HOU Yue 1,2 , ZHANG Tianming 1 , LI Tongzhou 2 , HUANG Wei 3 , LIU Zhuohan 4 , WANG Hong 1
  • 1. Department of Pulmonary and Critical Care Medicine, The Second Hospital of Lanzhou University, Lanzhou, Gansu 730000, P. R. China;
  • 2. The Second Clinical Medical School, Lanzhou University, Lanzhou, Gansu 730000, P. R. China;
  • 3. Department of Pulmonary and Critical Care Medicine, Chongqing Three Gorges Medical College Affiliated People's Hospital, Chongqing 404000, P. R. China;
  • 4. Medical College of Northwest Minzu University, Lanzhou, Gansu 730000, P. R. China;
WANG Hong, Email: 1311098171@qq.com
Thunderstorm asthma; allergic asthma; climate change; artemisia pollen
10.7507/1671-6205.202504076
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Objective  To analyze the clinical characteristics of massive thunderstorm asthma (TA) patients in Lanzhou City, explore the independent risk factors for moderate-to-severe exacerbations, and provide an evidence-based basis for the prevention and management of TA. Methods  We retrospectively included 159 TA patients admitted to the outpatient and inpatient departments of the Second Hospital of Lanzhou University within 24h after the occurrence of thunderstorms on September 3, September 8, and September 27, 2024. The patients were divided into a mild group and a moderately severe group according to the severity grading criteria for acute asthma exacerbations in the Global Initiative for Asthma Control and Prevention (GINA). Logistic regression analyses were applied to compare the differences in the clinical characteristics of the two groups, and to find the independent risk factors for moderate-to-severe exacerbations. Results  A total of 159 patients were included in the study, including 67 (42.1%) males and 92 (57.9%) females, with a median age of 34 years; 106 (66.7%) cases had their first attack; 84 (52.8%) cases had a history of previous allergic diseases, and 49 (30.8%) cases had a familial history of allergic diseases. There were 115 (72.3%) patients with mild attacks and 44 (27.7%) with moderate-to-severe attacks; 111 (69.8%) patients with serum IgE positive and 91 (57.2%) patients with Artemisia pollen allergens; the baseline lung ventilation function was dominated by the normal range (32.1%) and mild obstructive pulmonary dysfunction (30.8%), and the bronchodilation test was positive in 45 cases (28.3%). Mean FEV1/FVC was 75.31%, median FEV1%pred was 90.3%, mean PEF%pred was 86.70%, median FeNO50 was 38 ppb, and FeNO50 was greater than 25 ppb in 74.8% of the patients. There was a statistically significant difference between the clinical characteristics of patients in the mild group and moderately severe group in terms of previous regular asthma treatment, first asthma exacerbation, familial history of allergic diseases, history of allergic rhinitis, visit to the clinic with wheezing as the main symptom, artemisia pollen allergy, baseline lung ventilation function grading, FEV1/FVC, FEV1%pred, PEF%pred, bronchodilation test and FeNO50. Further multifactorial logistic regression analysis showed that family history of allergic diseases, history of allergic rhinitis, visit to the clinic with wheezing as the main symptom, elevated peripheral blood eosinophil count and positive bronchodilation test were independent risk factors for the patients with moderate-to-severe exacerbations, and FEV1/FVC greater than 70% was an independent protective factor for them (P<0.05). Conclusions  Thunderstorm weather is an important environmental factor in triggering acute asthma attacks, and is closely associated with exposure of susceptible individuals to high concentrations of artemisia pollen allergens. A family history of allergic disease, previous allergic rhinitis, a visit to the doctor with wheezing as the main symptom, an elevated peripheral blood eosinophil count (>0.5×109/L) and a positive bronchodilation test are independent risk factors for patients with moderate-to-severe exacerbations, and an FEV1/FVC greater than 70% is an independent protective factor for them.

Citation： HOU Yue, ZHANG Tianming, LI Tongzhou, HUANG Wei, LIU Zhuohan, WANG Hong. Analysis of clinical characteristics and risk factors for moderate-to-severe exacerbations based on massive thunderstorm asthma events in Lanzhou City, China. Chinese Journal of Respiratory and Critical Care Medicine, 2026, 25(3): 153-162. doi: 10.7507/1671-6205.202504076 Copy

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