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急性病毒性细支气管炎表型对糖皮质激素和支气管扩张剂治疗的反应。

Acute viral bronchiolitis phenotype in response to glucocorticoid and bronchodilator treatment.

机构信息

Universidade Estadual de Maringá, Maringá, PR, Brazil.

Universidade Estadual de Maringá, Maringá, PR, Brazil.

出版信息

Clinics (Sao Paulo). 2024 Jun 5;79:100396. doi: 10.1016/j.clinsp.2024.100396. eCollection 2024.

Abstract

OBJECTIVE

To analyze whether infants admitted to hospital with Acute Viral Bronchiolitis (AVB), who received glucocorticoids and bronchodilators, and who had an atopic phenotype, spent less time in hospital and/or less time on oxygen therapy when compared to those who did not have the phenotype.

METHOD

A cross-sectional, retrospective epidemiological study was developed with data from medical records of infants admitted to hospital due to AVB from 2012 to 2019 in a sentinel public hospital. It was verified that the frequency of prescription of glucocorticoids, bronchodilators and antibiotics. Length of stay and oxygen therapy duration were then compared in the group that used glucocorticoids and bronchodilators between those who had a personal or family history of atopy and those who did not. Subsequently, the length of hospital stay was compared among infants who received antibiotic therapy and those who did not.

RESULTS

Fifty-eight infants were included. Of these, 62.1 % received an antibiotic, 100 % a bronchodilator and 98.3 % a glucocorticoid. When comparing infants without a family history of atopy, those who received antibiotics had a longer hospital stay (p = 0.01).

CONCLUSION

The presence of an atopic phenotype did not interfere with the length of stay and/or oxygen therapy duration of those who received bronchodilators and glucocorticoids. Increased length of stay of infants without a family history of atopy, who used antibiotics without evidence of bacterial co-infection, and the high frequency of prescription of non-recommended drugs call attention to stricter protocol implementation and professional training in AVB diagnosis and care.

摘要

目的

分析患有急性病毒性细支气管炎(AVB)并接受糖皮质激素和支气管扩张剂治疗且具有特应性表型的婴儿与不具有该表型的婴儿相比,住院时间和/或氧疗时间是否更短。

方法

这是一项横断面、回顾性流行病学研究,对 2012 年至 2019 年期间在一家哨点公立医院因 AVB 住院的婴儿的病历数据进行了研究。验证了糖皮质激素、支气管扩张剂和抗生素的处方频率。然后比较了使用糖皮质激素和支气管扩张剂的婴儿中,有个人或家族特应性史与无特应性史的婴儿的住院时间和氧疗时间。随后,比较了接受抗生素治疗和未接受抗生素治疗的婴儿的住院时间。

结果

共纳入 58 例婴儿。其中,62.1%接受了抗生素治疗,100%接受了支气管扩张剂治疗,98.3%接受了糖皮质激素治疗。在比较无特应性家族史的婴儿时,使用抗生素的婴儿住院时间更长(p=0.01)。

结论

特应性表型的存在并不影响接受支气管扩张剂和糖皮质激素治疗的婴儿的住院时间和/或氧疗时间。无特应性家族史的婴儿的住院时间延长,且未发现细菌合并感染而使用抗生素,以及不推荐药物的高处方频率,这都提醒我们应更严格地执行 AVB 诊断和治疗的方案,并加强对相关专业人员的培训。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/6a3c/11215958/7592db2a87a5/gr1.jpg

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