哮喘联盟

   摘要
   背景：婴儿细支气管炎可能是哮喘的首次表现。
   目的：旨在评估婴儿期患有细支气管炎后30年成年人中幼童期风险或哮喘保护因素与肺功能减退的关系。
   方法：47名曾患有细支气管炎的患者纳入本次临床研究，年龄中位数29.5岁，受试者经由医生通过通气-流量肺功能测定检查和测量使用支气管扩张药后的肺功能指标。收集生命早期风险因素，包括细支气管炎入院时及4～6周后康复时血中性粒细胞计数。
   结果：细支气管炎入院时的低血嗜酸性粒细胞计数<0.25x10E9/l是显著保护因素，康复时高血嗜酸性粒细胞计数>0.45x10E9/l是成年人哮喘独立于婴儿遗传过敏性的显著危险因素。父母哮喘及细支气管炎病程中高血嗜酸性粒细胞计数>0.45x10E9/l是不可逆气道阻塞（FEV1/FVC百分比低于细支气管炎正常后第五百分位数下限）的显著危险因素。
   结论：校正分析证实婴儿细支气管炎嗜酸性粒细胞水平降低预示低哮喘风险，非感染状态嗜酸性粒细胞升高预示直到28-31岁的高哮喘风险。父母哮喘及细支气管炎期间嗜酸性粒细胞升高被认为是不可逆性气道阻塞的危险因素。本文受版权保护。保留所有权利。
 

（杨冬 审校）
Pediatr Allergy Immunol. 2015 Jul 16.doi: 10.1111/pai.12448. [Epub ahead of print]
 

Low eosinophils during bronchiolitis in infancy are associated with lower risk of adulthood asthma.
 

Backman K1, Nuolivirta K2, Ollikainen H3, Korppi M4, Piippo-Savolainen E1.
 

Abstract
BACKGROUND:Infant bronchiolitis may be the first manifestation of asthma.
AIM:To evaluate the association of early-childhood risk or protective factors for asthma and lung function reduction in adults 30 years after bronchiolitis in infancy.
METHODS:Forty-seven former bronchiolitis patients attended the clinical study at the median age of 29.5 years, including doctoral examination and measurement of post-bronchodilator lung function with flow-volume spirometry. Data on early-life risk factors including blood eosinophil counts on admission for bronchiolitis and on convalescence 4-6 weeks after bronchiolitis were available.
RESULTS:Low blood eosinophil count <0.25x10E9/l on admission for bronchiolitis was a significant protective factor and high blood eosinophil count >0.45x10E9/l on convalescence was a significant risk factor for asthmain adulthood independently from atopic status in infancy. Parental asthma and high blood eosinophil count >0.45x10E9/l during bronchiolitis were significant risk factors for irreversible airway obstruction (FEV1/FVC-ratio below the 5th percentile lower limit of normality after bronchodilation).
CONCLUSION:Our adjusted analyses confirmed that eosinopenia during infant bronchiolitis predicted lowasthma risk and eosinophilia outside infection predicted high asthma risk up to the age of 28-31 years. Parental asthma and eosinophilia during bronchiolitis were recognized as risk factors for irreversible airway obstruction. This article is protected by copyright. All rights reserved.
 

Pediatr Allergy Immunol. 2015 Jul 16.doi: 10.1111/pai.12448. [Epub ahead of print]