在学龄前儿童中出现重复的喘息发作的危险因素:在英国进行的一项基于人口的队列研究
David Lo1,2, Claire Lawson3, Jonathan Broomfield4
1Respiratory Sciences, University of Leicester, Leicester, UK dkhl1@le.ac.uk.
Archives of disease in childhood
|June 20, 2025
概括
近40%的学龄前儿童在一年内经历了重复的急性喘息发作. 关键预测因素包括先前住院和先前的攻击,而年龄较大和吸入性皮质类固醇使用可能会降低风险.
科学领域:
- 儿科呼吸系统医学 儿科呼吸系统医学
- 流行病学 流行病学
- 医疗信息学 医疗信息学
背景情况:
- 经常出现的急性喘息是学龄前儿童的常见问题,影响了医疗保健资源的利用.
- 确定复发性喘息的预测因素对于有针对性的干预和改善临床管理至关重要.
研究的目的:
- 确定与学龄前儿童经常性急性喘息发作相关的人口和临床因素.
- 为学前喘恶化的临床风险预测模型提供信息.
主要方法:
- 使用英语初级保健和医院电子健康记录的回顾性队列研究.
- 分析了42,820名5岁或以下的儿童,至少有一次急性喘息.
- 对人口统计,临床并发症,药物 anamnesis 和先前攻击数据的多变量分析.
主要成果:
- 大约40%的儿童在12个月内经历了随后的喘息发作.
- 复发性发作最强的预测因素包括初次发作的住院治疗 (RR 1.42) 和之前的发作 (RR 1.27).
- 其他重要因素包括男性性别,南亚族裔,阿托皮,早产,增加缓解剂处方和先前住院;年龄较大和吸入性皮质类固醇使用具有保护作用.
结论:
- 在学龄前儿童中,复发性喘息的临床风险预测可以通过考虑诸如先前住院,先前的攻击和药物史等因素来提高.
- 这些发现支持制定有针对性的策略,以管理和预防幼儿中反复出现的喘息恶化.
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