Departamento de Pediatria, Faculdade de Medicina, Universidade Federal de Minas Gerais (UFMG), Belo Horizonte, MG, Brazil.
J Pediatr (Rio J). 2011 Jul-Aug;87(4):314-8. doi: 10.2223/JPED.2101. Epub 2011 Jul 14.
To evaluate the prevalence of corticoid utilization for the treatment of wheezing in infants less than 12 months old and to analyze factors associated with this practice.
This was a cross-sectional study that administered the validated questionnaire from the International Study on the Prevalence of Wheezing in Infants to 1,261 infants aged 12 to 15 months in Belo Horizonte, Brazil. Proportions and 95% confidence intervals were calculated and the chi-square test was used to detect associations between variables.
Six hundred and fifty-six (52%) infants, 53% male and 48.2% white, exhibited wheezing during the first year of life. Mean age at first episode was 5.11±2.89 months. There was a high rate of morbidity, with many emergency visits (71%) and hospitalizations (27.8%). Also common were a family history of asthma and atopic disease (32.2 to 71%) and exposure to passive smoking (41.5%) and to mould (47.3%). The prevalence rates for corticoid use, whether via oral route (48.7%) or inhaled (51.3%), were elevated and were higher in the group that suffered three or more episodes. Children suffering greater morbidity were more likely to be prescribed a corticoid (p < 0.05).
The high frequency of corticoid use highlights the need to establish specific criteria for the treatment of wheezing in the first years of life in order to avoid extrapolation of asthma treatments to other conditions that are transitory and self-limiting and in which using corticoids could involve more risk than benefit.
评估皮质激素治疗 12 个月以下婴儿喘息的使用率，并分析与该治疗方法相关的因素。
这是一项横断面研究，对巴西贝洛奥里藏特 12-15 个月龄的 1261 名婴儿使用了经国际婴儿喘息流行研究验证的问卷。计算了比例和 95%置信区间，并使用卡方检验来检测变量之间的关联。
656 名（52%）婴儿，53%为男性，48.2%为白人，在生命的第一年出现喘息。首次发作的平均年龄为 5.11±2.89 个月。发病率很高，有许多急诊就诊（71%）和住院（27.8%）。哮喘和特应性疾病的家族史（32.2%至 71%）以及被动吸烟（41.5%）和霉菌暴露（47.3%）也很常见。皮质激素使用的患病率，无论是口服途径（48.7%）还是吸入途径（51.3%）都很高，且在经历了 3 次或更多次发作的组中更高。患有更多疾病的儿童更有可能被处方皮质激素（p<0.05）。
皮质激素使用率高，强调需要为生命最初几年的喘息治疗制定具体标准，以避免将哮喘治疗方法外推至其他短暂和自限性的情况，在这些情况下，使用皮质激素可能弊大于利。
