Magnier Julie, Julian Valérie, Mulliez Aurélien, Usclade Alexandra, Rochette Emmanuelle, Evrard Bertrand, Amat Flore, Egron Carole
CHU Clermont-Ferrand, Pôle Pédiatrique, Unité d'allergologie de l'enfant, CHU Estaing, 1 Place Lucie et Raymond Aubrac, F-63003 Clermont-Ferrand, France.
Department of Sport Medicine and Functional Explorations, Diet and Musculoskeletal Health Team, CRNH, INRA, University Teaching Hospital of Clermont-Ferrand, University of Clermont Auvergne, F-63003 Clermont-Ferrand, France.
Children (Basel). 2021 Sep 26;8(10):850. doi: 10.3390/children8100850.
We set out to assess the risk factors for asthma outcome in a cohort of infants who experienced their first episode of acute bronchiolitis.
A cohort of 222 infants who were included during a first episode of acute bronchiolitis was prospectively followed. Herein, we present the results of their assessments (symptom history, skin prick tests, specific IgE assay, respiratory function tests) at age seven.
Of the 68/222 (30.6%) children assessed at age seven, 15 (22.05%) presented with asthma and were mainly males ( = 0.033), 14 (20%) had respiratory allergies, 17 (25%) presented atopic dermatitis and none had a food allergy. Family history of atopy was associated with asthma and sensitisation to aeroallergens at age seven ( = 0.003, = 0.007). Rhinovirus (hRV) infection and rhinovirus/respiratory syncytial virus (RSV) co-infection were significantly associated with asthma at age seven ( = 0.035, = 0.04), but not with the initial severity of bronchiolitis. Eosinophil counts at ages three and seven were significantly higher in the asthmatics ( = 0.01, = 0.046).
Any infant, especially male, presenting a first episode of acute bronchiolitis due to hRV with a family history of atopy should be closely monitored via follow-up due to a higher risk for asthma at school age.
我们着手评估一组首次经历急性细支气管炎发作的婴儿哮喘转归的危险因素。
对222名首次发作急性细支气管炎时纳入的婴儿队列进行前瞻性随访。在此，我们展示了他们7岁时评估（症状史、皮肤点刺试验、特异性IgE检测、呼吸功能测试）的结果。
在7岁时接受评估的68/222名（30.6%）儿童中，15名（22.05%）患有哮喘，且主要为男性（P = 0.033），14名（20%）有呼吸道过敏，17名（25%）有特应性皮炎，无一人有食物过敏。特应性家族史与7岁时的哮喘及对气传变应原致敏相关（P = 0.003，P = 0.007）。鼻病毒（hRV）感染及鼻病毒/呼吸道合胞病毒（RSV）合并感染与7岁时的哮喘显著相关（P = 0.035，P = 0.04），但与细支气管炎的初始严重程度无关。哮喘患儿3岁和7岁时的嗜酸性粒细胞计数显著更高（P = 0.01，P = 0.046）。
任何因hRV导致首次急性细支气管炎发作且有特应性家族史的婴儿，尤其是男性，由于学龄期哮喘风险较高，应通过随访密切监测。
