Objective To explore the relationship between recurrent wheezing and gene prediction model of four-locus asthma in children, and to analyze the risk factors of recurrent wheezing. Methods A total of 91 asthmatic children who were hospitalized or saw a doctor in outpatient clinics in Yuhuan People's Hospital from January 2019 to March 2021 were selected into this study. According to the asthma predictive index(API) result, children were divided into API positive group(n=55) and API negative group(n=36).Meanwhile, 30 healthy children were selected as the control group. The high-risk rates of four-locus asthma gene prediction model among three groups were compared. The influencing factors of recurrent wheezing were analyzed by univariate and multivariate Logistic regression. Results The high-risk rate of four-locus asthma gene prediction model in API positive group was significantly higher than that in API negative group and control group(χ2 =12.487, P<0.05). The risk of the four-locus asthma gene prediction model in the API positive group was 2.54 times higher than that in the API negative group and 5.32 times higher than that in the control group. Univariate analysis indicated that children's recurrent wheezing was associated with high risk type of the four-locus asthma gene prediction model, allergy history, family history of allergic diseases, positive inhaled allergens, positive ingested allergens, passive smoking, elevated eosinophil count and respiratory syncytial virus infection(χ2=13.831, 22.817, 25.475, 20.573, 6.373, 11.487, 10.790, 10.789, P<0.05), but not related to living surroundings(P>0.05). Multivariate Logistic regression analysis showed that the high risk type of four-locus asthma gene prediction model(OR=5.535, 95%CI: 1.928 -15.893), allergy history(OR=4.921, 95%CI:1.661 - 14.577), family history of allergic diseases(OR=4.460, 95%CI:1.560 - 12.749),positive inhaled allergens(OR=13.105, 95%CI:2.436 - 70.503) and passive smoking(OR=3.704, 95%CI:1.304 - 10.521) were independent risk factors for recurrent wheezing. Conclusions The high risk rate of four-locus asthma gene prediction model is significantly increased in children with recurrent wheezing, especially API positive children. Repeated wheezing is caused by multiple factors, among which the high risk type of four-locus asthma gene prediction model is an important reason.
Key words
wheezing /
asthma predictive index /
gene /
asthma /
children
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References
[1] Kwong CG, Bacharier LB. Phenotypes of wheezing and asthma in preschool children[J].Curr Opin Allergy Clin Immunol,2019,19(2):148-153.
[2] Ünal S,Kaya A,Bilgin L,et al.Wheezing, asthma, and atopy in premature infants at 2 years of age [J].Turk J Med Sci,2017,47(2):607-613.
[3] 中华医学会儿科学分会呼吸学组,《中华儿科杂志》编辑委员会.儿童支气管哮喘诊断与防治指南(2016年版)[J].中华儿科杂志,2016,54(3):167-181.
[4] Hua L,Zuo XB,Bao YX,et al.Fourlocus gene interaction between IL13,IL4,FCER1B,and ADRB2 for asthma in Chinese Han children[J].Pediatr Pulmonol,2016,51(4):364-371.
[5] Bai S,Hua L,Wang X,et al.Association of a four-locus gene model including IL13,IL4,FCER1B,and ADRB2 with the asthma predictive index and atopy in Chinese Han children[J].J Investig Allergol Clin Immunol,2018,28(6):407-413.
[6] 中华医学会儿科学分会呼吸学组,《中华儿科杂志》编辑委员会.儿童支气管哮喘诊断与防治指南[J].中华儿科杂志,2008,46(10):745-753.
[7] 王志丹,何婷婷,姜倩雯,等. 哮喘患儿雾化吸入疗效与呼吸道感染及哮喘易感基因多态性的关联性[J].中华医院感染学杂志,2021,31(11):1748-1753.
[8] Scaparrotta A, Franzago M, Marcovecchio ML, et al. Role of THRB, ARG1, and ADRB2 genetic variants on bronchodilators response in asthmatic children[J].J Aerosol Med Pulm Drug Deliv,2019,32(3):164-173.
[9] 中华医学会变态反应分会儿童过敏和哮喘学组.四位点儿童哮喘基因预测模型与哮喘预测指数和特应性的相关性研究[J].中国实用儿科杂志,2021, 36(6):441-444.
[10] 盛美玲,邵启民,张春丽. 呼吸道合胞病毒毛细支气管炎患儿发生反复喘息的影响因素分析[J].中国妇幼保健,2021,36(13):3067-3069.
[11] 聂颖,李敬风,廖兴娟,等. 婴幼儿反复喘息危险因素分析及其潮气肺功能检测的临床意义[J].中国儿童保健杂志,2018,26(8):893-896.
[12] 曹向可,王维,钱庆增,等. 3岁以下婴幼儿喘息的危险因素分析[J].广东医学,2017,38(10):1548-1551.
[13] 王燕,张士发. 婴幼儿喘息的影响因素分析[J].皖南医学院学报,2016,35(2):180-183.
[14] 王双利.婴儿毛细支气管炎后反复喘息相关因素分析和列线图预测模型的建立[D].重庆:重庆医科大学,2020.
[15] Hasegawa K, Mansbach JM, Bochkov YA, et al. Association of rhinovirus C bronchiolitis and immunoglobulin E sensitization during infancy with developmentof recurrent wheeze[J]. JAMA Pediatr, 2019, 173(6):544-552.
[16] 朱雯靓,刘传合.鼻病毒感染与儿童哮喘[J].国际儿科学杂志,2016,43(3):170-172.
[17] Vardavas CI, Hohmann C, Patelarou E, et al.The independent role of prenatal andpostnatal exposure to active and passive smoking on the development of earlywheeze in children[J].Eur Respir J,2016,48(1):115-124.
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