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婴儿毛细支气管炎后反复喘息的危险因素:一项在中国进行的为期6年的单中心随访研究。

Risk factors for recurrent wheezing after infant bronchiolitis: a 6-year single-centre follow up study in China.

作者信息

Chen Sainan, Xu Xueyun, Wu Min, Zhou Luting, Wang Yuqing

机构信息

Department of Respiratory Medicine, Children's Hospital of Soochow University, Suzhou, China.

出版信息

Front Pediatr. 2025 Aug 7;13:1549475. doi: 10.3389/fped.2025.1549475. eCollection 2025.


DOI:10.3389/fped.2025.1549475
PMID:40852413
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC12367645/
Abstract

BACKGROUND: Infants with bronchiolitis have an increased risk of developing recurrent wheezing and asthma. However, the risk factors for recurrent wheezing or asthma after infant bronchiolitis remain controversial. The aim of our prospective observational study was to seek the risk factors for recurrent wheezing or asthma. METHODS: Infants with first bronchiolitis attack at the respiratory department, Children's Hospital of Soochow University were enrolled from November 2016 through March 2017. Serum cytokines, TSLP, IL2, IL13, TIMP-1, MMP-9, IL33, IL5, IL4, IL25, TNF-α and MIP-1α were measured via flow cytometry at enrolment. Patients were followed up with every 3 months for a duration of 6 years by telephone or as outpatients for the number of wheezing episodes. In the sixth year of follow-up, lung function tests, total IgE and allergen specific IgE test were performed in those children at 6-7 years of age. RESULTS: We enrolled 89 infants, 72 of whom were successfully followed up for 6 years. In total, 31.9% of the patients developed recurrent wheezing and 12.5% of patients developed asthma after 6 years of follow-up. The Kaplan-Meier curves of the overall analytic cohort ( = 72) revealed that compared with those in the non-eczema group and non-RSV group, the rate of recurrent wheezing preschool was significantly higher in patients with bronchiolitis with eczema and RSV ( < 0.05). There were no significant differences in cytokine levels between patients with and without current asthma ( > 0.05). CONCLUSIONS: A total of 31.9% of the children with hospitalization for bronchiolitis at an early age developed recurrent wheezing and 12.5% developed asthma at 6-years old. Infants hospitalised with RSV bronchiolitis and/ or with a history of eczema were at increased risk for developing recurrent wheezing.

摘要

背景:患细支气管炎的婴儿发生反复喘息和哮喘的风险增加。然而,婴儿细支气管炎后反复喘息或哮喘的危险因素仍存在争议。我们这项前瞻性观察性研究的目的是寻找反复喘息或哮喘的危险因素。 方法:2016年11月至2017年3月期间,招募了在苏州大学附属儿童医院呼吸科首次发作细支气管炎的婴儿。入组时通过流式细胞术检测血清细胞因子、TSLP、IL2、IL13、TIMP- 1、MMP-9、IL33、IL5、IL4、IL25、TNF-α和MIP-1α。通过电话或门诊对患者每3个月随访1次,持续6年,记录喘息发作次数。在随访的第6年,对6至7岁的儿童进行肺功能测试、总IgE和过敏原特异性IgE检测。 结果:我们招募了89名婴儿,其中72名成功随访6年。随访6年后,共有31.9%的患者出现反复喘息,12.5%的患者出现哮喘。整个分析队列(n = 72)的Kaplan-Meier曲线显示,与非湿疹组和非呼吸道合胞病毒(RSV)组相比,患细支气管炎且伴有湿疹和RSV的患者学龄前反复喘息的发生率显著更高(P<0.05)。目前患有哮喘和未患哮喘患者的细胞因子水平无显著差异(P>0.05)。 结论:共有31.9%的幼年因细支气管炎住院的儿童出现反复喘息,12.5%的儿童在6岁时出现哮喘。因RSV细支气管炎住院和/或有湿疹病史的婴儿发生反复喘息的风险增加。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/fcbd/12367645/5ea48c5cdcfd/fped-13-1549475-g003.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/fcbd/12367645/4e6c06685f68/fped-13-1549475-g001.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/fcbd/12367645/a2a3d4921603/fped-13-1549475-g002.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/fcbd/12367645/5ea48c5cdcfd/fped-13-1549475-g003.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/fcbd/12367645/4e6c06685f68/fped-13-1549475-g001.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/fcbd/12367645/a2a3d4921603/fped-13-1549475-g002.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/fcbd/12367645/5ea48c5cdcfd/fped-13-1549475-g003.jpg

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本文引用的文献

[1]
Risk factors for recurrent wheezing after bronchiolitis.

BMC Pediatr. 2023-6-23

[2]
Pulmonary sequelae in 2-year-old children after hospitalisation for respiratory syncytial virus lower respiratory tract infection during infancy: an observational study.

BMJ Open Respir Res. 2023-5

[3]
Respiratory syncytial virus infection during infancy and asthma during childhood in the USA (INSPIRE): a population-based, prospective birth cohort study.

Lancet. 2023-5-20

[4]
Bronchiolitis, Regardless of Its Etiology and Severity, Is Associated With Increased Risk of Asthma: A Population-Based Study.

J Infect Dis. 2023-10-3

[5]
Association of Severe Bronchiolitis during Infancy with Childhood Asthma Development: An Analysis of the ECHO Consortium.

Biomedicines. 2022-12-22

[6]
The Differences Between RSV and no RSV Acute Bronchiolitis in Hospitalized Infants: A Cross-Sectional Study.

Glob Pediatr Health. 2022-12-2

[7]
A Retrospective Cohort Study on Infant Respiratory Tract Infection Hospitalizations and Recurrent Wheeze and Asthma Risk: Impact of Respiratory Syncytial Virus.

J Infect Dis. 2022-8-12

[8]
The role of respiratory syncytial virus- and rhinovirus-induced bronchiolitis in recurrent wheeze and asthma-A systematic review and meta-analysis.

Pediatr Allergy Immunol. 2022-3

[9]
Asthma, atopy and lung function in young adults after hospitalisation for bronchiolitis in infancy: impact of virus and sex.

BMJ Open Respir Res. 2022-1

[10]
Serum periostin among infants with severe bronchiolitis and risk of developing asthma: A prospective multicenter cohort study.

Allergy. 2022-7

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