Kwinta Przemko, Tomasik Tomasz, Klimek Małgorzata, Lis Grzegorz, Cichocka-Jarosz Ewa, Pietrzyk Jacek J
Katedra Pediatrii, Klinika Chorób Dzieci, Uniwersytet Jagielloński Collegium Medicum w Krakowie.
Przegl Lek. 2007;64 Suppl 3:118-21.
Prevalence of wheezing during infancy and pre-school age among very low birth weight (VLBW) infants is high. There is too little data to determine exactly the cause of wheezing in this group of children--it may result from early neonatal lung injury or increased susceptibility for allergic reactions.
Analysis of wheezing episodes up to 5-7 years of age in a group of VLBW infants and recognition of risk factors.
A sample of 104 children aged 5-7 years with birth weight < or = 1500g was prospectively evaluated. The standardized ISAAC (International Study of Asthma and Allergies in Childhood) protocol was used to evaluate the number and quality of wheezing episodes. Total IgE level, specific IgE, lymphocyte Th1/Th2 ratio and skin prick tests (SPT) were performed. Children were divided into 3 groups: without wheezing, with episodes of wheezing in the history (more than 12 months previously), and with persistent episodes of wheezing.
Episodes of wheezing were diagnosed in 52 (50%) cases: 27% of children showed signs of wheezing during 12 previous months and 23% of children reported wheezing only in their past history. Children with persistent wheezing presented more frequently than other groups: positive family history for atopy, allergic rhinitis, and positive allergic laboratory markers. Children with wheezing only during early infancy had bronchopulmonary dysplasia and more severe respiratory distress syndrome after birth.
Prevalence of wheezing during infancy and preschool age among VLBW infants is high. Chronic and recurrent episodes of wheezing are more directly related to atopy than derive from neonatal problems.
极低出生体重（VLBW）婴儿在婴儿期和学龄前喘息的患病率很高。目前几乎没有数据能够确切确定这群儿童喘息的原因——这可能是由于早期新生儿肺损伤或过敏反应易感性增加所致。
分析一组极低出生体重婴儿5至7岁时的喘息发作情况并识别危险因素。
前瞻性评估了104名年龄在5至7岁、出生体重≤1500g的儿童样本。采用标准化的国际儿童哮喘和过敏研究（ISAAC）方案评估喘息发作的次数和性质。检测了总IgE水平、特异性IgE、淋巴细胞Th1/Th2比值以及皮肤点刺试验（SPT）。儿童被分为3组：无喘息组、有喘息病史组（超过12个月前）和持续性喘息组。
52例（50%）诊断有喘息发作：27%的儿童在之前12个月内有喘息迹象，23%的儿童仅在过去有喘息史。持续性喘息儿童比其他组更频繁出现：有特应性疾病家族史、过敏性鼻炎以及过敏实验室指标阳性。仅在婴儿早期有喘息的儿童出生后患有支气管肺发育不良和更严重的呼吸窘迫综合征。
极低出生体重婴儿在婴儿期和学龄前喘息的患病率很高。慢性和复发性喘息发作与特应性疾病的关系比与新生儿问题的关系更直接。
