Mehmet ASLAN, Ahmet KURT, Ramazan ÖZDEMİR, Ferhat ÇATAL, Gülsüm DEMİRTAŞ, Elif ŞENBABA, Ahmet KARADAĞ, Erdem TOPAL

Okul öncesi dönemde ağır hışıltı atağı ile ilişkili risk faktörleri

AMAÇ: Okul öncesi yaş grubunda ağır hışıltı atağı ile ilişkili risk faktörlerini belirlemektir. YÖNTEMLER: Ocak 2013 ile Haziran 2013 tarihleri arasında İnönü Üniversitesi Turgut Özal Tıp Merkezi Çocuk Alerji ve Astım polikliniği ile Çocuk Acil polikliniğine, tekrarlayan ağır hışıltı atağı ile başvuran altı yaşından küçük hastaların dosyaları geriye dönük olarak incelendi. BULGULAR: Altı aylık sürede her iki polikliniğe çocuk alerji ve çocuk acil 70 çocuk ağır hışıltı atağı ile başvurmuştu. Çalışmaya, karşılaştırma yapabilmek için aynı yaşta hafif hışıltı atağı ile başvuran 72 çocuk hasta da dahil edildi. Ağır hışıltı atak tanısı konulan olguların 49 %68,1 ’u erkek idi ve ortanca yaşı 30 ay 6-60 idi. Hastaların ilk geçirdikleri atak yaşının ortancası 6 ay 1-60 , son bir yıl içerisindeki atak sayısının ortancası 5 1-10 ve son bir yılda sistemik steroid gerektiren atak sayısının ortancası 2 1-10 idi. Modifiye astım prediktif indeks hastaların 27 %38,1 ’sinde pozitifti ve 29 hastada %41,4 hışıltı çoklu tetiklenen hışıltı fenotipindeydi. Ağır hışıltı atağı erkek cinsiyette p=0,004 ve pasif sigara maruziyeti olan çocuklarda p=0,011 daha fazlaydı. Ayrıca son 1 yılda atak sıklığı p=0,029 ve sistemik steroid gerektiren atak sayısı da p=0,001 ağır hışıltı atağı ile başvuran hastalarda daha fazlaydı.SONUÇ: Ağır hışıltı atağı erkek cinsiyette, pasif sigara maruziyeti olan çocuklarda, son bir yılda hışıltı atakları sık olan ve sistemik steroid gerektiren hastalarda daha fazla görülmektedir. Bu nedenle hışıltısı olan çocukların son 1 yıldaki hışıltı öyküleri detaylı bir şekilde sorgulanmalı ve sigara maruziyeti önlenmelidir.

Anahtar Kelimeler:

sigara, şiddet, hışıltı

The risk factors associated with severe wheeze episode in preschool children

OBJECTIVE: To determine the risk factors which associated with severe wheeze episode in preschool childrenMETHODS: Between January 2013 and June 2013, the files of the patients, who were seen as severe wheeze episode and under 6 years old at the time of application, were analyzed retrospectively in the pediatric allergy and pediatric emergency department of Inonü University Turgut Ozal Medical CenterRESULTS: During the six month period, 70 children applied to two clinics pediatric allergy and pediatric emergency due to severe wheeze episode. Seventy-two children who applied with mild wheeze episode were included in the study to compare with severe wheeze episode. Forty-nine patients 68.1% who were diagnosed with severe wheeze episode were male and the median age was 30 6-60 months. The median age of first wheeze episode was 6 1-60 months, median episode of wheeze number in the previous year was 5 1-10 and median episode of wheeze required systemic steroid in the previous year was 2 1-10 . Modified Asthma Predictive Index was positive in 27 patients 38.1% and wheeze was the multiple-trigger phenotype in 29 patients 41.1% . Severe wheeze episode was more in male gender p=0.004 and in children who exposure to passive smoking p=0.011 . Also, frequency of wheeze episode p=0.029 and required systemic steroid p=0.001 in previous year were more in the patients with severe wheeze episodeCONCLUSION: Severe wheeze episode were seen more in the patient who were male gender, exposure to passive smoking, have frequent wheeze episode and require systemic steroid in previous year. Therefore detailed previous year history of wheeze should be questioned in the patient who have wheeze and exposure of passive smoking should be prevented

Keywords:

smoking, severe, wheeze,

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