尘螨阳性婴幼儿首次喘息后反复喘息发作的危险因素

Risk factors for recurrent wheezing in infants and young children suffering from dust mite allergy after their first wheezing

摘要:

目的 探讨尘螨阳性婴幼儿首次喘息后反复喘息发作的危险因素。方法 选取2014年8月至2015年2月间住院的首次喘息发作婴幼儿共1 236例，其中尘螨阳性387例，出院后随访1年，随访1年内再发喘息3次及3次以上的患儿设定为反复喘息组（n=67），随访期间未再发生喘息的患儿设定为对照组（n=84）。采用单因素分析和多因素logistic逐步回归分析，探讨尘螨阳性的婴幼儿反复喘息发作的危险因素。结果 单因素分析显示，入院时年龄、入院前喘息时间、肺炎支原体感染率、流感病毒感染率与反复喘息发作相关联。多因素logistic逐步回归分析显示，入院时年龄较大（OR=2.21，P=0.04）、合并肺炎支原体感染（OR=3.54，P=0.001）为反复喘息发作的独立危险因素。结论 尘螨阳性的婴幼儿，特别是幼儿，若首次喘息时合并有肺炎支原体感染，则反复喘息发作的风险明显升高。

Abstract:

Objective To investigate the risk factors for recurrent wheezing in infants and young children suffering from dust mite allergy after their first wheezing. Methods A total of 1 236 infants and young children who experienced a first wheezing episode and were hospitalized between August 2014 and February 2015 were enrolled, among whom 387 were allergic to dust mites. These infants and young children were followed up to 1 year after discharge. A total of 67 infants and young children who experienced 3 or more recurrent wheezing episodes within 1 year were enrolled as the recurrent wheezing group, while 84 infants and young children who did not experience recurrent wheezing during follow-up were enrolled as the control group. Univariate analysis and multivariate logistic stepwise regression analysis were performed to investigate the risk factors for recurrent wheezing in these patients. Results The univariate analysis showed that the age on admission, wheezing time before admission, Mycoplasma pneumoniae infection rate, and influenza virus infection rate were associated with recurrent wheezing. The multivariate logistic stepwise regression analysis showed that the older age on admission (OR=2.21,P=0.04) and Mycoplasma pneumoniae infection (OR=3.54,P=0.001) were independent risk factors for recurrent wheezing. Conclusions Infants and young children who are allergic to dust mites, especially young children, have a significantly increased risk of recurrent wheezing if they are complicated by Mycoplasma pneumoniae infection during the first wheezing episode.