Abstract：
Tracheobronchomalacia (TBM) is often manifested as wheezing. Reassessing the role of TBM in persistent wheezing in children is essential.
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.
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.
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.
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.
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.
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.
摘要：
气管支气管软化症（TBM）通常表现为喘息。重新评估TBM在儿童持续喘息中的作用至关重要。
我们选择了在2009年1月至2019年7月期间经支气管镜检查诊断为TBM并接受支气管镜复查的持续性喘息或慢性咳嗽的儿童。收集并回顾性分析临床和支气管镜检查数据。为了进行统计分析，我们使用了Kaplan-Meier方法,Kruskal-Wallis测试,和Fisher精确检验。
共纳入79例患者（男57例，女22例）。首次诊断TBM的中位年龄为7个月（四分位间[IQR]4-11个月）。首次喘息发作的中位年龄为4（IQR3-7）个月。在两次支气管镜检查之间的时间间隔内，50例（63.3%）软化病变消退，14例患者(17.7%)有所改善，11例患者（13.9%）无变化，4例患者(5.1%)病情加重。37例患者的软化病变在2岁之前解决。在50名患者中，22例患者（44.0%）在支气管镜检查评估之间报告了3次或更多的喘息，22例患者中有13例（59.1%）有特应性或过敏性疾病家族史，最终诊断为支气管哮喘。
在持续喘息的儿童中，TBM的作用应该重新评估，尤其是那些有特应性或过敏性疾病家族史的人，支气管哮喘应及早考虑。
我们选择了在2009年1月至2019年7月期间经支气管镜检查诊断为TBM并接受支气管镜复查的持续性喘息或慢性咳嗽的儿童。收集并回顾性分析临床和支气管镜检查数据。为了进行统计分析，我们使用了Kaplan-Meier方法,Kruskal-Wallis测试,和Fisher精确检验。
共纳入79例患者（男57例，女22例）。首次诊断TBM的中位年龄为7个月（四分位间[IQR]4-11个月）。首次喘息发作的中位年龄为4（IQR3-7）个月。在两次支气管镜检查之间的时间间隔内，50例（63.3%）软化病变消退，14例患者(17.7%)有所改善，11例患者（13.9%）无变化，4例患者(5.1%)病情加重。37例患者的软化病变在2岁之前解决。在50名患者中，22例患者（44.0%）在支气管镜检查评估之间报告了3次或更多的喘息，22例患者中有13例（59.1%）有特应性或过敏性疾病家族史，最终诊断为支气管哮喘。
在持续喘息的儿童中，TBM的作用应该重新评估，尤其是那些有特应性或过敏性疾病家族史的人，支气管哮喘应及早考虑。
