Reassessing the role of tracheobronchomalacia in persistent wheezing

作者全名："Guo, Qian; Fu, Wenlong; Du, Jielin; Dai, Jihong; Geng, Gang; Yan, Li; Yang, Ting; Li, Ying; Liu, Jingyue; Chen, Jianchuan; Liu, Zheng; Yuan, Xiaoping; Deng, Dan; Tian, Daiyin"

作者地址："[Guo, Qian; Fu, Wenlong; Dai, Jihong; Geng, Gang; Yan, Li; Yang, Ting; Li, Ying; Liu, Jingyue; Chen, Jianchuan; Liu, Zheng; Yuan, Xiaoping; Tian, Daiyin] Chongqing Med Univ, Childrens Hosp,Key Lab Child Dev & Disorders,Dept, Natl Clin Res Ctr Child Hlth & Disorders,Minist E, China Int Sci & Technol Cooperat Base Child Dev &, Chongqing, Peoples R China; [Du, Jielin; Deng, Dan] Chongqing Med Univ, Res Ctr Med & Social Dev, Sch Publ Hlth & Management, Epidemiol & Hlth Stat, Chongqing, Peoples R China"

通信作者："Tian, DY (通讯作者)，Chongqing Med Univ, Childrens Hosp, Dept Resp Dis, Chongqing 400014, Peoples R China."

来源：PEDIATRIC PULMONOLOGY

ESI学科分类：CLINICAL MEDICINE

WOS号：WOS:000769554400024

JCR分区：Q1

影响因子：3.1

年份：2022

卷号：57

期号：4

开始页：976

结束页：981

文献类型：Article

关键词：asthma; bronchoscopy; tracheobronchomalacia; wheezing

摘要："Background Tracheobronchomalacia (TBM) is often manifested as wheezing. Reassessing the role of TBM in persistent wheezing in children is essential. Methods We selected children who were diagnosed with TBM by bronchoscopy and who underwent bronchoscopic reexamination for persistent wheezing or chronic cough between January 2009 and July 2019. The clinical and bronchoscopy data were collected and retrospectively reviewed. For statistical analysis, we used the Kaplan-Meier method, Kruskal-Wallis test, and Fisher exact test. Results A total of 79 patients (57 males and 22 females) were included. The median age of the first TBM diagnosis was 7 (interquartile [IQR] 4-11) months. The median age of the first wheezing episode was 4 (IQR 3-7) months. During the time interval between the two bronchoscopies, malacia lesions resolved in 50 patients (63.3%), improvement was seen in 14 patients (17.7%), no change was observed in 11 patients (13.9%), and the condition was aggravated in 4 patients (5.1%). The malacia lesions in 37 patients resolved before 2 years of age. Among the 50 resolved patients, 22 patients (44.0%) reported wheezing three times or more between bronchoscopy evaluations, and 13 of these 22 patients (59.1%) with atopy or family history of allergic diseases were ultimately diagnosed with bronchial asthma. Conclusions In children with persistent wheezing, the role of TBM should be reassessed, especially in those with atopy or family history of allergic diseases, and bronchial asthma should be considered early."

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