Midulla Fabio, Nicolai Ambra, Ferrara Marianna, Gentile Federico, Pierangeli Alessandra, Bonci Enea, Scagnolari Carolina, Moretti Corrado, Antonelli Guido, Papoff Paola
Department of Paediatrics, Sapienza University, Rome, Italy.
Acta Paediatr. 2014 Oct;103(10):1094-9. doi: 10.1111/apa.12720. Epub 2014 Jul 7.
Links between respiratory syncytial virus bronchiolitis and asthma are well known, but few studies have dealt with wheezing following bronchiolitis induced by other viruses. We assessed the risk factors for recurrent wheezing in infants hospitalised for acute viral bronchiolitis.
We followed 313 infants for three years after they were hospitalised for bronchiolitis, caused by 14 different viruses, to identify risk factors for recurrent wheezing. Parents provided feedback on wheezing episodes during telephone interviews 12 (n = 266), 24 (n = 242) and 36 (n = 230) months after hospitalisation.
The frequency of wheezing episodes diminished during the follow-up period: 137 children (51.7%) at 12 months, 117 (48.3%) at 24 months and 93 (40.4%) at 36 months. The risk of wheeze after three years was OR = 7.2 (95% CI 3.9-13.3) if they had episodes of wheezing during the first year after bronchiolitis, 16.8 (8.7-32.7) if they had episodes of wheezing during the second year and 55.0 (22.7-133.2) if they wheezed during both years. Blood eosinophils >400 cells/μL (OR 7.7; CI 1.4-41.8) and rhinovirus infections (3.1; 1.0-9.4) were the major risk factors for recurrent wheezing.
Recurrent wheezing 36 months after infant bronchiolitis was associated with rhinoviruses and blood eosinophilia.
呼吸道合胞病毒细支气管炎与哮喘之间的联系已为人熟知，但很少有研究涉及其他病毒引起的细支气管炎后的喘息情况。我们评估了因急性病毒性细支气管炎住院的婴儿反复喘息的危险因素。
我们对313名因细支气管炎住院的婴儿进行了三年随访，这些细支气管炎由14种不同病毒引起，以确定反复喘息的危险因素。家长在住院后12个月（n = 266）、24个月（n = 242）和36个月（n = 230）的电话访谈中提供了喘息发作的反馈。
在随访期间，喘息发作的频率有所下降：12个月时137名儿童（51.7%），24个月时117名（48.3%），36个月时93名（40.4%）。如果在细支气管炎后的第一年有喘息发作，三年后喘息的风险为OR = 7.2（95% CI 3.9 - 13.3）；如果在第二年有喘息发作，风险为16.8（8.7 - 32.7）；如果两年都有喘息发作，风险为55.0（22.7 - 133.2）。血液嗜酸性粒细胞>400个细胞/μL（OR 7.7；CI 1.4 - 41.8）和鼻病毒感染（3.1；1.0 - 9.4）是反复喘息的主要危险因素。
婴儿细支气管炎36个月后的反复喘息与鼻病毒和血液嗜酸性粒细胞增多有关。
