020 May 12;8:240. doi: 10.3389/fped.2020.00240. eCollection 2020.
Wheezing is very common in infancy affecting one in three children during the first 3 years of life. Several wheeze phenotypes have been identified and most rely on temporal pattern of symptoms. Assessing the risk of asthma development is difficult. Factors predisposing to onset and persistence of wheezing such as breastfeeding, atopy, indoor allergen exposure, environmental tobacco smoke and viral infections are analyzed. Inhaled corticosteroids are recommended as first choice of controller treatment in all preschool children irrespective of phenotype, but they are particularly beneficial in terms of fewer exacerbations in atopic children. Other therapeutic options include the addition of montelukast or the intermittent use of inhaled corticosteroids. Overuse of inhaled steroids must be avoided. Therefore, adherence to treatment and correct administration of the medications need to be checked at every visit.
喘息在婴儿期非常常见，在生命的前3年中，每三个儿童中就有一个受其影响。已确定了几种喘息表型，大多数取决于症状的时间模式。评估哮喘发展的风险很困难。分析了导致喘息发作和持续的因素，如母乳喂养、特应性、室内过敏原暴露、环境烟草烟雾和病毒感染。无论表型如何，吸入性糖皮质激素都被推荐为所有学龄前儿童控制治疗的首选药物，但它们在减少特应性儿童的病情加重方面特别有益。其他治疗选择包括加用孟鲁司特或间歇性使用吸入性糖皮质激素。必须避免吸入性类固醇的过度使用。因此，每次就诊时都需要检查治疗依从性和药物的正确使用情况。
