Analysis Of Atopy And Recurrent Wheezing Factors In Infants

OBJECTIVE: This article reviews the clinical cases of infants with acute wheezing episodes,analyzes the distribution of characteristics and the composition of causes and pathogen in infants.Discussing the correlation between atopy factors(Eczema and allergic rhinitis diagnosed by physicians,positive-allergy/asthma history of family,positive-allergen-specific Ig E,elevated serum Ig E,and increased peripheral blood eosinophil count)and recurrent wheezing to help giving treatment and prevention of wheezing recurrence timely and effectively.METHODS: The first part was selected 480 cases of infants with acute wheezing episodes in Tianjin Children's Hospital from January 2018 to January 2019.The distribution of characteristics and the composition of causes and pathogen were analyzed.In the second part,according to the inclusion and exclusion criteria,the infants were given a return visit every 3 months with the questions of recurrence of wheezing,the corresponding incentives and treatments,etc,Finally,209 infants were enrolled.Counting the basic data(including gender,age,height,weight,pregnancy history,living environment,etc.),medical history data(eczema history,rhinitis history,family allergy/asthma history),laboratory tests(including Fe NO,allergen specificity Ig E,serum Ig E,peripheral blood eosinophil count,lung function),then,analyzing the data above.RESULTS: The first part: Among 480 infants with acute wheezing,318(66.25%)were male and 162(33.75%)were female,which the male to female ratio is 1.96:1.Wheezing infants with acute attacks can be found in various times,especially in winter and spring.The main cause of wheezing infants is respiratory infection,accounting for 66.46% of total wheezing children(Pneumonia 61.25%,Bronchitis 5.21%).Among the infection-related wheezing infants,there were 79(24.76%)cases with viral infection,of which 53(67.09%)cases were RSV infection.The second part: The infants with first-wheezing-attack are 209 cases,49(23.44%)infants with recurrent wheezing.There are 158 infants with atopy,which accounting for 75.60%,among the first-wheezing-attack infants.There are 83(39.71%)infants with a history of eczema,6(2.87%)infants with a history of allergic rhinitis, 39(18.66%)infants with positive-allergy/asthma history of family,77(36.84%)infants with positive-allergen-specific Ig E,41(19.62%)infants with elevated serum Ig E,and 14(6.70%)infants with increased eosinophil count of peripheral blood infants in first-wheezing-attack.Atopy is associated with recurrent wheezing in infants(OR=2.666).Among the atopy factors,children with eczema(OR=2.329)and allergic rhinitis(OR=24.601)had a higher risk of recurrent wheezing.The positive-allergy/asthma history of family,positive-allergen-specific Ig E,elevated serum Ig E and high peripheral blood eosinophils are may not associated with recurrent wheezing(P>0.05).Among the infants with recurrent wheezing,43(87.76%)infants with atopy.In the recurrent wheezing infants,39(79.60%)infants were induced by respiratory infection.Conclusion:1.Atopy is associated with recurrent wheezing,eczema and rhinitis are risk factors of recurrent wheezing.2.The first-time wheezing infants with atopic performance should be treated regularly and follow-up.3.The episodes of acute wheezing mainly occur in winter.Respiratory infections is the main cause and incentive reason of wheezing,The main infectious pathogen is virus,and RSV plays a major role in viral infection.4.Boys are more common in infants with acute wheezing episodes.