儿童哮喘严重恶化相关因素
2011/08/10
摘要
背景：哮喘恶化是导致儿童住院的常见原因，在美国，因哮喘恶化导致的急诊(ICU)住院，每年约为10,000人次。尽管儿童哮喘发病率较高，但与哮喘严重恶化相关的因素目前大部分尚不清楚。
方法：本试验为回顾性病例-对照研究，入选儿童为1年内入院患儿。因哮喘严重恶化入ICU治疗的患儿，其潜在相关因素和疾病转归，与急性哮喘入病房住院的患儿进行对比。
结果：共计188名患儿在整个研究期内因哮喘住院。57（30%）名患儿入ICU治疗。两组患者在年龄、性别、种族上无显著差异。与对照患儿相比，ICU治疗患儿更有可能出现过敏症和刺激物诱导的哮喘恶化（OR 3.9; 95% CI 1.9-8.2; p =0.0003）。此外，ICU患儿入院前的疾病持续时间显著低于入院治疗患者(1.7 ± 2.3 vs. 3.4 ± 4.8 days; p =0.002)。
结论：本项回顾性研究显示，儿童哮喘严重恶化与症状快速发作相关，而且更有可能与过敏原或刺激物相关，支持特应性在该人群中具有重要作用。
（刘国梁 审校）
J Asthma. 2011 Jun 6. [Epub ahead of print]
Factors Associated with the Development of Severe Asthma Exacerbations in Children.
Sala KA, Carroll CL, Tang YS, Aglio T, Dressler AM, Schramm CM.
Source
Department of Pediatrics, Connecticut Children’s Medical Center , Hartford, CT , USA .
Abstract
BACKGROUND：Asthma exacerbations are one of the most common causes of hospitalization in children and account for approximately 10,000 intensive care unit (ICU) admissions per year in the United States. Despite the prevalence of this disease in children, the factors associated with the development of these severe exacerbations are largely unknown.
METHODS： A retrospective case-control study was conducted involving all eligible children admitted to the hospital with asthma for a 1-year period. Potential associated factors and outcomes of children admitted to the ICU with a severe exacerbation (cases) were compared to those of children with acute asthma admitted to the ward (controls).
RESULTS： A total of 188 children were hospitalized with asthma during the study period, 57 (30%) of whom required admission to the ICU. There were no differences in age, gender, or race between cases and controls. Children admitted to the ICU were significantly more likely to have an allergy or irritant-triggered exacerbation than children admitted to the ward (OR 3.9; 95% CI 1.9-8.2; p = .0003). Additionally, children in the ICU had a significantly shorter duration of illness before being admitted to the hospital compared to those admitted to the ward (1.7 ± 2.3 vs. 3.4 ± 4.8 days; p = .002).
CONCLUSIONS： In this retrospective review, severe asthma exacerbations in children are associated with a more rapid onset of symptoms and are more likely to be associated with allergens or irritants, supporting the importance of atopy in this population.
J Asthma. 2011 Jun 6. [Epub ahead of print]
