Clinical characteristics of hospitalized infants with acute lower respiratory tract infections induced wheezing and their changes in lung function / 中华实用儿科临床杂志

ABSTRACT

Objective To determine the clinical characteristics of acute lower respiratory tract infections (ALRIs)induced wheezing,and to explore the impact of wheezing ALRIs on the subsequent respiratory diseases and lung function. Methods A total of 1726 hospitalized infants who were diagnosed with ALRIs in Children′s Hospital of Fudan University between March 2011 and February 2012 were enrolled and classified into wheezing group and non -wheezing group. Data were collected regarding demographic characteristics,family status,clinical presentations,respira-tory pathogens,and pulmonary function tests (PFTs). Subjects were followed up with questionnaires in 6 months and 1 year after discharge. PFTs were performed in 50 wheezing infants at 6 months after discharge. Results In the 1726 hospitalized infants,471 cases had a wheezing episode (27. 3％). The majority (262 / 471 cases,55. 6％)of infants with wheezing were reported with a family history of atopy. The total detection rate of viruses in wheezing group was 73. 7％ . The detection rate of respiratory syncytial virus (RSV)in wheezing group was higher than that of non-whee-zing group (68. 6％ vs. 47. 0％),and the difference was significant (P < 0. 001). For infants less than 3 months,the wheezing group had less time to peak tidal expiratory flow as a percentage of total expiratory time (TPTEF/ TE)and volume to peak tidal expiratory flow as a percentage of total expiratory volume (VPTEF/ VE),compared with the non -wheezing group [(22. 9 ± 9. 8)％ vs. (29. 2 ± 12. 3)％ and (25. 7 ± 8. 0)％ vs. (29. 8 ± 9. 6)％,respectively],and the differences were significant (all P < 0. 05). After 6 months,the wheezing group increased TPTEF/ TE and VPTEF/VE [(24. 0 ± 9. 0)％ vs. (19. 9 ± 6. 7)％,(25. 8 ± 7. 0)％ vs. (23. 2 ± 5. 0)％,respectively],and the differences were significant (all P < 0. 05),but still below normal level. Patients with wheezing were more likely to develop subse-quent wheezing during the following 1 year (20. 0％ vs. 10. 6％),and the difference was significant (P < 0. 001). Conclusion Wheezing in infants with ALRIs is related to family history of atopy and viral infections,especially to RSV. Hospitalization for wheezing ALRIs is associated with impaired lung function and a higher frequency of subsequent wheezing.