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Asthma and lung function in adulthood after a viral wheezing episode in early childhood

机译：在早期童年期的病毒喘息发作后成年期的哮喘和肺功能

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Summary Background Viral aetiology of infection has a significant role in the long‐term outcome of early‐childhood wheezing. Objective This study examines asthma and lung function in adulthood after early‐childhood wheezing induced by respiratory syncytial virus ( RSV ) and rhinovirus ( RV ). Methods A total of 100 children were hospitalized for a wheezing episode at less than 24 months of age from 1992 to 1993 in Kuopio University Hospital (Finland). Adenovirus, influenza A and B virus, parainfluenza (1‐3) virus, and RSV were tested on admission using antigen detection and antibody assays, and RSV and RV were tested by polymerase chain reaction ( PCR ). In 2010, 49 cases and 60 population controls attended a follow‐up study, which included spirometry with bronchodilation test and fractionally exhaled nitric oxide ( FE NO ) measurements. Results Current asthma was present in 64% of the cases with RV ‐induced wheezing ( OR 17.0 [95% CI 3.9‐75.3] vs controls), in 43% of the cases with RSV ‐induced wheezing episode (6.1 [1.5‐24.9] vs controls), and in 12% of the controls. The RV group showed significantly higher mean FE NO values than the RSV group and controls. RV ‐positive cases had lower MEF 50 before bronchodilation and higher MEF 50, FEV 1, and FEV 1/ FVC bronchodilation responses than controls. RSV ‐positive cases had lower FVC than controls before bronchodilation. Conclusion Cases with RV ‐ and RSV ‐induced early‐childhood wheezing had increased risk for asthma in adulthood, and RV ‐positive cases had significantly higher FE NO values than RSV ‐positive cases and controls. Compared to controls, RV ‐positive cases showed more bronchial reactivity, and RSV ‐positive cases showed lower FVC before bronchodilation in lung function testing. Clinical relevance Children with RV ‐ or RSV ‐induced wheezing in early childhood have an increased risk for asthma and lung function abnormalities in adulthood.
机译：发明内容背景感染的病毒性病毒学在早期儿童喘息的长期结果中具有重要作用。目的本研究在呼吸道合胞病毒（RSV）和鼻病毒（RV）诱导的早期儿童喘息后的成年后哮喘和肺功能。方法在长于1992年至1993年在库皮奥大学医院（芬兰）的年龄不到24个月，总共增加了100名儿童的喘息集。使用抗原检测和抗体测定对腺瘤病毒，流感A和B病毒，Parainfluenza（1-3）病毒和RSV进行预测，并通过聚合酶链式反应（PCR）测试RSV和RV。 2010年，49例和60例人口控制参加了随访的研究，包括用支气管扩张试验和分馏一氧化氮（Fe NO）测量的肺动力测定法。结果目前的哮喘存在于64％的患者中，其中RV-诱导的喘息（或17.0 [95％[95％CI 3.9-75.3] VS对照），43％的RSV诱导的喘息集（6.1 [1.5-24.9]。 VS控件），并在12％的控件中。 RV组显示出比RSV组和控制的显着更高的平均值。在支气管扩张和更高的MEF 50，FEV1和FEV 1 / FVC支气管扩张响应之前，RV叠层均为较低的MEF 50。 RSV阳性病例比支气管扩张前的对照较低的FVC。结论患有RV - 和RSV-诱导的早期儿童喘息的病例在成年期内增加了哮喘的风险，并且RV叠层病例明显高于RSV阳性病例和对照。与对照组相比，RV阳性病例显示出更多的支气管反应性，RSV阳性病例在肺功能测试中的支气管扩张前显示出低于FVC。患有RV - 或RSV诱因的临床关联儿童在幼儿早期的喘息率增加了成年期哮喘和肺功能异常的风险。

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