吸入性糖皮质激素对哮喘合并肺炎儿童的保护作用。
Protective effect of inhaled corticosteroid on children with asthma with pneumonia.
作者信息
Wei Bing, Dang Yan-Hong, Liu Xiang-Ping, Li Miao
机构信息
Department of Neonatology, General Hospital of Northern Theater Command, Shenyang, China.
Department of Pediatrics, Shengjing Hospital of China Medical University, Shenyang, China.
出版信息
Front Pediatr. 2022 Aug 25;10:908857. doi: 10.3389/fped.2022.908857. eCollection 2022.
BACKGROUND
The aim of this study was to determine the differences in the characteristics of pneumonia (MPP) in children with and without asthma and in children with asthma with and without inhaled corticosteroid (ICS) therapy in order to determine the risk factors for asthma exacerbation and the effect of regular ICS therapy on children with asthma with MPP.
MATERIALS AND METHODS
Children with MPP were divided into two groups according to whether they had a history of asthma. Children with asthma were further divided into an ICS therapy group and a group without ICS therapy. The clinical characteristics, laboratory test results, and pulmonary images were compared between the children with and without asthma. Differences in the severity of acute exacerbation were compared between the children with asthma in the ICS therapy and without ICS therapy groups. Multivariable logistic regression was used to determine the risk factors for exacerbation of MPP in children with asthma.
RESULTS
In children with MPP, the differences in the eosinophil counts; total immunoglobulin E (IgE), C-reactive protein, procalcitonin (PCT), and lactate dehydrogenase (LDH) levels; and fever duration, wheezing, extrapulmonary complications, oxygen saturation < 92%, severe pneumonia, pleural effusion, co-infection with other pathogens, and lobar pneumonia between children with and without asthma were statistically significant. Among children with asthma with MPP, those in the ICS therapy group were less likely to experience an exacerbation, and exacerbations were less severe than those in the without ICS therapy group. The multivariable logistic regression analysis showed that the ICS therapy was an independent protective factor against exacerbation.
CONCLUSION
Among children with MPP, the chance of wheezing was higher in children with asthma than in children without asthma. The ICS therapy was a protective factor against exacerbation in children with asthma with MPP.
背景
本研究的目的是确定患有和未患有哮喘的儿童以及接受和未接受吸入性糖皮质激素（ICS）治疗的哮喘儿童中肺炎支原体肺炎（MPP）的特征差异，以确定哮喘加重的危险因素以及规律ICS治疗对患有MPP的哮喘儿童的影响。
材料与方法
根据是否有哮喘病史将MPP患儿分为两组。哮喘患儿进一步分为ICS治疗组和未接受ICS治疗组。比较有哮喘和无哮喘患儿的临床特征、实验室检查结果和肺部影像。比较ICS治疗组和未接受ICS治疗组哮喘患儿急性加重严重程度的差异。采用多变量逻辑回归分析确定哮喘患儿MPP加重的危险因素。
结果
在MPP患儿中，哮喘患儿与非哮喘患儿在嗜酸性粒细胞计数、总免疫球蛋白E（IgE）、C反应蛋白、降钙素原（PCT）和乳酸脱氢酶（LDH）水平以及发热持续时间、喘息、肺外并发症、氧饱和度<92%、重症肺炎、胸腔积液、合并其他病原体感染和大叶性肺炎方面的差异具有统计学意义。在患有MPP的哮喘患儿中，ICS治疗组患儿发生加重的可能性较小，且加重程度比未接受ICS治疗组患儿轻。多变量逻辑回归分析显示，ICS治疗是预防加重的独立保护因素。
结论
在MPP患儿中，哮喘患儿喘息的几率高于非哮喘患儿。ICS治疗是患有MPP的哮喘患儿预防加重的保护因素。
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