Study On The Outcome And Influencing Factors Of Recurrent Wheezing In 80 Infants

Objective:To explore the outcome of recurrent wheezing in infants and its influencing factors,and to understand the risk factors of persistent wheezing,so as to provide theoretical basis for clinical evaluation and prediction of children who may develop into persistent wheezing.Methods:The recurrent wheezing infants diagnosed and treated in the Pediatric Respiratory Department of the affiliated Hospital of Guizhou Medical University from June 2017 to June 2018 were collected,and their general data,laboratory data and medical history were recorded.The wheezing condition of the children was followed up by telephone 3 years after discharge,and was divided into transient wheezing group and continuous wheezing group according to whether they had wheezing after 3 years old.The sex,first wheezing age,pneumonia,serum total Ig E,food allergen,dust mite allergen,eczema history,allergic rhinitis,time to peak ratio(t PTEF/t E),peak volume ratio(VPEF/VE)and bronchodilation test were compared between the two groups by univariate analysis,and the ROC(working characteristics)curve was drawn.Then the related factors with statistical significance in univariate analysis were analyzed by multi-factor Logistic regression analysis.Results:A total of 98 children met the inclusion criteria,18 children with lost follow-up and incomplete data were excluded,and finally 80 children were included,including48 males and 32 females,all of whom were in pre-school age at the time of follow-up.among them,51 children in the transient wheezing group(64.0%)and 29 children in the persistent wheezing group(36.0%)were compared.The positive rates of food allergen,dust mite allergen and bronchodilation test in the persistent wheezing group were significantly higher than those in the transient wheezing group.The median level of serum total Ig E in the persistent wheezing group was also significantly higher than that in the transient wheezing group.The area under the ROC curve(AUC)of serum total Ig E for evaluating persistent wheezing was 0.802,the sensitivity was69.0%,and the specificity was 94.1%.There was no significant difference in pneumonia,eczema history,allergic rhinitis,tidal pulmonary function parameters t PTEF/t E and VPEF/VE between the two groups.Multivariate analysis showed that the risk of developing persistent wheezing was higher when the children were male(OR=4.401),the age of first wheezing was 1-3 years old(OR=6.194)and the bronchodilation test was positive(OR=6.187).Conclusion:1.After repeated wheezing infants enter preschool,about a third of children are still breathing attack;2.The risk factors of persistent wheezing in preschool children were male,first wheezing age from 1 to 3 years old,elevated serum total Ig E,food allergen,dust mite allergen and positive bronchodilator test.Serum total Ig E has some predictive value in children with persistent wheezing.3.The risk of persistent wheezing was higher in preschool children when they were male,first wheezing at1-3 years of age,and had a positive tidal bronchodilator test at enrollment.