年幼儿童早期喘息进展为哮喘的影响因素分析  

Influencing factors of asthma in young children with early wheezing

作　　者：赵梦雅[1] 刘传合[1] 沙莉[1] 田春雨 邵明军[1] 李硕[1] ZHAO Meng-ya;LIU Chuan-he;SHA Li;TIAN Chun-yu;SHAO Ming-jun;LI Shuo(Department of Allergy,Children's Hospital of Capital Institute of Pediatrics,Beijing 100020,China)

机构地区：[1]首都儿科研究所附属儿童医院变态反应科,北京100020

出　　处：《中华实用诊断与治疗杂志》2022年第8期856-858,共3页Journal of Chinese Practical Diagnosis and Therapy

基　　金：国家卫计委公益性行业科研专项(201502025);北京市医院管理局儿科学科协同发展中心儿科专项重点项目子课题(XTZD20180103)。

摘　　要：目的观察年幼儿童早期喘息的临床特征,探讨其进展为哮喘的影响因素。方法135例早期喘息的年幼儿童(≤5岁),喘息发作急性期采用吸入糖皮质激素、β_(2)受体激动剂、M受体激动剂或口服白三烯受体拮抗剂治疗,治疗后随访1年,根据是否进展为哮喘分为哮喘组60例和非哮喘组75例。比较2组首次喘息年龄、过敏原、病毒病原学等临床资料,采用多因素logistic回归分析年幼儿童早期喘息1年内进展为哮喘的影响因素。结果哮喘组合并呼吸道感染比率(76.7%)低于非哮喘组(93.3%)(χ^(2)=6.34,P=0.01),鼻病毒感染比率(58.3%)高于非哮喘组(40.0%)(χ^(2)=4.49,P=0.04);2组性别比例、首次喘息年龄、出生史、过敏性炎症相关指标、血清总IgE水平、过敏原及其他病毒感染比较差异均无统计学意义(P>0.05)。给予短效β_(2)受体激动剂后呼吸状况改善(OR=2.885,95%CI:1.233~6.749,P=0.015)、鼻病毒检测阳性(OR=2.400,95%CI:1.131~5.094,P=0.023)是年幼儿童早期喘息1年内进展为哮喘的危险因素。结论喘息发作时给予短效β_(2)受体激动剂后呼吸状况改善、鼻病毒检测阳性的年幼儿童早期喘息发生后1年内易进展为哮喘。Objective To observe the clinical features of early wheezing in young children and to investigate the influencing factors of asthma.Methods Totally 135 early wheezing children aged 5 years or younger inhaled corticosteroid,β_(2)-agonist,muscarine anticholinergic or oral administration of leukotriene receptor antagonist during acute wheezing attack.According to whether asthma developed within one year,135 children were divided into asthma group(n=60)and no-asthma group(n=75).The baseline data as age,allergen and infected virous were compared between two groups,and the influencing factors of asthma in one year were analyzed by multivariate logistic regression.Results The percentage of patients with respiratory infection was lower in asthma group(76.6%)than that in no-asthma group(93.3%)(χ^(2)=6.34,P=0.01),and the percentage of patients with rhinovirus infection was higher in asthma group(58.3%)than that in no-asthma group(40.0%)(χ^(2)=4.49,P=0.04).There were no significant differences in the gender ratio,age of first wheezing,history of delivery,allergy related indexes,serum total IgE level,allergen and other virus infection between two groups(P>0.05).The respiratory condition was improved after application of short-actingβ_(2)-agonist during acute wheezing attack(OR=2.885,95%CI:1.233-6.749,P=0.015)and positive rhinovirus(OR=2.400,95%CI:1.131-5.094,P=0.023)were the risk factors of asthma within one year after early wheezing in young children.Conclusion The young children with respiratory condition improved after application of short-actingβ_(2)-agonist during acute wheezing attack and positive rhinovirus are prone to develop asthma within one year after early wheezing.

关 键 词：早期喘息 哮喘 年幼儿童 

分 类 号：R725.6[医药卫生—儿科]