儿童喘息的相关危险因素分析

Clinical application of probiotics in pediatrics

目的探讨儿童不同表型喘息发作的相关危险因素及转归。方法将2013年6月至2014年5月该院收治的89例反复喘息患儿分为持续性喘息组(56例)、晚发性喘息组(18例)和一过性喘息组(15例),坚持3年以上的电话随访调查患儿喘息发作情况,比较3组患儿湿疹、鼻炎、父母哮喘史及过敏相关指标等。结果89例随访儿童平均年龄(6.91±1.15)岁,其中男69例,女20例。3组患儿第4年喘息次数均明显减少,差异均有统计学意义(P<0.05)。一过性喘息组患儿第4年伴发鼻炎、既往鼻炎发生率明显低于其他两组,差异均有统计学意义(P<0.05)。晚发性喘息患儿外周血嗜酸性粒细胞(EOS)百分比、吸入性过敏原阳性率、血清总IgE最高,一过性喘息组患儿最低,3组患儿EOS百分比、吸入性过敏原阳性率、血清总IgE比较,差异均有统计学意义(P<0.05)。一过性喘息组患儿起始喘息年龄明显早于其他两组,差异均有统计学意义(P<0.05)。结论喘息的转归与起始年龄、鼻炎、过敏等因素显著相关,喘息发作随儿童年龄增加而显著减少。

Objective Risk factors and outcomes of different phenotypic wheezing attacks in children. Methods The children with recurrent wheezing from June 2013 to May 2014 were divided into persistent wheezing group,late wheezing group and transient wheezing group,Follow-up telephone survey for more than 3 years was conducted to investigate the incidence of wheezing attacks.Eczema,rhinitis,parents'asthma history and allergic related indicators were compared. Results In 89 follow-up children,the average age was(6.91±1.15)years,including 69 males and 20 females.The number of wheezing in the fourth year of the three groups was significantly reduced( P <0.05).In the fourth year,there were significant differences in the incidence of rhinitis and previous rhinitis among the three groups( P <0.05).The incidence of transient wheezing group was significantly lower than that of the other two groups.The percentage of peripheral blood eosinophils(EOS),positive rate of inhalation allergens and total serum IgE were the highest in children with late asthma and the lowest in children with transient asthma( P <0.05).The onset age of asthma in 15 children with transient asthma was earlier than that in 18 children with late onset and 56 children with persistent asthma( P <0.05). Conclusion The prognosis of wheezing was significantly correlated with such factors as age at onset,rhinitis and allergy.The incidence of wheezing attacks decreased significantly with the increase of children's age.