毛细支气管炎后反复喘息的危险因素。
Risk factors for recurrent wheezing after bronchiolitis.
机构信息
Department of Pediatric Pulmonary Chengdu Women's and Children's Central Hospital, School of Medicine, University of Electronic Science and Technology of China, Chengdu, 611731, China.
出版信息
BMC Pediatr. 2023 Jun 23;23(1):317. doi: 10.1186/s12887-023-04108-9.
BACKGROUND
This study aimed to determine whether there was an association between certain factors in patients with bronchiolitis and recurrent wheezing in childhood.
METHOD
In 2021 we tracked children hospitalized for bronchiolitis at Chengdu Women's and Children's Central Hospital in 2017. The patients were classified into recurrent wheezing group (RWG) and non-recurrent wheezing group (NRWG). Possible risk factors including maternal age, school-age siblings, allergic history, atopic dermatitis, allergic rhinitis, atopic family history, severity of the condition, duration of hospitalization, nasopharyngeal secretions culture, blood eosinophil counts, FeNO and skin prick test were compared between the two groups. Continuous variables were analyzed by independent sample t-test for normal distribution and Mann-Whitney U-test for non-normal distribution. Categorical variables were tested using chi-square tests. Multifactor analysis was conducted by stepwise logistics regression analysis.
RESULTS
In total 167 participants were included, of which 26 and 141 were in RWG and NRWG respectively. In RWG children represented higher maternal age (P = 0.02) and greater probability of allergic history, atopic dermatitis, allergic rhinitis, atopic family history (odds ratio [OR] = 4.0,3.7, 7.8, 10.9 respectively, P < 0.01). However, school-age siblings, severity of the condition, duration of hospitalization, blood eosinophil counts, fractional exhaled nitric oxide and skin prick test results seemed unrelated to recurrent wheezing. In the subgroup analysis of nasopharyngeal secretion culture, there were more Moraxella catarrhalis-positive in RWG(P = 0.043). Atopic dermatitis, allergic rhinitis and atopic family history were identified as independent risk factors for recurrent wheezing.
CONCLUSION
Some children with bronchiolitis will develop recurrent wheezing, and the risk factors are allergic history, Moraxella catarrhalis infection or colonization, atopic dermatitis, allergic rhinitis and atopic family history; the latter three are independent risk factors.
背景
本研究旨在确定毛细支气管炎患儿的某些因素与儿童反复喘息之间是否存在关联。
方法
2021 年，我们对 2017 年在成都市妇女儿童中心医院住院的毛细支气管炎患儿进行了随访。将患儿分为反复喘息组（RWG）和非反复喘息组（NRWG）。比较两组患儿的母亲年龄、学龄期兄弟姐妹、过敏史、特应性皮炎、变应性鼻炎、特应性家族史、病情严重程度、住院时间、鼻咽分泌物培养、血嗜酸性粒细胞计数、FeNO 和皮肤点刺试验等可能的危险因素。正态分布的连续变量采用独立样本 t 检验，非正态分布的连续变量采用 Mann-Whitney U 检验。分类变量采用卡方检验。多因素分析采用逐步逻辑回归分析。
结果
共纳入 167 例患儿，其中 RWG 患儿 26 例，NRWG 患儿 141 例。RWG 患儿的母亲年龄较大（P=0.02），过敏史、特应性皮炎、变应性鼻炎、特应性家族史的发生概率更高（比值比[OR]分别为 4.0、3.7、7.8、10.9，P<0.01）。然而，学龄期兄弟姐妹、病情严重程度、住院时间、血嗜酸性粒细胞计数、呼出气一氧化氮分数和皮肤点刺试验结果与反复喘息无关。在鼻咽分泌物培养的亚组分析中，RWG 患儿中莫拉卡他菌阳性率更高（P=0.043）。特应性皮炎、变应性鼻炎和特应性家族史是反复喘息的独立危险因素。
结论
部分毛细支气管炎患儿会发展为反复喘息，其危险因素包括过敏史、莫拉卡他菌感染或定植、特应性皮炎、变应性鼻炎和特应性家族史，后三者为独立危险因素。
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