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特应性是否会影响病毒性肺炎的病程?

Does atopy affect the course of viral pneumonia?

作者信息

Erdem S B, Can D, Girit S, Çatal F, Şen V, Pekcan S, Yüksel H, Bingöl A, Bostancı I, Erge D, Ersu R

机构信息

Dr Behcet Uz Children's Hospital, Department of Pediatric Allergy, Izmir, Turkey.

Dr Behcet Uz Children's Hospital, Department of Pediatric Allergy, Izmir, Turkey.

出版信息

Allergol Immunopathol (Madr). 2018 Mar-Apr;46(2):119-126. doi: 10.1016/j.aller.2017.04.003. Epub 2017 Jun 17.

Abstract

BACKGROUND

The presence of atopy is considered as a risk factor for severe respiratory symptoms in children. The objective of this study was to examine the effect of atopy on the course of disease in children hospitalised with viral pneumonia.

METHODS

Children between the ages of 1 and 6 years hospitalised due to viral pneumonia between the years of 2013 and 2016 were included to this multicentre study. Patients were classified into two groups as mild-moderate and severe according to the course of pneumonia. Presence of atopy was evaluated with skin prick tests. Groups were compared to evaluate the risk factors associated with severe viral pneumonia.

RESULTS

A total of 280 patients from nine centres were included in the study. Of these patients, 163 (58.2%) were male. Respiratory syncytial virus (29.7%), Influenza A (20.5%), rhinovirus (18.9%), adenovirus (10%), human metapneumovirus (8%), parainfluenza (5.2%), coronavirus (6%), and bocavirus (1.6%) were isolated from respiratory samples. Eighty-five (30.4%) children had severe pneumonia. Atopic sensitisation was found in 21.4% of the patients. Ever wheezing (RR: 1.6, 95% CI: 1.1-2.4), parental asthma (RR: 1.5, 95% CI: 1.1-2.2), other allergic diseases in the family (RR: 1.8, 95% CI: 1.2-2.9) and environmental tobacco smoke (RR: 1.6, 95% CI: 1.1-3.5) were more common in the severe pneumonia group.

CONCLUSIONS

When patients with mild-moderate pneumonia were compared to patients with severe pneumonia, frequency of atopy was not different between the two groups. However, parental asthma, ever wheezing and environmental tobacco smoke exposure are risk factors for severe viral pneumonia in children.

摘要

背景

特应性被认为是儿童出现严重呼吸道症状的一个风险因素。本研究的目的是探讨特应性对因病毒性肺炎住院儿童的病程的影响。

方法

本多中心研究纳入了2013年至2016年间因病毒性肺炎住院的1至6岁儿童。根据肺炎病程将患者分为轻度-中度和重度两组。通过皮肤点刺试验评估特应性的存在情况。比较两组以评估与严重病毒性肺炎相关的风险因素。

结果

共有来自9个中心的280名患者纳入研究。其中,163名(58.2%)为男性。从呼吸道样本中分离出呼吸道合胞病毒(29.7%)、甲型流感病毒(20.5%)、鼻病毒(18.9%)、腺病毒(10%)、人偏肺病毒(8%)、副流感病毒(5.2%)、冠状病毒(6%)和博卡病毒(1.6%)。85名(30.4%)儿童患有严重肺炎。21.4%的患者存在特应性致敏。曾经喘息(相对危险度:1.6,95%可信区间:1.1 - 2.4)、父母患哮喘(相对危险度:1.5,95%可信区间:1.1 - 2.2)、家庭中存在其他过敏性疾病(相对危险度:1.8,95%可信区间:1.2 - 2.9)以及环境烟草烟雾暴露(相对危险度:1.6,95%可信区间:1.1 - 3.5)在严重肺炎组中更为常见。

结论

将轻度-中度肺炎患者与重度肺炎患者进行比较时,两组的特应性频率无差异。然而,父母患哮喘、曾经喘息和环境烟草烟雾暴露是儿童严重病毒性肺炎的风险因素。

相似文献

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Does atopy affect the course of viral pneumonia?特应性是否会影响病毒性肺炎的病程?
Allergol Immunopathol (Madr). 2018 Mar-Apr;46(2):119-126. doi: 10.1016/j.aller.2017.04.003. Epub 2017 Jun 17.

本文引用的文献

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Asthma: the interplay between viral infections and allergic diseases.哮喘:病毒感染与过敏性疾病之间的相互作用
Immunol Allergy Clin North Am. 2015 Feb;35(1):115-27. doi: 10.1016/j.iac.2014.09.012. Epub 2014 Nov 21.
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Exacerbation of asthma and airway infection: is the virus the villain?哮喘加重与气道感染:病毒是罪魁祸首吗?
J Pediatr (Rio J). 2014 Nov-Dec;90(6):542-55. doi: 10.1016/j.jped.2014.07.001. Epub 2014 Sep 26.
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Asthma: the importance of dysregulated barrier immunity.哮喘:失调的屏障免疫的重要性。
Eur J Immunol. 2013 Dec;43(12):3125-37. doi: 10.1002/eji.201343730. Epub 2013 Nov 20.
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Cellular and humoral immunity of virus-induced asthma.病毒诱导性哮喘的细胞与体液免疫。
Front Microbiol. 2013 Aug 27;4:252. doi: 10.3389/fmicb.2013.00252. eCollection 2013.

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