哮喘联盟

   摘要
   背景：细支气管炎为儿童最常见的住院指征，与并发哮喘相关。血嗜酸性粒细胞升高与哮喘严重程度增加有关，但是否与细支气管炎的疾病严重程度有关尚不可知。假设血嗜酸性粒细胞升高与细支气管炎住院治疗的短期不良结果有关。
   方法：运用Population Explorer (Explorys, Cleveland, OH)软件提取我院2010年至2013年间首次细支气管炎住院数据。研究对象被分为无CBC组（住院7天内无血常规[CBC]数据），EOS阳性组（至少一次血常规嗜酸性粒细胞≥300/μL或嗜酸性粒细胞比率≥3%）和EOS阴性组（至少一次血常规且无嗜酸性粒细胞升高）。运用Spearman相关计算住院时间与最高绝对嗜酸性粒细胞计数（AEC）的关系。运用其他逐步多元回归，分析与延长住院天数（超过72小时）相关的独立因素。
   结果：1356例小于24个月的细支气管炎住院患者中，平均住院天数为2.46天，38.0%住院时间延长。32.4%的研究对象有CBC数据：20.7%为EOS阳性，79.3%为EOS阴性。最大AEC的升高与住院时间的增加显著相关。住院延长与EOS阳性比EOS阴性独立相关(OR 1.88, 95%CI: 1.12-3.17, P = 0.020)。机械通气在EOS阳性组中更为普遍（24.2%），EOS阴性组为7.2%，无CBC组为0.7%(P < 0.001)。
   结论：大型细支气管患者队列中，血嗜酸性粒细胞升高与不良住院治疗结果相关。
 

（杨冬 审校）
 Pediatr Pulmonol. 2015 Jun 9. doi: 10.1002/ppul.23219. [Epub ahead of print]

 

Blood eosinophilia is associated with unfavorable hospitalization outcomes in children with bronchiolitis.
 

Shein SL1, Li H2, Gaston B3.
 

Abstract
BACKGROUND:Bronchiolitis, the most common indication for hospitalization of young children, is associated with subsequent asthma. Blood eosinophilia is associated with increased severity of asthma, but it is unclear if eosinophilia is associated with severity of illness in bronchiolitis. We hypothesized that blood eosinophilia is associated with unfavorable short-term outcomes of bronchiolitis hospitalizations.
METHODS:Data from initial bronchiolitis admissions to our institution between 2010 and 2013 were extracted using Population Explorer software (Explorys, Cleveland, OH). Children were categorized as "CBC-none" (no complete blood count [CBC] data during the first 7 days of hospitalization), EOS-positive (at least one CBC with ≥300 eosinophils per microliter or ≥3% of all leukocytes identified as eosinophils) or EOS-negative (at least one CBC and no eosinophilia). The association between hospitalization duration and maximum absolute eosinophil count (AEC) was analyzed using Spearman correlation. Variables independently associated with prolonged (≥72 hr) hospitalization were identified using stepwise multivariate logistic regression.
RESULTS:In 1356 inpatients <24 months with bronchiolitis, median hospitalization duration was 2.46 days and 38.0% had prolonged hospitalization. CBC data were available in 32.4% of subjects: 20.7% were EOS-positive and 79.3% were EOS-negative. Increased maximum AEC was significantly associated with longer duration of hospitalization. Prolonged hospitalization was independently associated with EOS-positive versus EOS-negative children (OR 1.88, 95%CI: 1.12-3.17, P = 0.020). Mechanical ventilation was most common in EOS-positive subjects (24.2% of cases), versus EOS-negative (7.2%) and CBC-none (0.7%) (P < 0.001).
CONCLUSIONS:Blood eosinophilia is associated with unfavorable clinical outcomes in a large cohort of inpatients with bronchiolitis. Pediatr Pulmonol.
 

Pediatr Pulmonol. 2015 Jun 9. doi: 10.1002/ppul.23219. [Epub ahead of print]