[1至2岁因病毒性下呼吸道感染住院婴儿的呼吸系统疾病：一年随访]

[Respiratory diseases in infants hospitalized during the 1st 2 years of life for viral lower respiratory tract infections: a one-year follow-up].

作者信息

Giovannini M, Rossi G A, Merolla R, Arena F, Cutrera R, Dalla Casa P, D'Andrea N, Galluzzo C, Indinnimeo L, Ivaldi M, Pifferi M, Rinaldi G, Torcoletti M, Zuccotti G V

机构信息

Clinica Pediatrica Ospedale San Paolo, Università degli Studi di Milano, Milano, Italy.

出版信息

Minerva Pediatr. 2003 Apr;55(2):149-55.

PMID:12754459

Abstract

BACKGROUND

Epidemiologic data suggest strong links between hospitalisation with bronchiolitis in infancy and subsequent higher risk of developing lower respiratory tract infections (LRTI) and/or hyperreactive airway diseases. The aim of this study was to evaluate in an Italian population the natural history of respiratory diseases in children hospitalised for LRTI when they were <2 years.

METHODS

An observational, perspective, longitudinal study was performed through telephone interviews. Nine pediatric tertiary care centres participated to the study evaluating a population of 187 children, hospitalised in the previous year (November 1999-April 2000) for bronchiolitis or pneumonia when they were <2 years of age and participated to a previous study on the prevalence of infant LRTI in Italy (RADAR).

RESULTS

Twenty-three (12.3%) children had a gestational age <36 weeks. In the 12 months following the first hospitalisation, an elevated frequency of respiratory symptoms was found. Indeed, 152 (81.3%) children suffered from not-requiring-hospital-admission respiratory infections and 21 (11.2%) were hospitalized again for LRTI: 11.6% had bronchiolitis, 23.5% bronchitis and 35.2% pneumonia. In addition, 1.2% had gs;3 infectious episodes and 21.4% gs;6: 68 (36.4%) showed wheezy bronchitis and 17 (9.1%) were reported to have asthma; 132 children (71%) took antibiotics during the last year, 19.4% >3 times; 111 (59.4%) bronchodilators and 49 (26.2%) oral corticosteroids. One year after the first hospitalisation, 19 subjects (10.2%) were found to be positive to at least one class of allergens by prick test or RAST.

CONCLUSIONS

Thus, the demonstration of a high morbidity rate for LRTI, wheezing and asthma in this study group during the first year follow-up after hospital admission further support the need for prophylactic interventions to reduce the morbidity and severity of sequelae of LRTI, in particularly in premature children and/or with additional risk factors.

摘要

背景

流行病学数据表明，婴儿期因细支气管炎住院与随后发生下呼吸道感染（LRTI）和/或高反应性气道疾病的较高风险之间存在密切联系。本研究的目的是在意大利人群中评估2岁以下因LRTI住院的儿童呼吸系统疾病的自然病程。

方法

通过电话访谈进行了一项观察性、前瞻性、纵向研究。九个儿科三级护理中心参与了该研究，评估了187名儿童，这些儿童在前一年（1999年11月至2000年4月）因细支气管炎或肺炎住院，当时他们年龄小于2岁，并且参与了之前关于意大利婴儿LRTI患病率的研究（RADAR）。

结果

23名（12.3%）儿童的胎龄小于36周。在首次住院后的12个月内，发现呼吸道症状的发生率较高。事实上，152名（81.3%）儿童患有无需住院治疗的呼吸道感染，21名（11.2%）因LRTI再次住院：11.6%患有细支气管炎，23.5%患有支气管炎，35.2%患有肺炎。此外，1.2%有≥3次感染发作，21.4%有≥6次；68名（36.4%）表现为喘息性支气管炎，17名（9.1%）被报告患有哮喘；132名儿童（71%）在去年使用了抗生素，19.4%使用次数超过3次；111名（59.4%）使用了支气管扩张剂，49名（26.2%）使用了口服皮质类固醇。首次住院一年后，通过点刺试验或RAST发现19名受试者（10.2%）对至少一类过敏原呈阳性。