Objective To analyze the risk factors of recurrent wheezing in infants, and to evaluate its correlation with tidal breathing pulmonary function. Methods Infants with “recurrent wheezing” over three times hospitalized in the Department of Pediatrics of the First Hospital of Wuhan were enrolled in observation group from March 2015 to March 2017.Meanwhile, healthy children in outpatient were selected as control group.Questionnaires were used to analyze risk factors of recurrent wheezing.Tidal breathing pulmonary function was tested at admission (acute phase) and discharge (remission phase).And respiratory rate(RR), TV/kg、Ti/Te、TPTEF/TE、VPEF/VE of two groups were tested. Results 1) Eczema (OR=5.86,95%CI:1.72~22.06), secondhand smoking (OR=2.16, 95%CI:1.36~5.29), parents′ history of asthma or allergic rhinitis (OR=7.83, 95%CI:2.56~30.31), city residence(OR=3.12,95%CI:1.17~12.46) and dwelling adjacent to road (OR=2.05,95%CI:1.08~3.03) were the independent risk factors for recurrent wheezing.2) Compared with the control group, RR was significantly faster in both acute stage and wheezing stage of wheezing group (both P<0.05); RR in wheezing remission stage was significantly lower than that in acute wheezing stage(P<0.05).TPTEF/TE and VPEF/VE were significantly lower in both acute wheezing stage and wheezing remission stage than those in control group (both P<0.01).After positive treatment, TPTEF/TE and VPEF/VE in wheezing remission stage were significantly higher than those in acute wheezing stage (both P<0.05). Conclusions Eczema, secondhand smoking, parents′ history of asthma or allergic rhinitis, city residence and dwelling adjacent to road are the independent risk factors for recurrent wheezing.Tidal breathing analysis of pulmonary function may be a reliable and Objective indicator for clinical diagnosis of asthma in infants.
Key words
recurrent wheezing /
infants /
risk factors /
tidal breathing pulmonary function
{{custom_sec.title}}
{{custom_sec.title}}
{{custom_sec.content}}
References
[1] Neuman A, Bergstrm A, Gustafsson P, et al.Infant wheeze, comorbidities and school age asthma[J].Pedliatr Allergy Immunol, 2014,25 (4):380-386.
[2] Nicolai A1, Frassanito A, Nenna R, et al.Risk factors for virus-induced acute respiratory tract infections in children younger than 3 years and recurrent wheezing at 36 months follow-up after discharge[J].Pediatr Infect Dis J, 2017,36(2):179-183.
[3] Valkonen H, Waris M, Ruohola A, et al.Recurrent wheezing after respiratory syncytial virus or non-respiratory syncytial virus bronchiolitis in infancy:a 3-year follow-up[J].Allergy, 2009, 64(9):1359-1365.
[4] Bacharier LB1, Guilbert TW.Diagnosis and management of early asthma in preschool-aged children[J].J Allergy Clin Immunol,2012,130(2):287-296.
[5] 中华医学会呼吸病学分会哮喘学组.支气管哮喘防治指南(2016年版)[J].中华结核和呼吸杂志, 2016, 39 (9) :675-697.
[6] Reber LL, Hernandez JD, Galli SJ.The pathophysiology of anaphylaxis[J].J Allergy Clin Immunol, 2017,140(2):335-348.
[7] Kurukulaaratchy RJ, Matthews S, Arshad SH.Relationship between childhood atopy and wheeze:what mediates wheezing in atopic phenotypes[J] Ann Allergy Asthma Immunol,2006,97(1):84-91.
[8] Kusel MM, Kebadze T, Johnston SL, et al.Febrile respiratory illnesses in infancy and atopy are risk factors for persistent asthma and wheeze[J].Eur Respir J, 2012,39(4):876-882.
[9] 王强,徐春雨,徐东群,等.中国城市儿童哮喘危险因素分析[J].中华流行病学杂志,2014,35(3):237-241.
[10] 单文婕,卢燕鸣,李亚琴,等.婴幼儿反复喘息危险因素meta分析[J].中华实用儿科临床杂志,2015,30(10):761-764.
[11] Relic＇T, Ilic＇ N, Kostic＇ G,et al. Respiratory syncytial virus infection and bronchialhyperreactivity in children up to two years of age in correlation with atopy[J].Vojnosanit Pregl, 2016,73(1):59-65.
[12] Spindel ER, McEvoy CT.The Role of nicotine in the effects of maternal smoking during pregnancy on lung development and childhood respiratory disease:implications for dangers of e-cigarettes[J].Am J Respir Crit Care Med, 2016,193(5):486-494.
[13] Grazuleviciene R, Andrusaityte S, Uzdanaviciute I, et al.The impact of tobacco smoke exposure on wheezing and overweight in 4~6-year-old children[J].Biomed Res Int,2014,2014:240757.
[14] Nouri-Shirazi M, Kahlden C, Nishino P,et al.Nicotine exposure alters the mRNA expression of Notch ligands in dendritic cells and their response to Th1-/Th2-promoting stimuli[J] .Scand J Immunol,2015,81(2):110-120.
[15] Wright DB, Meurs H, Dekkers BG.Integrins:therapeutic targets in airway hyperresponsiveness and remodelling[J]. Trends Pharmacol Sci,2014, 35(11):567-574.
[16] 李睿, 王吉安, 许家增, 等.毛细支气管炎患儿单次潮气肺功能测定的临床意义[J].临床儿科杂志, 2014, 32 (11) :1057-1059.
[17] De-Benedictis FM, Attanasi M.Asthma in childhood[J].Eur Respir Rev,2016,139(25):41-47.
[18] 张皓, 邬宇芬, 黄剑峰 ,等.儿童肺功能检测及评估专家共识[J].临床儿科杂志, 2014,32(2):104-114.
PDF(582 KB)
