To assess risk factors of recurrent bronchial obstruction and allergic sensitization 3 years after an episode of acute bronchiolitis, whether after ambulatory care treatment or hospitalization. A monocentric prospective longitudinal study including infants aged under 1 year with acute bronchiolitis was performed, with clinical (severity score), biological (serum Krebs von den Lungen 6 antigen), and viral (14 virus by naso-pharyngeal suction detection) assessments. Follow-up included a quaterly telephone interview, and a final clinical examination at 3 years. Biological markers of atopy were also measured in peripheral blood, including specific IgEs towards aero- and food allergens. Complete data were available for 154 children. 46.8% of them had recurrent wheezing (RW). No difference was found according to initial severity, care at home or in the hospital, respiratory virus involved, or existence of co-infection. A familial history of atopy was identified as a risk factor for recurrent bronchial obstruction (60% for RW infants versus 39%, P = 0.02), as living in an apartment (35% versus 15%, P = 0.002). 18.6% of the infants were sensitized, with 48.1% of them sensitized to aeroallergens and 81.5% to food allergens. Multivariate analysis confirmed that a familial history of atopy (P = 0.02) and initial co-infection RSV-hRV (P = 0.02) were correlated with the risk of sensitization to aeroallergens at 3 years. Familial history of atopy and RSV-hRV co-infection are risk factors for recurrent bronchial obstruction and sensitization.

译文

:评估急性细支气管炎发作后3年(无论是在非卧床护理治疗后还是住院后)复发性支气管阻塞和过敏致敏的危险因素。进行了一项单中心前瞻性纵向研究,包括1岁以下的急性毛细支气管炎婴儿,并进行了临床(严重性评分),生物学(血清Krebs von den Lungen 6抗原)和病毒(鼻咽抽吸检测为14病毒)评估。随访包括季度电话访谈和3年期的最终临床检查。还测量了外周血中特应性的生物学标记,包括针对航空和食物过敏原的特异性IgE。有154名儿童的完整数据。他们中有46.8%患有反复性喘息(RW)。根据最初的严重程度,在家中或医院中的护理,所涉及的呼吸道病毒或是否存在合并感染,均未发现差异。特应性家族病史被确定为复发性支气管阻塞的危险因素(RW婴儿为60%,而39%,P = 0.02),以及居住在公寓中(35%对15%,P = 0.002)。有18.6%的婴儿过敏,其中48.1%的婴儿对空气过敏原敏感,81.5%的食物对过敏原敏感。多变量分析证实,特应性家族史(P = 0.02)和初次合并感染RSV-hRV(P = 0.02)与3年时对气敏原致敏的风险有关。特应性家族病史和RSV-hRV合并感染是复发性支气管阻塞和致敏的危险因素。

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