Analysis of incidence of post-bronchiolitis recurrent wheezing and its risk factors in children / 中华实用儿科临床杂志

ABSTRACT

Objective To investigate the incidence of post-bronchiolitis recurrent wheezing and its risk factors in children.Methods This study was conducted on patients with bronchiolitis admitted to the Department of Respiratory Disease,Children's Hospital of Soochow University between November 2016 and March 2017.Nasopharyngeal secretions were taken from all patients and assessed for respiratory pathogens.After discharge,the patients were followed up every 3 months by outpatient visit or telephone call for 1 year.Results Eighty-nine patients with bronchiolitis were enrolled in this study.Among those 89 patients,respiratory syncytial virus(RSV) infection accounted for 46.1％ (41/89 cases),Mycoplasma pneumonia(MP) for 5.6％ (5/89 cases),rhinovirus (RV) for 4.5％ (4/89 cases),and human bocavirus(hBoV) for 2.2％ (2/89 cases).Eighty-three patients were successfully followed up.At the 3,6,9,and 12 months of follow-up,the occurrence of wheezing episodes for only once happened in 20 cases(24.1％),27 cases(32.5％),35 cases (42.2％),and 38 cases (45.8％),respectively.At 12 months after initial bronchiolitis,the occurrence of wheezing episodes for only once happened in 21 cases (25.3％),2 episodes of wheezing in 10 cases (12.0％),and 7 cases (8.4％) had more than 3 episodes of wheezing,and 6 cases lost follow-up.The proportion of eczema and milk-protein allergy in post-bronchiolitis recurrent wheezing group was significantly higher than that of the group with not post-bronchiolitis recurrent wheezing patients (x2 =6.219,4.855,all P ＜ 0.05).Logistic regression analysis showed eczema was the independent risk factor for post-bronchiolitis recurrent wheezing(OR =0.189,95％ CI0.047-0.765).There were no significant difference in gender,age,premature birth,birth weight,feeding patterns,family history of asthma,pet contact history,severity of disease,course of disease,total immunoglobulin E of serum and the species of virus infected between 2 groups (all P ＞ 0.05).Conclusions The incidence of recurrent wheezing among post-bronchiolitis patients is higher during one-year follow-up period.Eczema is the independent risk factor for post-bronchiolitis recurrent wheezing.The specific pathogens and severity of disease have no correlation with post-bronchiolitis wheezing.