同卵双生子呼吸道合胞病毒所致毛细支气管炎与哮喘的因果关联研究
2011/04/15
背景：已知呼吸道合胞病毒（respiratory syncytial virus, RSV）所致毛细支气管炎和随后发生哮喘、喘息、肺功能异常和过敏具有相关性。我们研究的目的旨在确定同卵双生子在婴幼儿期因不一致的重症RSV所致毛细支气管炎对继后发展为哮喘、肺功能异常和过敏症差异性影响。
方法：37例同卵双生子在婴幼儿期（平均年龄10.6月）因不一致RSV感染住院，在其平均年龄7.6岁时进行比较，比较内容包括肺功能、支气管反应性、呼出气一氧化氮（fractional exhaled nitric oxide, FENO）浓度、哮喘的诊断、使用哮喘药物、对普通吸入性变应原的皮肤点刺试验。
结果：因在婴幼儿期不一致的RSV感染住院的同卵双生子在肺功能、FENO、哮喘患病率、哮喘药物使用或过敏方面没有差异（所有比较指标P>0.1）。
结论：我们发现婴幼儿期因不一致RSV感染住院的同卵双生子中RSV感染的严重程度对发展为哮喘和过敏性疾病没有差异影响。此结果不支持严重RSV感染对哮喘和过敏症的特异性影响的观点。由于样本量小，这项研究应当被视为一产生假设的研究。
(王刚 四川大学华西医院中西医结合科呼吸组 610041 摘译)
（Chest; 2010; 138(2):338–344）
Causal Direction Between Respiratory Syncytial Virus Bronchiolitis and Asthma Studied in Monozygotic Twins
Poorisrisak P, Halkjaer LB, Thomsen SF, Stensballe LG, Kyvik KO, Skytthe A, Schioetz PO, Bisgaard H.
Chest; 2010; 138(2):338–344
Background: Respiratory syncytial virus (RSV) bronchiolitis has been associated with later development of asthma, wheezing, abnormal pulmonary function, and sensitization. Our aim was to determine the differential effect within monozygotic (MZ) twin pairs discordant for severe RSV bronchiolitis in infancy on the subsequent development of asthma, pulmonary function, and allergy.
Methods: Thirty-seven MZ twin pairs discordant for RSV hospitalization in infancy (mean age 10.6 months) were compared at the mean age of 7.6 years for lung function, bronchial responsiveness, fractional exhaled nitric oxide (FENO), asthma diagnosis, use of asthma medication, and skin prick test to common inhalant allergens.
Results: There were no differences within MZ twin pairs discordant for RSV hospitalization in infancy with respect to pulmonary function, FENO, asthma prevalence, asthma medication use, or sensitization (P . .1 for all comparisons).
Conclusions: We found no differential effect from severity of RSV infection on the development of asthma and allergy in MZ twin pairs discordant for RSV hospitalization in infancy. This argues against a specic effect of severe RSV infection in the development of asthma and allergy. Because of the small sample size, this study must be considered as a hypothesis-generating study.
