导致婴儿在出生后两年内易患喘息性下呼吸道感染的因素。

Factors predisposing infants to lower respiratory infection with wheezing in the first two years of life.

作者信息

Yau K I, Fang L J, Shieh K H

机构信息

Department of Pediatrics, College of Medicine, National Taiwan University, Taipei, Taiwan.

出版信息

Ann Allergy Asthma Immunol. 1999 Feb;82(2):165-70. doi: 10.1016/S1081-1206(10)62592-6.

DOI:10.1016/S1081-1206(10)62592-6

PMID:10071520

Abstract

BACKGROUND

Acute lower respiratory illness (LRI) early in life has been implicated as a factor for adverse respiratory outcomes later in life. Factors that predispose infants to LRI with wheezing have not been conclusively defined.

OBJECTIVES

This prospective study assessed factors that might contribute to LRI with wheezing in the first 2 years of life.

METHODS

Seventy-one healthy full-term infants (44 boys, 27 girls) completed the 2-year follow-up. Demographic and environmental factors were evaluated by questionnaire. Respiratory function was assessed by single occlusion technique and rapid thoracic compression technique. Both techniques were performed successfully in 40 infants at 2.6 (+/- 1.4) months old before they developed any episode of LRI.

RESULTS

Eighteen infants (25%) developed LRI with wheezing. The first episode of LRI with wheezing occurred in the first year of life in 8 infants, and in the second year of life in 10 infants. There were no significant differences in the demographic or environmental features between infants with or without wheezing LRI, or between infants who acquired LRI with wheezing in the second year of life and those who did not acquire or acquired in the first year of life. Infants from different groups did not differ in airway resistance or maximal flow at functional residual capacity. Infants who developed LRI with wheezing had higher incidence of low values for total respiratory system compliance corrected for body weight compared with those who did not (5/30 versus 6/10, odds ratio = 7.5, 95% confidence interval: 1.53 to 36.7, P = .013). None of the variables of the pulmonary function test could differentiate infants who subsequently developed LRI with wheezing in the first year of life or did not develop any episode of LRI with wheezing from those who developed LRI with wheezing in the second year of life.

CONCLUSIONS

Differences in lung function in early life may predispose infants to LRI with wheezing in the first 2 years of life.

摘要

背景

生命早期的急性下呼吸道疾病（LRI）被认为是日后出现不良呼吸结局的一个因素。导致婴儿发生喘息性LRI的因素尚未得到明确界定。

目的

这项前瞻性研究评估了可能导致生命最初2年内发生喘息性LRI的因素。

方法

71名健康足月儿（44名男孩，27名女孩）完成了为期2年的随访。通过问卷调查评估人口统计学和环境因素。采用单次阻断技术和快速胸廓按压技术评估呼吸功能。在40名婴儿2.6（±1.4）月龄且尚未发生任何LRI发作之前，这两种技术均成功实施。

结果

18名婴儿（25%）发生了喘息性LRI。8名婴儿在生命的第一年发生了首次喘息性LRI，10名婴儿在生命的第二年发生。发生或未发生喘息性LRI的婴儿之间，以及在生命第二年发生喘息性LRI的婴儿与在生命第一年未发生或发生喘息性LRI的婴儿之间，在人口统计学或环境特征方面均无显著差异。不同组的婴儿在气道阻力或功能残气量时的最大流量方面没有差异。与未发生喘息性LRI的婴儿相比，发生喘息性LRI的婴儿经体重校正后的总呼吸系统顺应性低值发生率更高（5/30对6/10，比值比=7.5，95%置信区间：1.53至36.7，P=0.013）。肺功能测试的任何变量均无法区分那些在生命第一年随后发生喘息性LRI或未发生任何喘息性LRI发作的婴儿与那些在生命第二年发生喘息性LRI的婴儿。