Sigurs N, Bjarnason R, Sigurbergsson F, Kjellman B
Department of Pediatrics, Borâs Central Hospital, Borâs, Sweden.
Am J Respir Crit Care Med. 2000 May;161(5):1501-7. doi: 10.1164/ajrccm.161.5.9906076.
We previously reported an increased risk for bronchial obstructive disease and allergic sensitization up to age 3 in 47 children hospitalized with a respiratory syncytial virus (RSV) bronchiolitis in infancy compared with 93 matched control subjects recruited during infancy. The aims of the present study were to evaluate the occurrences of bronchial obstructive disease and allergic sensitization in these children at age 7(1)/ (2). All 140 children reported for the follow-up, which included physical examination, skin prick tests, and serum IgE tests for common food and inhaled allergens. The cumulative prevalence of asthma was 30% in the RSV group and 3% in the control group (p < 0.001), and the cumulative prevalence of "any wheezing" was 68% and 34%, respectively (p < 0.001). Asthma during the year prior to follow-up was seen in 23% of the RSV children and 2% in the control subjects (p < 0.001). Allergic sensitization was found in 41% of the RSV children and 22% of the control subjects (p = 0.039). Multivariate evaluation of possible risk factors for asthma and sensitization using a stepwise logistic statistical procedure for all 140 children showed that RSV bronchiolitis had the highest independent risk ratio for asthma (OR: 12.7, 95% CI 3.4 to 47.1) and a significantly elevated independent risk ratio for allergic sensitization (OR: 2.4, 95% CI 1.1 to 5.5). In conclusion, RSV bronchiolitis in infancy severe enough to cause hospitalization was highly associatied with the development of asthma and allergic sensitization up to age 7(1)/ (2). The results support the theory that the RSV influences the mechanisms involved in the development of asthma and allergy in children.
我们之前报告称,与93名在婴儿期招募的匹配对照受试者相比,47名在婴儿期因呼吸道合胞病毒(RSV)细支气管炎住院的儿童在3岁前患支气管阻塞性疾病和过敏致敏的风险增加。本研究的目的是评估这些儿童在7岁时支气管阻塞性疾病和过敏致敏的发生情况(1)/ (2)。所有140名儿童均前来接受随访,随访内容包括体格检查、皮肤点刺试验以及针对常见食物和吸入性过敏原的血清IgE检测。RSV组哮喘的累积患病率为30%,对照组为3%(p<0.001),“任何喘息”的累积患病率分别为68%和34%(p<0.001)。在随访前一年,23%的RSV儿童出现哮喘,对照组为2%(p<0.001)。41%的RSV儿童存在过敏致敏,对照组为22%(p = 0.039)。对所有140名儿童使用逐步逻辑统计程序对哮喘和致敏的可能危险因素进行多变量评估,结果显示RSV细支气管炎对哮喘具有最高的独立风险比(OR:12.7,95%CI 3.4至47.1),对过敏致敏的独立风险比也显著升高(OR:2.4,95%CI 1.1至5.5)。总之,婴儿期严重到足以导致住院的RSV细支气管炎与7岁前哮喘和过敏致敏的发生高度相关(1)/ (2)。这些结果支持了RSV影响儿童哮喘和过敏发展相关机制的理论。