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复发性喘息的危险因素——国际婴幼儿喘息研究(EISL)第三阶段

Risk factors for recurrent wheezing--International Study of Wheezing in Infants (EISL) phase 3.

作者信息

Aranda C S, Wandalsen G, Fonzar L, Bianca A C D, Mallol J, Solé D

机构信息

Federal University of São Paulo-Escola Paulista de Medicina (UNIFESP-EPM), São Paulo, Brazil.

Federal University of São Paulo-Escola Paulista de Medicina (UNIFESP-EPM), São Paulo, Brazil.

出版信息

Allergol Immunopathol (Madr). 2016 Jan-Feb;44(1):3-8. doi: 10.1016/j.aller.2015.05.011. Epub 2015 Aug 28.

Abstract

BACKGROUND

We aimed to identify factors associated with recurrent wheezing (RW) in infants in the first year of life living in the Southern region of São Paulo city and participating in the "Estudio Internacional de Sibilancias en Lactantes (EISL)" - phase 3 (P3).

METHODS

1335 parents of infants who were attended in primary care health units in the Southern region of São Paulo city from 2009 to 2010 answered the EISL-P3 written questionnaire. The wheezing group was stratified in accordance to the frequency of wheezing episodes as occasional wheezing (OW, less than three episodes), or RW (three or more episodes). Wheezing-associated factors were evaluated using multivariate analysis and were expressed as odds ratio (OR) and 95% confidence interval (95%CI).

RESULTS

The most relevant factors related to OW were pneumonia (OR=3.10, 95%CI=1.68-5.73), hospitalisation due to pneumonia (OR=2.88, 95%CI=1.26-6.56) and recurrent upper respiratory infection (URI, OR=1.87, 95%CI=1.25-2.81). Regarding RW, recurrent URI (OR=5.34, 95%CI=3.83-7.45), pneumonia (OR=4.06, 95%CI=2.87-5.74) and asthmatic siblings (OR=3.02, 95%CI=1.67-5.45) were the most significantly associated factors.

CONCLUSIONS

In the present study, we found that recurrent URI, positive history of pneumonia and familiar history of asthma were the most relevant factors associated with RW. The precocious knowledge of these factors can enable the identification of the probable asthmatic infants and can improve both prevention strategies and treatment of these patients.

摘要

背景

我们旨在确定圣保罗市南部地区一岁以内婴儿复发性喘息(RW)的相关因素,这些婴儿参与了“国际婴幼儿喘息研究(EISL)”——第三阶段(P3)。

方法

2009年至2010年期间,在圣保罗市南部地区基层医疗保健单位就诊的1335名婴儿的家长回答了EISL-P3书面问卷。喘息组根据喘息发作频率分为偶尔喘息(OW,少于三次发作)或RW(三次或更多次发作)。使用多变量分析评估与喘息相关的因素,并以比值比(OR)和95%置信区间(95%CI)表示。

结果

与OW最相关的因素是肺炎(OR=3.10,95%CI=1.68-5.73)、因肺炎住院(OR=2.88,95%CI=1.26-6.56)和复发性上呼吸道感染(URI,OR=1.87,95%CI=1.25-2.81)。关于RW,复发性URI(OR=5.34,95%CI=3.83-7.45)、肺炎(OR=4.06,95%CI=2.87-5.74)和哮喘同胞(OR=3.02,95%CI=1.67-5.45)是最显著相关的因素。

结论

在本研究中,我们发现复发性URI、肺炎阳性病史和哮喘家族史是与RW最相关的因素。对这些因素的早期了解可以帮助识别可能患哮喘的婴儿,并改善这些患者的预防策略和治疗。

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