普通感冒季节每周监测哮喘患儿是否存在感染及其他疾病
2010/08/11
背景：儿童哮喘加重和鼻病毒感染发病率在春秋季节达到高峰，表明病毒感染是季节性哮喘发病的主要原因。
目的：本文旨在哮喘儿童中评价高峰季节鼻病毒感染情况，分析病毒感染与疾病严重程度的关系。
方法：在9月和4月份，连续5周，每周1次，检测58名6～8岁的哮喘患儿的鼻腔灌洗液，并记录症状、药物使用和峰值流量。采用多重聚合酶链反应和病毒基因组部分测序方法来鉴别病毒感染。
结果： 36～50％的样本检测出病毒，其中72～99％的病毒为鼻病毒。分离的169个鼻病毒中共计有52个不同的病毒株（包括16个人鼻病毒C）。两次收集的样本未见有相同的病毒株。除了2名儿童外，其余患儿均存在呼吸道感染。病毒阳性周与感冒和哮喘症状严重程度有关（P分别为 < .0001和P = .0002）。此外，病毒阳性疾病病程增加，感冒和哮喘症状严重程度增加，而且哮喘失控更为常见（47% vs 22%, P = .008）。虽然过敏原致敏和非致敏儿童有相同数量的病毒感染，前者较后者有症状性病毒疾病的发生率多47％（1.19 vs 0.81/月, P = .03）。
结论：感冒季节，哮喘儿童鼻病毒感染较为常见，可能与每个季节出现的新病毒株有关。与病毒相关的疾病其病程和严重程度增加。此外，过敏性哮喘患者更常出现严重的病毒诱发性疾病。
（苏楠 审校）
J Allergy Clin Immunol. 2010 May;125(5):1001-1006.e1. Epub 2010 Apr 14.
Weekly monitoring of children with asthma for infections and illness during common cold seasons.
Olenec JP, Kim WK, Lee WM, Vang F, Pappas TE, Salazar LE, Evans MD, Bork J, Roberg K, Lemanske RF Jr, Gern JE.
Department of Pediatrics, University of Wisconsin, Madison, WI 53792-4108, USA.
Abstract
BACKGROUND: Exacerbations of childhood asthma and rhinovirus infections both peak during the spring and fall, suggesting that viral infections are major contributors to seasonal asthma morbidity.
OBJECTIVES: We sought to evaluate rhinovirus infections during peak seasons in children with asthma and to analyze relationships between viral infection and illness severity.
METHODS: Fifty-eight children aged 6 to 8 years with asthma provided 5 consecutive weekly nasal lavage samples during September and April; symptoms, medication use, and peak flow were recorded. Rhinoviruses were identified by using multiplex PCR and partial sequencing of viral genomes.
RESULTS: Viruses were detected in 36% to 50% of the specimens, and 72% to 99% of the viruses were rhinoviruses. There were 52 different strains (including 16 human rhinovirus C) among the 169 rhinovirus isolates; no strains were found in more than 2 collection periods, and all but 2 children had a respiratory tract infection. Virus-positive weeks were associated with greater cold and asthma symptom severity (P < .0001 and P = .0002, respectively). Furthermore, virus-positive illnesses had increased duration and severity of cold and asthma symptoms and more frequent loss of asthma control (47% vs 22%, P = .008). Although allergen-sensitized versus nonsensitized children had the same number of viral infections, the former had 47% more symptomatic viral illnesses (1.19 vs 0.81 per month, P = .03).
CONCLUSIONS: Rhinovirus infections are nearly universal in children with asthma during common cold seasons, likely because of a plethora of new strains appearing each season. Illnesses associated with viruses have greater duration and severity. Finally, atopic asthmatic children experienced more frequent and severe virus-induced illnesses.
J Allergy Clin Immunol. 2010 May;125(5):1001-1006.e1. Epub 2010 Apr 14.
目的：本文旨在哮喘儿童中评价高峰季节鼻病毒感染情况，分析病毒感染与疾病严重程度的关系。
方法：在9月和4月份，连续5周，每周1次，检测58名6～8岁的哮喘患儿的鼻腔灌洗液，并记录症状、药物使用和峰值流量。采用多重聚合酶链反应和病毒基因组部分测序方法来鉴别病毒感染。
结果： 36～50％的样本检测出病毒，其中72～99％的病毒为鼻病毒。分离的169个鼻病毒中共计有52个不同的病毒株（包括16个人鼻病毒C）。两次收集的样本未见有相同的病毒株。除了2名儿童外，其余患儿均存在呼吸道感染。病毒阳性周与感冒和哮喘症状严重程度有关（P分别为 < .0001和P = .0002）。此外，病毒阳性疾病病程增加，感冒和哮喘症状严重程度增加，而且哮喘失控更为常见（47% vs 22%, P = .008）。虽然过敏原致敏和非致敏儿童有相同数量的病毒感染，前者较后者有症状性病毒疾病的发生率多47％（1.19 vs 0.81/月, P = .03）。
结论：感冒季节，哮喘儿童鼻病毒感染较为常见，可能与每个季节出现的新病毒株有关。与病毒相关的疾病其病程和严重程度增加。此外，过敏性哮喘患者更常出现严重的病毒诱发性疾病。
（苏楠 审校）
J Allergy Clin Immunol. 2010 May;125(5):1001-1006.e1. Epub 2010 Apr 14.
Weekly monitoring of children with asthma for infections and illness during common cold seasons.
Olenec JP, Kim WK, Lee WM, Vang F, Pappas TE, Salazar LE, Evans MD, Bork J, Roberg K, Lemanske RF Jr, Gern JE.
Department of Pediatrics, University of Wisconsin, Madison, WI 53792-4108, USA.
Abstract
BACKGROUND: Exacerbations of childhood asthma and rhinovirus infections both peak during the spring and fall, suggesting that viral infections are major contributors to seasonal asthma morbidity.
OBJECTIVES: We sought to evaluate rhinovirus infections during peak seasons in children with asthma and to analyze relationships between viral infection and illness severity.
METHODS: Fifty-eight children aged 6 to 8 years with asthma provided 5 consecutive weekly nasal lavage samples during September and April; symptoms, medication use, and peak flow were recorded. Rhinoviruses were identified by using multiplex PCR and partial sequencing of viral genomes.
RESULTS: Viruses were detected in 36% to 50% of the specimens, and 72% to 99% of the viruses were rhinoviruses. There were 52 different strains (including 16 human rhinovirus C) among the 169 rhinovirus isolates; no strains were found in more than 2 collection periods, and all but 2 children had a respiratory tract infection. Virus-positive weeks were associated with greater cold and asthma symptom severity (P < .0001 and P = .0002, respectively). Furthermore, virus-positive illnesses had increased duration and severity of cold and asthma symptoms and more frequent loss of asthma control (47% vs 22%, P = .008). Although allergen-sensitized versus nonsensitized children had the same number of viral infections, the former had 47% more symptomatic viral illnesses (1.19 vs 0.81 per month, P = .03).
CONCLUSIONS: Rhinovirus infections are nearly universal in children with asthma during common cold seasons, likely because of a plethora of new strains appearing each season. Illnesses associated with viruses have greater duration and severity. Finally, atopic asthmatic children experienced more frequent and severe virus-induced illnesses.
J Allergy Clin Immunol. 2010 May;125(5):1001-1006.e1. Epub 2010 Apr 14.
