急性細支氣管炎與兒童氣喘之長期性研究

張日錦

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急性細支氣管炎與兒童氣喘之長期性研究

A Longitudinal Study on Acute Bronchiolitis and Subsequent Childhood Asthma

張日錦 , Masters　　Advisor：呂克桓;柯俊良　　

繁體中文

細支氣管炎；氣喘； bronchiolitis ； asthma

Abstract │ Reference (81) │ Altmetrics

Abstract 〈TOP〉

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Background: 
The symptoms of wheezing and dyspnea in acute asthmatic attacks are similar to bronchiolitis. Whether the occurrence times of bronchiolitis poses a risk for the development of asthma has not been clearly investigated. 
Objective: 
The aim is to analyze the relationship between acute bronchiolitis in children younger than 2 years of age and subsequent childhood asthma. 
Design: 
This was a retrospective cohort study design. 
Methods: 
Children younger than 24 months who were diagnosed with acute bronchiolitis from 2001-2010 were retrieved from the National Health Insurance Research Database of Taiwan, and compared to subjects without bronchiolitis diagnosis with regards to asthma. Potential comorbidities and medical care conditions were also compared between two groups.
Results: 
In total, 64013 children were enrolled into analysis inclusive of 31058 exposure subjects compared with 32955 controls. The incidence of childhood astma was significantly higher in the study group (13.87 v.s. 9.06 per 103 person years after propensity score match，p<0.0001). The hazard ratio was highest (5.892，95%C.I.：3.254-10.667) for bronchiolitis outpatient visits more than three times and hospitalized more than twice before 24 months of age. Gender and atopic dermatitis have no adjust effect on hazard ratios of bronchiolitis with regards to asthma development.
Conclusion: 
Early bronchiolitis infection do increase the risk of developing subsequent childhood asthma, and more bronchiolitis episodes significantly increase the effect. Nevertheless bronchiolitis may be related with earlier onset of asthma. We suggest the parents of children with bronchiolitis before 24 months of age should be informed for the higher risk of developing subsequent asthma and be well evaluated, especially in children with increased outpatient visits (>3 times) and hospitalization (>2 times).

Reference ( 81 ) 〈TOP〉

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