目的 分析哮喘急性发作期住院患儿的临床特点，为哮喘诊治提供临床参考。方法 回顾性分析2011年1月至2021年6月重庆医科大学附属儿童医院呼吸中心收治的支气管哮喘患儿的临床资料。结果 纳入支气管哮喘患儿900例，男615例、女285例，中位年龄2.3（1.3~3.9）岁。婴幼儿期559例、学龄前期246例、学龄期92例，不同年龄组男性比例、确诊时间分布差异均有统计学意义（P<0.05），婴幼儿组男性比例较高，首诊确诊比例较高。入院后首次诊断为哮喘的患儿比例为63.5%。因轻度哮喘急性发作入院患儿占76.6%，其中婴幼儿较多（475例，52.8%），其次为学龄前期患儿（180例，20.0%）。900例患儿中，501例（55.7%）痰培养检出致病菌，肺炎链球菌比例最高（26.9%），其次为卡他莫拉菌、流感嗜血杆菌。4种病毒（呼吸道合胞病毒、腺病毒、流感病毒、副流感病毒）检出阳性率为25.0%，其中呼吸道合胞病毒检出率最高（16.3%）。不同年龄组间哮喘合并过敏性鼻炎或鼻窦炎比例的差异有统计学意义（P<0.01）。共224例患儿行过敏原特异性IgE（sIgE）检测，119例次（53.1%）吸入性过敏原阳性，76例次（33.9%）食源性过敏原阳性；尘螨阳性比例最高（27.7%），其次为屋尘（8.9%）。不同年龄组间大部分吸入性过敏原（如尘螨、屋尘、猫狗毛、树组合、桑树等）阳性率差异有统计学意义（P<0.05）。结论 轻度哮喘急性发作是<6岁哮喘患儿最主要的住院原因，大部分患儿为首诊确诊哮喘。呼吸道感染是哮喘急性发作最主要诱发因素。应重视哮喘患儿过敏原筛查与过敏性鼻炎防治。

Objective To analyze the characteristics of hospitalized children with asthma exacerbation, and provide clinical reference for the diagnose and treatment of asthma. Methods Clinical data of children with bronchial asthma admitted to the Respiratory Center of Children's Hospital of Chongqing Medical University from January 2011 to June 2021 were retrospectively analyzed. Results 900 children were enrolled in the study, including 615 boys and 285 girls, with a median age of 2.3 (1.3-3.9) years. In the study, 559 toddlers, 246 preschool children, and 92 school-age children were enrolled, and significant differences were found in the proportions of boys and in the time distribution of initial diagnosis as asthma among the three age groups (P<0.05). The proportion of children first diagnosed with asthma after admission was 63.5%. The percentage of children admitted for mild acute asthma attacks was 76.6%, with more infants (475 cases, 52.8%) followed by preschool children (180 cases, 20.0%). Among 900 children, 501 (55.7%) had pathogenic bacteria detected by sputum culture, with the highest proportion of Streptococcus pneumoniae (26.9%), followed by Moraxella catarrhalis and Haemophilus influenzae. The positive proportion of four viruses detected in the study, including respiratory syncytial virus, adenovirus, influenza virus, parainfluenza virus, was 25.0%, and of which respiratory syncytial virus had the highest detection rate (16.3%). The difference in the proportions of asthma children combined with allergic rhinitis or sinusitis among the three age groups was statistically significant (P < 0.01). A total of 224 children were tested for allergen sIgE, of which 119 children (53.1%) were positive for inhalant allergens and 76 children (33.9%) were positive for foodborne allergens. Dust mite (27.7%) was the most important allergens, followed by house dust (8.9%). There were significant differences in the positive rates of most inhalant allergens (e.g., dust mite, house dust, cat and dog hair, tree allergens, mulberry, etc.) between the three age groups (P < 0.05). Conclusions Mild acute asthma attacks was the most important cause for hospitalization in children under 6 years old with asthma being firstly diagnosed after admission. Respiratory tract infection was the most important trigger of acute exacerbation of asthma. For children with asthma, allergen screening and allergic rhinitis prevention and treatment should be emphasized.