[重症细支气管炎呼吸过程的回顾性调查]。

Archives francaises de pediatrie Pub Date : 1993-08-01
E Bodart, J Just, A Grimfeld, J Costil
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引用次数: 0

摘要

背景:婴儿呼吸道合胞病毒(RSV)感染可诱导支气管反应性和病毒特异性IgE的产生;这些反应可能有利于哮喘的后期发展。本回顾性研究探讨了早期和严重形式的细支气管炎对这一结果的影响。人群和方法:研究了1986-1990年间43例因严重毛细支气管炎合并呼吸暂停和/或高碳酸血症和/或低氧血症而在重症监护中度过1至24天(平均7.8天)的婴儿的档案。所有这些儿童的父母同意回答一份标准问卷,内容包括围产期事件、胎龄、喘息复发次数和频率、个人和家族过敏史以及环境条件。其中15名儿童为早产儿,其中12名在新生儿期给予呼吸支持;其中5例发生支气管-肺发育不良。39例患者中有20例分离到RSV。结果:41例存活患者中有26例在5 - 54个月(平均27.6个月)期间出现至少3次喘息发作:其中15例因哮喘入院至少一次,17例接受长期支气管扩张剂和/或皮质类固醇治疗。在8名有过敏史的患者中,6名患有哮喘,与其他儿童密切接触的9名患者中有7名患有哮喘,15名接触过烟草的患者中有9名患有哮喘。结论:哮喘的发展不仅与危险因素(呼吸道合胞病毒感染、支气管肺发育不良、过敏史、与其他儿童密切接触和接触烟草)有关,而且细支气管炎本身的严重程度也与这种风险有关。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
[A retrospective survey on the respiratory course of severe bronchiolitis].

Background: Respiratory syncytial virus (RSV) infection in infancy can induce bronchial reactivity and virus-specific IgE production; these responses may favor the later development of asthma. This retrospective study examines the influences of early and severe forms of bronchiolitis on such an outcome.

Population and methods: The files of 43 infants who had spent 1 to 24 days (mean 7.8 days) in intensive care between 1986-1990 for severe bronchiolitis with apnea and/or hypercapnia and/or hypoxemia were studied. The parents of all these children agreed to answer a standard questionnaire covering perinatal events, gestational age, number and frequency of recurrent episodes of wheezing, personal and familial history of allergy and environmental conditions. 15 of the children were preterm and 12 of them were given respiratory support during the neonatal period; 5 of these patients developed broncho-pulmonary dysplasia. RSV was isolated in 20 of 39 patients.

Results: 26 of the 41 surviving patients developed at least 3 episodes of wheezing over periods ranging from 5 to 54 months (mean 27.6 months): 15 of them were admitted at least once for asthma and 17 were given long-term bronchodilators and/or corticosteroids. Of the 8 patients with histories of allergy, 6 developed asthma, as did 7 of the 9 that had been in close contact with other children, and 9 of the 15 patients who had been exposed to tobacco.

Conclusions: Not only is the development of asthma associated with risk factors (RSV infection, bronchopulmonary dysplasia, history of allergy, close contact with other children and exposure to tobacco) but the severity of the bronchiolitis per se is also correlated with this risk.

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