低丙种球蛋白血症在儿童哮喘临床随访中的重要性
The Importance of Hypogammaglobulinemia in the Clinical Follow-Up of Childhood Asthma.
摘要(中文译文)
哮喘是一种临床表现多样的异质性疾病。低丙种球蛋白血症可能增加呼吸道感染的易感性，从而影响哮喘的患病率。我们回顾性分析了2015年至2020年间在一家三级儿科过敏与临床免疫学诊所接受哮喘随访的332名4至12岁儿童。患者被分为正常丙种球蛋白血症组（NGG）（n = 286）和低丙种球蛋白血症组（HGG）（n = 46）。低丙种球蛋白血症定义为持续性IgG降低（低于同龄-2 SD），伴或不伴IgA和/或IgM降低。HGG组儿童哮喘症状起病更早、哮喘诊断更早，且母乳喂养率更低（分别为p < 0.001、p = 0.001和p = 0.024）。该组特应性皮炎和父母特应性体质的患病率更高，上呼吸道感染、急性中耳炎、无需住院的下呼吸道感染（支气管肺炎）及哮喘急性发作的年频率均显著更高（均p < 0.005）。HGG组儿童吸入性糖皮质激素治疗的起始和停用年龄更小（分别为p < 0.001和p = 0.002）。两组间特应性致敏率无差异。在这一三级医疗队列中，以持续性IgG降低定义的低丙种球蛋白血症与哮喘症状起病更早及更高的感染和急性发作负担相关。这些发现可能支持对部分哮喘儿童考虑进行免疫学评估和更密切的监测。
Abstract
Asthma is a heterogeneous disease with varying clinical presentations. Hypogammaglobulinemia may increase susceptibility to respiratory tract infections and thereby influence asthma morbidity. We retrospectively analyzed 332 children aged 4-12 years who were followed up for asthma at a tertiary pediatric allergy and clinical immunology clinic between 2015 and 2020. Patients were categorized as normogammaglobulinemic (NGG) (n = 286) or hypogammaglobulinemic (HGG) (n = 46). Hypogammaglobulinemia was defined as persistently low IgG (below -2 SD for age), with or without concomitant low IgA and/or IgM. Children in the HGG group had an earlier onset of asthma symptoms and earlier asthma diagnosis, and lower breastfeeding rates (p < 0.001, p = 0.001, and p = 0.024, respectively). The prevalence of atopic dermatitis and parental atopy was higher, and the annual frequency of upper respiratory tract infections, acute otitis media, lower respiratory tract infections (bronchopneumonia) not requiring hospitalization, and asthma exacerbations were significantly higher in this group (all p < 0.005). Inhaled corticosteroid therapy was initiated and discontinued at younger ages among HGG children (p < 0.001 and p = 0.002, respectively). Atopic sensitization rates did not differ between groups. In this tertiary-care cohort, HGG defined by persistently low IgG was associated with earlier onset asthma symptoms and a higher infection and exacerbation burden. These findings may support considering immunologic evaluation and closer monitoring in a subset of children with asthma.
如何引用
AMA
Gizem Akpinar, Emine Vezir. The Importance of Hypogammaglobulinemia in the Clinical Follow-Up of Childhood Asthma.. International archives of allergy and immunology. 2026; doi:10.1159/000551663.
APA
Gizem Akpinar, Emine Vezir (2026). The Importance of Hypogammaglobulinemia in the Clinical Follow-Up of Childhood Asthma.. International archives of allergy and immunology. https://doi.org/10.1159/000551663
GB/T 7714
Gizem Akpinar, Emine Vezir. The Importance of Hypogammaglobulinemia in the Clinical Follow-Up of Childhood Asthma.[J]. International archives of allergy and immunology, 2026 doi:10.1159/000551663.
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