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婴幼儿毛细支气管炎:它是儿童反复喘息的危险因素吗?

Bronchiolitis in young infants: is it a risk factor for recurrent wheezing in childhood?

机构信息

Pediatric Department A', HaEmeq Medical Center, POB 10535, 16100, Afula, Israel.

Pediatric Infectious Disease unit, Meyer Children Hospital, Haifa, Israel.

出版信息

World J Pediatr. 2017 Feb;13(1):41-48. doi: 10.1007/s12519-016-0056-4. Epub 2016 Sep 15.

Abstract

BACKGROUND

Acute bronchiolitis in infancy is considered a risk factor for recurrent wheezing episodes in childhood. The present study assessed prevalence, clinical manifestations and risk factors for recurrent wheezing events during the first 3 years of life and persistent wheezing events beyond this age in children hospitalized as young infants with acute bronchiolitis.

METHODS

Two groups of children aged 6 years were included. The study group comprised 150 children with a history of hospitalization for bronchiolitis, with the first event at <6 months of age. The control group comprised 66 age- and sex-matched children with no history of bronchiolitis before 6 months of age. Children in both groups had been followed until 6 years of age by their pediatricians; data were obtained retrospectively by reviewing ambulatory records during children's visits in pediatricians' clinics. The data included epidemiological parameters, prevalence, age at onset, number of and treatments given for episodes of wheezing events prior to 6 years of age, pathogens detected, and severity of acute bronchiolitis in the study group.

RESULTS

Overall, 58% and 27% of children in the study and control groups, respectively (P=0.001) had recurrent wheezing episodes prior to the age of 3 years. Children in the study group had earlier onset of recurrent wheezing, had more episodes of wheezing, and required more bronchodilator and systemic steroids treatments compared to the control group.

CONCLUSION

Hospitalization within the first six months of life for acute bronchiolitis is an independent risk factor for recurrent wheezing episodes during the first 3 years of life.

摘要

背景

婴儿期急性细支气管炎被认为是儿童反复喘息发作的危险因素。本研究评估了急性细支气管炎住院的婴儿在生命的头 3 年中反复喘息发作的患病率、临床表现和危险因素,以及在此年龄后持续喘息发作的患病率。

方法

纳入了两组年龄为 6 岁的儿童。研究组包括 150 名有因细支气管炎住院史的儿童,首次发病年龄<6 个月。对照组包括 66 名年龄和性别匹配的儿童,他们在 6 个月之前没有细支气管炎病史。两组儿童均由儿科医生随访至 6 岁;通过回顾儿科医生诊所就诊时的门诊记录,从病史中获取数据。数据包括流行病学参数、患病率、发病年龄、6 岁前喘息发作次数和治疗方法、病原体检测以及研究组急性细支气管炎的严重程度。

结果

总体而言,研究组和对照组分别有 58%和 27%的儿童(P=0.001)在 3 岁之前有反复喘息发作。研究组儿童的喘息发作发病年龄更早,喘息发作次数更多,需要更多的支气管扩张剂和全身皮质类固醇治疗。

结论

在生命的前 6 个月内因急性细支气管炎住院是生命头 3 年反复喘息发作的独立危险因素。

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