Henderson John, Hilliard Tom N, Sherriff Andrea, Stalker Deborah, Al Shammari Nufoud, Thomas Huw M
Department of Respiratory Medicine, Bristol Royal Hospital for Children, UK.
Pediatr Allergy Immunol. 2005 Aug;16(5):386-92. doi: 10.1111/j.1399-3038.2005.00298.x.
Several epidemiological studies have reported recurrent wheezing and asthma in children after respiratory syncytial virus (RSV) bronchiolitis in infancy. The relationship with allergic sensitization is less clear and recent evidence suggests an interaction between atopy and RSV infection in the development of asthma. Data from a large, population-based, birth-cohort (Avon Longitudinal Study of Parents and Children) were used to compare outcomes of children according to whether or not they had been admitted to hospital in the first 12 months with RSV-proven bronchiolitis. Outcomes considered were 12-month prevalence of wheeze at two ages (between 30-42 and 69-81 months), cumulative prevalence of doctor-diagnosed asthma at 91 months and skin prick test defined atopy at 7 yr. Multivariable logistic regression models were used to calculate odds ratios for outcomes adjusted for potential confounders. A total of 150 infants (1.1% of the cohort) were admitted to hospital within 12 months of birth with RSV bronchiolitis. The prevalence of wheezing was 28.1% in the RSV group and 13.1% in controls at 30-42 months and 22.6% vs. 9.6% at 69-81 months. The cumulative prevalence of asthma was 38.4% in the RSV group and 20.1% in controls at 91 months. Atopy was found in 14.6% of the RSV group and in 20.7% of controls at 7 yr. RSV bronchiolitis was associated with subsequent wheezing between 30-42 (Odds ratio [95% CI] 2.3 [1.3, 3.9]) and 69-81 months (OR 3.5 [1.8, 6.6]) and with the cumulative prevalence of asthma at 91 months (OR 2.5 [1.4, 4.3]) but not with atopy (OR 0.7 [0.2, 1.7]). In a population-based birth cohort, RSV bronchiolitis was associated with subsequent wheezing and asthma but not with the development of atopy by age 7 yr.
多项流行病学研究报告称，婴儿期呼吸道合胞病毒（RSV）细支气管炎后，儿童会反复出现喘息和哮喘。其与过敏致敏的关系尚不清楚，最近的证据表明，特应性与RSV感染在哮喘发展过程中存在相互作用。来自一项大型的、基于人群的出生队列研究（阿冯父母与儿童纵向研究）的数据，被用于比较儿童的结局，这些儿童根据在出生后的前12个月内是否因经RSV证实的细支气管炎而住院。所考虑的结局包括两个年龄（30 - 42个月和69 - 81个月之间）时喘息的12个月患病率、91个月时医生诊断哮喘的累积患病率以及7岁时皮肤点刺试验确定的特应性。使用多变量逻辑回归模型计算针对潜在混杂因素调整后的结局的比值比。共有150名婴儿（占队列的1.1%）在出生后的12个月内因RSV细支气管炎住院。在30 - 42个月时，RSV组喘息患病率为28.1%，对照组为13.1%；在69 - 81个月时，分别为22.6%和9.6%。在91个月时，RSV组哮喘的累积患病率为38.4%，对照组为20.1%。在7岁时，RSV组14.6%发现有特应性，对照组为20.7%。RSV细支气管炎与30 - 42个月（比值比[95%置信区间]2.3[1.3, 3.9]）和69 - 81个月时随后的喘息（比值比3.5[1.8, 6.6]）以及91个月时哮喘的累积患病率（比值比2.5[1.4, 4.3]）相关，但与特应性无关（比值比0.7[0.2, 1.7]）。在一个基于人群的出生队列中，RSV细支气管炎与随后的喘息和哮喘相关，但与7岁时特应性的发展无关。
