儿童哮喘重度发作的相关因素
2011/10/13
摘要
背景：哮喘发作是导致儿童住院的最常见原因，在美国，每年导致约10000次重症监护室（ICU）住院。虽然哮喘在儿童较常见，但与哮喘重度发作相关的因素尚不完全清楚。
方法：本试验为回顾性病例对照研究，对1年内住院的患儿进行研究。因急性恶化住入ICU的患儿（病例）与因急性哮喘住院的患儿（对照）之间进行潜在相关因素和转归的比较。
结果：研究期内共计188名哮喘患儿住院，57名（30%）ICU住院。两组间在年龄、性别和种族上无显著差异。与普通病房住院患儿相比，ICU住院患儿更有可能出现过敏症或刺激物导致的发作(OR 3.9; 95% CI 1.9-8.2; p =0.0003)。此外，ICU住院患者从发作至住院前的间隔时间较短(1.7 ± 2.3 vs. 3.4 ± 4.8天; p =0.002)。
结论：在本项回顾性研究中，儿童哮喘重度发作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，这一点支持特应性在儿童哮喘中的重要性。
(林江涛 审校)
J Asthma. 2011 Aug;48(6):558-64. Epub 2011 Jun 6.
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 Aug;48(6):558-64. Epub 2011 Jun 6.
背景：哮喘发作是导致儿童住院的最常见原因，在美国，每年导致约10000次重症监护室（ICU）住院。虽然哮喘在儿童较常见，但与哮喘重度发作相关的因素尚不完全清楚。
方法：本试验为回顾性病例对照研究，对1年内住院的患儿进行研究。因急性恶化住入ICU的患儿（病例）与因急性哮喘住院的患儿（对照）之间进行潜在相关因素和转归的比较。
结果：研究期内共计188名哮喘患儿住院，57名（30%）ICU住院。两组间在年龄、性别和种族上无显著差异。与普通病房住院患儿相比，ICU住院患儿更有可能出现过敏症或刺激物导致的发作(OR 3.9; 95% CI 1.9-8.2; p =0.0003)。此外，ICU住院患者从发作至住院前的间隔时间较短(1.7 ± 2.3 vs. 3.4 ± 4.8天; p =0.002)。
结论：在本项回顾性研究中，儿童哮喘重度发作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，这一点支持特应性在儿童哮喘中的重要性。
(林江涛 审校)
J Asthma. 2011 Aug;48(6):558-64. Epub 2011 Jun 6.
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 Aug;48(6):558-64. Epub 2011 Jun 6.
上一篇：
皮质激素吸入和鼻腔给药对哮喘患儿下丘脑-垂体-肾上腺轴的抑制：早晨血清促肾上腺皮质激素（ACTH）的
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