Venarske Daniel L, Busse William W, Griffin Marie R, Gebretsadik Tebeb, Shintani Ayumi K, Minton Patricia A, Peebles R Stokes, Hamilton Robert, Weisshaar Elizabeth, Vrtis Rose, Higgins Stanley B, Hartert Tina V
Department of Medicine, Vanderbilt University School of Medicine, Nashville, Tennessee 37230-8300 USA.
J Infect Dis. 2006 Jun 1;193(11):1536-43. doi: 10.1086/503809. Epub 2006 Apr 27.
Although rhinovirus (RV) respiratory infections trigger asthma exacerbations, the etiologic association between this virus and severe exacerbations, as well as the clinical characteristics of adults at risk for RV-associated asthma that necessitates hospitalization, have not been established.
During 1999-2003, we conducted a cohort study of 101 adults prospectively enrolled at hospital admission for an asthma exacerbation. Patient characteristics and frequencies of RV in nasal specimens were analyzed, by reverse-transcription polymerase chain reaction (RT-PCR), at asthma-related hospital admission and at a 3-month convalescent follow-up visit.
RV was detected by RT-PCR in 21% of hospitalized patients over a 4-year period and in 1.3% of patients who returned for a 3-month follow-up visit. RV detection was strongly associated with hospitalization for asthma (adjusted odds ratio [OR], 15.1 [95% confidence interval {CI}, 1.88-121.4]). After adjustment for baseline asthma severity, RV-positive patients were more likely than RV-negative patients to be current smokers and nonusers of inhaled corticosteroids (ICSs) (adjusted OR, 11.18 [95% CI, 2.37-52.81]; P=.002).
RV respiratory infection is an etiologic agent in severe asthma exacerbations necessitating hospitalization in adults. Compared with hospitalized patients with asthma who were RV negative, RV-positive patients were significantly more likely to be smokers and nonusers of ICSs.
尽管鼻病毒（RV）呼吸道感染会引发哮喘加重，但这种病毒与严重加重之间的病因学关联，以及需要住院治疗的RV相关性哮喘成年高危患者的临床特征尚未明确。
在1999年至2003年期间，我们对101名因哮喘加重而入院的成年人进行了一项队列研究。通过逆转录聚合酶链反应（RT-PCR）分析了患者特征以及哮喘相关住院时和3个月康复随访时鼻标本中RV的频率。
在4年期间，21%的住院患者通过RT-PCR检测到RV，在3个月随访复诊的患者中这一比例为1.3%。RV检测与因哮喘住院密切相关（校正比值比[OR]，15.1[95%置信区间{CI}，1.88 - 121.4]）。在对基线哮喘严重程度进行校正后，RV阳性患者比RV阴性患者更有可能是当前吸烟者且未使用吸入性糖皮质激素（ICSs）（校正OR，11.18[95%CI，2.37 - 52.81]；P = 0.002）。
RV呼吸道感染是导致成年人严重哮喘加重并需要住院治疗的病因。与RV阴性的哮喘住院患者相比，RV阳性患者显著更有可能是吸烟者且未使用ICSs。
