Diagnosis of asthmaThe diagnosis of asthma is usually based on the patient's symptoms and history (Table 1).Table 1 is this asthma?As long a
Diagnosis of asthma
The diagnosis of asthma is usually based on the patient's symptoms and history (Table 1).
Table 1 is this asthma?
As long as any of the following symptoms and signs, should consider asthma:
- breathing exhale appear high pitched, wheezing, especially in children (physical examination of the chest normal cannot exclude asthma)
Not have any of the following history:
Cough, especially at night
Recurrent chest tightness
- or aggravated symptoms at night, to wake the patient
- or aggravated symptoms with seasonal
- eczema, hay fever, asthma and other allergic diseases or family history
- contact following material after the onset of symptoms or symptoms
Human chemical substances
And house dust mite
Drugs (aspirin, receptor blockers)
Respiratory tract (virus) infection
Severe mood swings
In response to the treatment of asthma symptoms
In patients with cold, or "deep chest" more than 10 d are needed to heal lung function measurement can be reversible, variability assessment of asthma severity and airflow limitation, helps to establish the diagnosis of asthma. Respiratory flow measurement is recommended for the determination of airflow limitation and reversibility to identify the diagnosis of asthma.
After giving bronchodilator agent, FEV. The increase is more than 12% (or = 200 mL) revealed reversible airflow limitation, which is in line with the characteristics of asthma (but the majority of patients with asthma and not every detection showed reversible, therefore recommended to repeat the test).
Maximal expiratory flow (PEF) measurement can provide a very important help in the diagnosis and monitoring of asthma.
PEF assay had better use the patient's own peak flow meter, and his / her previous best value comparison.
- suction bronchodilator PEF increased after 60 L / min (or a bronchodilator before the increase of more than 20% days), or the variation rate of more than 20% (reading, 2 times a day more than 10%), suggesting the diagnosis of asthma.
Other diagnostic tests:
For patients with symptoms consistent with asthma, but with normal lung function, airway responsiveness to methacholine, histamine, mannitol, or exercise may be helpful in the diagnosis of asthma.
- allergen skin test, serum specific I or if detection of allergic asthma diagnosis, increased possibility, this test also helps to determine individual risk factors in patients with asthma symptoms.
In cough variant asthma: some asthma patients with chronic cough (nocturnal frequent) as the main or even the only symptom. It is particularly important for these patients to have a clear indication of pulmonary function variability and airway hyperresponsiveness.
- exercise bronchoconstriction: for most patients with asthma, physical activity is an important cause of asthma symptoms, some patients (including many children) is probably the only reason. Exercise test (8 minutes running) can establish a clear diagnosis of asthma.
In children under the age of 5 for infants and young children, not all are wheezing asthma. For the children of this age group, the diagnosis of asthma is mostly based on clinical judgment. Please refer to the pocket guide for asthma management and Prevention
- the elderly asthma: due to a variety of factors, such as the symptom perception difference, the dyspnea as elderly "normal" performance on the health status and activity of the expected value decreased, and so on, the diagnosis and treatment of asthma in the elderly is more complex. The differential diagnosis of asthma and COPD is particularly difficult and may require experimental treatment.
- occupation asthma: the workplace for asthma is often missed. The diagnosis requires a clear history of exposure to occupation of irritating substances; no symptoms of asthma before engaging in the occupation; there is a clear relationship between the symptoms and the workplace (leaving the workplace symptoms back to the workplace, symptoms).