Harsten G, Prellner K, Heldrup J, Kalm O, Kornfält R
Department of Oto-Rhino-Laryngology, University Hospital, Lund, Sweden.
Acta Otolaryngol. 1989 Jan-Feb;107(1-2):111-9. doi: 10.3109/00016488909127487.
To evaluate possible risk factors for developing recurrent acute otitis media (rAOM), 113 children were followed prospectively from birth to the age of 3 years. One of the aims was to determine whether such risk factors could be identified before the onset of the recurrences, so that optimal care and prophylactic measures could be made available at an early stage in such cases, on the basis of continuous follow-up by an ENT specialist. During the follow-up, 13 children developed rAOM, defined as six or more episodes of acute otitis media (AOM) during a 12-month period, 57 children had occasional episodes of AOM, and 43 children had no AOM at all. Of the children with onset of AOM before 6 months of age, 80% developed frequent episodes of AOM. The frequency of other respiratory tract infections and of family histories of otitis-proneness was higher among rAOM children than among the other children. The development of rAOM was unrelated to such factors as sex, familial history of allergy, duration of breast-feeding, or domestic environment. Nor could attendance at day-care centres be concluded as constituting a risk factor for the development of rAOM. An onset of AOM before 6 months of age was highly predictive of subsequent recurrent bouts of AOM, which emphasizes the importance of correct diagnosis in infants.
为评估复发性急性中耳炎（rAOM）发生的可能危险因素，对113名儿童从出生到3岁进行了前瞻性随访。目的之一是确定能否在复发开始前识别出这些危险因素，以便在耳鼻喉科专家持续随访的基础上，在此类病例的早期阶段提供最佳护理和预防措施。在随访期间，13名儿童患上了rAOM，定义为在12个月内发生6次或更多次急性中耳炎（AOM），57名儿童偶尔发生AOM，43名儿童根本没有患过AOM。在6个月前发病的AOM儿童中，80%出现了频繁发作的AOM。rAOM儿童中其他呼吸道感染的频率和易患中耳炎的家族史高于其他儿童。rAOM的发生与性别、过敏家族史、母乳喂养时间或家庭环境等因素无关。也不能得出日托中心的出勤是rAOM发生的危险因素的结论。6个月前发生AOM高度预示着随后AOM的复发，这强调了婴儿正确诊断的重要性。
