Hyvärinen M K, Kotaniemi-Syrjänen A, Reijonen T M, Korhonen K, Korppi M O
Department of Paediatrics, Kuopio University and Kuopio University Hospital, Kuopio, Finland.
Acta Paediatr. 2007 Oct;96(10):1464-9. doi: 10.1111/j.1651-2227.2007.00458.x.
Atopic infants hospitalized for wheezing not caused by respiratory syncytial virus (RSV) carry the highest risk for later asthma. In the present paper, early risk factors for later lung function abnormalities and for bronchial hyper-responsiveness (BHR) were evaluated in 81 children, hospitalized for bronchiolitis in infancy, at the median age of 12.3 years.
The basic data, including data on atopy in children and viral aetiology of bronchiolitis, had been collected on entry to the study at less than 2 years of age. Lung function was studied by flow-volume spirometry (FVS), and BHR by methacholine and exercise challenge tests 11.4 years after hospitalization during infancy.
RSV aetiology of bronchiolitis was associated with reduced forced vital capacity (FVC; 93.65% of predicted +/- 11.05 vs. 99.57%+/- 12.59, p = 0.009). Early sensitization to inhalant allergens (OR 12.59, 95% CI 2.30-68.77) and maternal smoking during pregnancy (OR 4.58, 95% CI 1.28-16.39) were associated with BHR to exercise, and early atopic dermatitis (OR 3.48, 95% CI 1.09-11.10) was associated with BHR to methacholine.
RSV bronchiolitis was associated with a restrictive pattern of lung function. Early atopy and maternal smoking during pregnancy may play a role in the development and persistence of BHR.
因喘息住院但非由呼吸道合胞病毒（RSV）引起的特应性婴儿日后患哮喘的风险最高。在本文中，对81名婴儿期因细支气管炎住院、中位年龄为12.3岁的儿童，评估了其日后肺功能异常和支气管高反应性（BHR）的早期危险因素。
在研究开始时，即儿童年龄小于2岁时收集了包括儿童特应性数据和细支气管炎病毒病因的数据。在婴儿期住院11.4年后，通过流速容量肺活量测定法（FVS）研究肺功能，通过乙酰甲胆碱和运动激发试验研究BHR。
细支气管炎的RSV病因与用力肺活量（FVC）降低相关（预测值的93.65%±11.05 vs. 99.57%±12.59，p = 0.009）。对吸入性过敏原的早期致敏（比值比12.59，95%可信区间2.30 - 68.77）和孕期母亲吸烟（比值比4.58，95%可信区间1.28 - 16.39）与运动诱发的BHR相关，早期特应性皮炎（比值比3.48，95%可信区间1.09 - 11.10）与乙酰甲胆碱诱发的BHR相关。
RSV细支气管炎与限制性肺功能模式相关。早期特应性和孕期母亲吸烟可能在BHR的发生和持续中起作用。
