Dept of Paediatrics, Sapienza University Rome, Viale Regina Elena 324, 00161 Rome, Italy.
Eur Respir J. 2012 Feb;39(2):396-402. doi: 10.1183/09031936.00188210. Epub 2011 Aug 18.
The association between bronchiolitis and recurrent wheezing remains controversial. In this prospective study, we assessed risk factors for recurrent wheezing during a 12-month follow-up in 313 infants aged <12 months hospitalised for their first episode of bronchiolitis. Demographic, clinical and laboratory data were obtained with a questionnaire and from medical files. A total of 14 respiratory viruses were concurrently assayed in nasal washings. Parents were interviewed 12 months after hospitalisation to check whether their infants experienced recurrent wheezing. The rate of recurrent wheezing was higher in infants with bronchiolitis than in controls (52.7 versus 10.3%; p<0.001). Multivariate analysis identified rhinovirus (RV) infection (OR 3.3, 95% CI 1.0-11.1) followed by a positive family history for asthma (OR 2.5, 95% CI 1.2-4.9) as major independent risk factors for recurrent wheezing. In conclusion, the virus most likely to be associated with recurrent wheezing at 12 months after initial bronchiolitis is RV, a viral agent that could predict infants prone to the development of recurrent wheezing.
毛细支气管炎与反复喘息之间的关联仍存在争议。在这项前瞻性研究中,我们评估了 313 名因首次毛细支气管炎住院的<12 个月大婴儿在 12 个月随访期间反复喘息的危险因素。通过问卷调查和病历获得人口统计学、临床和实验室数据。同时对鼻洗液进行了 14 种呼吸道病毒检测。住院 12 个月后,对父母进行访谈以检查其婴儿是否反复出现喘息。毛细支气管炎患儿的反复喘息发生率高于对照组(52.7%比 10.3%;p<0.001)。多变量分析确定鼻病毒(RV)感染(OR 3.3,95%CI 1.0-11.1)和哮喘阳性家族史(OR 2.5,95%CI 1.2-4.9)是反复喘息的主要独立危险因素。总之,最有可能与初始毛细支气管炎后 12 个月反复喘息相关的病毒是 RV,这是一种可能预测易发生反复喘息的婴儿的病毒。