早期急性中耳炎：学童急性中耳炎和呼吸道感染的预测指标？

Early acute otitis media: predictor for AOM and respiratory infections in schoolchildren?

作者信息

Bentdal Yngvild E, Karevold Gunnhild, Nafstad Per, Kvaerner Kari J

机构信息

Faculty Division of Akershus University Hospital, Department of Otorhinolaryngology, University of Oslo, Norway.

出版信息

Int J Pediatr Otorhinolaryngol. 2007 Aug;71(8):1251-9. doi: 10.1016/j.ijporl.2007.04.017. Epub 2007 Jun 7.

DOI:10.1016/j.ijporl.2007.04.017

PMID:17559950

Abstract

OBJECTIVE

It has been reported that acute otitis media (AOM) and respiratory infectious morbidity still are common in schoolchildren. However, the significance of early initiation of AOM on later respiratory infections is not known. The aim of the study was to assess whether early initiation of AOM is a predictor for AOM and other respiratory infections in schoolchildren, and if environmental exposures and host factors in early life predict later AOM.

METHODS

A population-based, prospective study of 3754 children born in Oslo in 1992/93, of which 2549 children were followed from birth to 10 years. Main outcome measures were questionnaire-based information on AOM and other respiratory infections at ages 6 months, 1 year and 10 years.

RESULTS

Of the 190 (5.3%) children with one or more episodes of AOM before 6 months, 97 (51.1%) remained susceptible the next 6 months. The total number of children with one or more episodes of AOM from 6 to 12 months was 812 (25.1%). Of the 336 (13.2%) with AOM at 10, 95 (28.3%) also had AOM the first year of life. One or more episodes of tonsillopharyngitis or lower respiratory infections were experienced in 624 (24.4%) of the children at 10 years. There was a predominance of boys with AOM the first year of life, while girls were more prone to AOM at age 10. AOM the first year of life was not strongly associated with AOM at age 10 with crude and adjusted odds ratios 1.3 (95% CI 1.0-1.6) and 1.2 (95% CI 0.9-1.5), respectively. A corresponding tendency was found for other respiratory infections (tonsillopharyngitis or lower respiratory infections) at age 10. Tobacco smoke exposure at birth, early life atopic eczema and otitis media surgery increased the risk of AOM at age 10.

CONCLUSIONS

We found no strong association between early AOM and AOM and other respiratory infections in schoolchildren. Parental smoking at birth, early life atopic eczema and female gender were only weakly associated with AOM in 10-year olds while otitis media surgery was strongly associated with AOM in schoolchildren.

摘要

目的

据报道，急性中耳炎（AOM）和呼吸道感染性疾病在学童中仍然很常见。然而，AOM早期发病对后期呼吸道感染的影响尚不清楚。本研究的目的是评估AOM早期发病是否是学童AOM和其他呼吸道感染的预测因素，以及早期生活中的环境暴露和宿主因素是否能预测后期的AOM。

方法

对1992/93年在奥斯陆出生的3754名儿童进行了一项基于人群的前瞻性研究，其中2549名儿童从出生到10岁进行了随访。主要观察指标是基于问卷的6个月、1岁和10岁时AOM和其他呼吸道感染的信息。

结果

在6个月前有一次或多次AOM发作的190名（5.3%）儿童中，97名（51.1%）在接下来的6个月内仍易患AOM。6至12个月时有一次或多次AOM发作的儿童总数为812名（25.1%）。在10岁时患有AOM的336名（13.2%）儿童中，95名（28.3%）在生命的第一年也患有AOM。10岁时，624名（24.4%）儿童经历过一次或多次扁桃体咽炎或下呼吸道感染。生命第一年患AOM的男孩居多，而10岁时女孩更容易患AOM。生命第一年的AOM与10岁时的AOM没有强烈关联，粗比值比和调整后的比值比分别为1.3（95%CI 1.0-1.6）和1.2（95%CI 0.9-1.5）。10岁时其他呼吸道感染（扁桃体咽炎或下呼吸道感染）也有相应趋势。出生时接触烟草烟雾、早期特应性皮炎和中耳炎手术增加了10岁时患AOM的风险。