Viral etiology and atopic characteristics in high-risk asthmatic children hospitalized for lower respiratory tract infection
Viral etiology and atopic characteristics in high-risk asthmatic children hospitalized for lower respiratory tract infection
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因下呼吸道感染住院的哮喘高危儿童的病毒病原学和特应性特征
DOI：
10.21037/tp-20-165
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发表时间：
2020-08-01
影响因子：
2
通讯作者：
Yan, Yongdong
中科院分区：
文献类型：
--
作者：
Wang, Ting;Dong, Heting;Yan, Yongdong
病毒病因学和特应性特征，如过敏原和分数型呼出一氧化氮（FeNO），在哮喘的发展中起重要作用。本研究旨在探讨这些因素在哮喘高危儿童中的相关性，以指导哮喘的可靠诊断和治疗。方法选取2016年4月~ 2017年8月收治的哮喘高危住院下呼吸道感染（LRTI）伴喘息患儿135例作为研究对象（观察组）。采用实时荧光聚合酶链反应（PCR）分析其病因。样品也用Phadiatop （Pharmacia Diagnostics AB, Uppsala, Sweden）进行评估。选取研究期间在超声心动图门诊筛查随访的200名无哮喘、无过敏的健康儿童作为健康对照组，同时对观察组进行FeNO测量。结果观察组病毒检出率为49.63%。检出最多的病毒是人鼻病毒（HRV, 25.19%）。与<12个月的儿童相比，1-3岁儿童更容易感染HRV，对吸入性过敏原的敏感性较低，T-IgE较高。与未检测病毒组相比，检测病毒组对吸入性过敏原的敏感性更高。观察组FeNO低于健康对照组。与第一次喘息组相比，第二次喘息组对尘螨和真菌的敏感性更高，T-IgE水平也更高。结论：HRV是婴幼儿哮喘发作时最常见的病毒病原体。过敏是初始喘息和反复喘息的一个危险因素。吸入过敏原敏感的儿童比其他人更容易受到病毒感染。
Background Viral etiology and atopic characteristics, e.g., allergens and fractional exhaled nitric oxide (FeNO), play essential roles in asthma development. This study aimed to investigate associations among them in children at high risk of developing asthma to guide reliable diagnosis and treatment of wheezing. Methods From April 2016 to August 2017, 135 children aged <3 years identified as being at high risk of asthma and hospitalized for lower respiratory tract infection (LRTI) with wheezing were recruited as research subjects (observation group). Real-time fluorescent polymerase chain reaction (PCR) was used to explore their etiology. Samples were also evaluated with Phadiatop (Pharmacia Diagnostics AB, Uppsala, Sweden). Additionally, 200 non-asthmatic, non-allergic, healthy children who were screened and followed up in the Echocardiography clinic during the study period were recruited as a healthy control group for FeNO measurement, and the observation group also underwent FeNO measurement. Results Among the observation group, viruses were positively detected in 49.63%. The most often detected virus was human rhinovirus (HRV; 25.19%). Compared with children aged <12 months, those aged 1–3 years were more susceptible to HRV infection and had lower sensitivity rates for inhalant allergens and higher T-IgE. The virus-detected group had a higher sensitivity rate for inhalant allergens compared with the virus-undetected group. FeNO in the observation group was lower than that in the healthy control group. The second-wheezing group had higher sensitivity rates for dust mites and fungi and higher T-IgE levels compared with the first-wheezing group. Conclusions HRV was the most common viral pathogen present during an asthmatic attack in infants and young children at elevated risk of asthma. Allergy is a risk factor for both initial wheezing and repeated wheezing. Inhalant allergen-sensitive children are more susceptible than others to viral infection.