Chang Anne B, Clark Ron, Acworth Jason P, Petsky Helen L, Sloots Theo P
Queensland Children's Respiratory Centre, Royal Children's Hospital, Brisbane, Queensland, Australia.
Pediatr Infect Dis J. 2009 Apr;28(4):290-4. doi: 10.1097/INF.0b013e31819067b1.
: Viral respiratory illness triggers asthma exacerbations, but the influence of respiratory illness on the acute severity and recovery of childhood asthma is unknown. Our objective was to evaluate the impact of a concurrent acute respiratory illness (based on a clinical definition and PCR detection of a panel of respiratory viruses, Mycoplasma pneumoniae and Chlamydia pneumoniae) on the severity and resolution of symptoms in children with a nonhospitalized exacerbation of asthma.
: Subjects were children aged 2 to 15 years presenting to an emergency department for an acute asthma exacerbation and not hospitalized. Acute respiratory illness (ARI) was clinically defined. Nasopharyngeal aspirates (NPA) were examined for respiratory viruses, Chlamydia and Mycoplasma using PCR. The primary outcome was quality of life (QOL) on presentation, day 7 and day 14. Secondary outcomes were acute asthma severity score, asthma diary, and cough diary scores on days 5, 7, 10, and 14.
: On multivariate regression, presence of ARI was statistically but not clinically significantly associated with QOL score on presentation (B = -0.36, P = 0.025). By day 7 and 14, there was no difference between groups. Asthma diary score was significantly higher in children with ARI (B = 0.41, P = 0.039) on day 5 but not on presentation or subsequent days. Respiratory viruses were detected in 54% of the 78 NPAs obtained. There was no difference in the any of the asthma outcomes of children grouped by positive or negative NPA.
: The presence of a viral respiratory illness has a modest influence on asthma severity, and does not influence recovery from a nonhospitalized asthma exacerbation.
病毒性呼吸道疾病会引发哮喘急性发作，但呼吸道疾病对儿童哮喘急性严重程度及恢复的影响尚不清楚。我们的目的是评估并发急性呼吸道疾病（基于临床定义以及对一组呼吸道病毒、肺炎支原体和肺炎衣原体进行聚合酶链反应检测）对非住院哮喘急性发作患儿症状严重程度及缓解情况的影响。
研究对象为2至15岁因急性哮喘发作到急诊科就诊且未住院的儿童。急性呼吸道疾病（ARI）通过临床定义。使用聚合酶链反应对鼻咽抽吸物（NPA）进行呼吸道病毒、衣原体和支原体检测。主要结局指标为就诊时、第7天和第14天的生活质量（QOL）。次要结局指标为第5、7、10和14天的急性哮喘严重程度评分、哮喘日记及咳嗽日记评分。
多变量回归分析显示，ARI的存在与就诊时的QOL评分在统计学上有显著关联，但在临床上无显著差异（B = -0.36，P = 0.025）。到第7天和第14天，两组之间无差异。第5天，ARI患儿的哮喘日记评分显著更高（B = 0.41，P = 0.039），但就诊时及随后几天无差异。在获取的78份NPA中，54%检测到呼吸道病毒。NPA检测结果为阳性或阴性的儿童在任何哮喘结局方面均无差异。
病毒性呼吸道疾病的存在对哮喘严重程度有一定影响，但不影响非住院哮喘急性发作的恢复。
