摘要
背景：尽管既往研究已提示嗜酸性食管炎（EoE）与哮喘之间存在相关性，但迄今尚无研究专门评估重度哮喘患儿中嗜酸性食管炎的患病率及其预测因素。
目的：评估重度哮喘儿童中嗜酸性食管炎的患病率及其预测因素。
方法：本研究为横断面研究，纳入因呼吸道症状接受支气管镜检查、并因胃肠道症状接受食管胃十二指肠镜检查的反复喘息/重度哮喘儿童。EoE病例依据共识指南进行界定。诊断性检测包括支气管肺泡灌洗液（BAL）细胞计数及分类、外周血绝对嗜酸性粒细胞计数（AEC）以及总IgE水平测定。采用卡方检验和Student’s t检验比较人口学与临床特征差异，并应用logistic回归及受试者工作特征（ROC）曲线分析EoE的预测因素。
结果：共纳入214例存在顽固性喘息或哮喘控制不佳且伴胃肠道症状的儿童。结果显示，EoE的患病率为23.4%；EoE与BAL嗜酸性粒细胞增多相关（OR = 2.61，95% CI 1.13–6.00，p = 0.001），但该关联在校正分析后未能维持统计学显著性。合并EoE的患儿更常伴有其他过敏性共病，且其外周血AEC水平更高（672.0 ± 1043.4/μL vs 235.4 ± 216.9/μL，p < 0.001）。当AEC与过敏性共病联合应用时，对EoE具有较高的诊断准确性。
结论：重度哮喘患儿中共存EoE的比例较高。合并EoE的重度哮喘患儿更可能伴有其他过敏性疾病，且外周血AEC水平更高。未来研究应进一步明确外周血 AEC在重度哮喘患儿EoE筛查中的应用价值。
关键词：哮喘；IgE；绝对嗜酸性粒细胞计数；支气管肺泡灌洗；支气管镜检查；内镜检查；嗜酸性食管炎；预测因素；患病率；严重程度。
Background: Although previous studies have found an association between eosinophilic esophagitis (EoE) and asthma, no studies to date have assessed the prevalence or predictors of EoE among children with severe asthma.
Objective: To assess the prevalence and predictors of EoE among children with severe asthma.
Methods: This was a cross-sectional study of children with recurrent wheeze/severe asthma who underwent bronchoscopy for respiratory symptoms and esophagogastroduodenoscopy for gastrointestinal symptoms. EoE cases were defined according to consensus guidelines. Diagnostic tests included bronchoalveolar lavage (BAL) for cell count/differential and measurements of blood absolute eosinophils (AEC) and total IgE. Differences in demographic and clinical characteristics were compared using chi-square and student's t-tests; predictors of EoE were assessed using logistic regression and Receiver Operating Characteristic (ROC) curves.
Results:A total of 214 children with problematic wheeze or poorly controlled asthma and gastrointestinal symptoms were included. EoE prevalence was 23.4%. EoE was associated with BAL eosinophilia (OR 2.61; 95% CI 1.13-6.00; p=0.001), but this did not persist in adjusted analyses. Patients with co-existing EoE had a higher prevalence of allergic comorbidities and higher blood AEC (672.0±1043.4/μL vs. 235.4±216.9; p value<0.001). AEC demonstrated high diagnostic accuracy for EoE when used in combination with the presence of allergic comorbidities.
Conclusion: We found a high prevalence of co-existing EoE in pediatric severe asthmatics. Severe asthmatics with EoE were more likely to have other allergic conditions and higher blood AEC levels. Future studies should evaluate if AEC can be used to screen for EoE among children with severe asthma.
Keywords:Asthma; IgE; absolute eosinophilic counts; bronchoalveolar lavage; bronchoscopy; endoscopy; eosinophilic esophagitis; predictors; prevalence; severity.
背景：尽管既往研究已提示嗜酸性食管炎（EoE）与哮喘之间存在相关性，但迄今尚无研究专门评估重度哮喘患儿中嗜酸性食管炎的患病率及其预测因素。
目的：评估重度哮喘儿童中嗜酸性食管炎的患病率及其预测因素。
方法：本研究为横断面研究，纳入因呼吸道症状接受支气管镜检查、并因胃肠道症状接受食管胃十二指肠镜检查的反复喘息/重度哮喘儿童。EoE病例依据共识指南进行界定。诊断性检测包括支气管肺泡灌洗液（BAL）细胞计数及分类、外周血绝对嗜酸性粒细胞计数（AEC）以及总IgE水平测定。采用卡方检验和Student’s t检验比较人口学与临床特征差异，并应用logistic回归及受试者工作特征（ROC）曲线分析EoE的预测因素。
结果：共纳入214例存在顽固性喘息或哮喘控制不佳且伴胃肠道症状的儿童。结果显示，EoE的患病率为23.4%；EoE与BAL嗜酸性粒细胞增多相关（OR = 2.61，95% CI 1.13–6.00，p = 0.001），但该关联在校正分析后未能维持统计学显著性。合并EoE的患儿更常伴有其他过敏性共病，且其外周血AEC水平更高（672.0 ± 1043.4/μL vs 235.4 ± 216.9/μL，p < 0.001）。当AEC与过敏性共病联合应用时，对EoE具有较高的诊断准确性。
结论：重度哮喘患儿中共存EoE的比例较高。合并EoE的重度哮喘患儿更可能伴有其他过敏性疾病，且外周血AEC水平更高。未来研究应进一步明确外周血 AEC在重度哮喘患儿EoE筛查中的应用价值。
关键词：哮喘；IgE；绝对嗜酸性粒细胞计数；支气管肺泡灌洗；支气管镜检查；内镜检查；嗜酸性食管炎；预测因素；患病率；严重程度。
（南方医科大学南方医院 凌嘉骏 樊可可 赵海金）
（Licari E, Borish LC, et, al. Prevalence and Predictors of Eosinophilic Esophagitis (EoE) Among Children with Severe Asthma. J Allergy Clin Immunol Pract. 2026 Mar 6:S2213-2198(26)00182-0. doi: 10.1016/j.jaip.2026.02.030. Epub ahead of print. PMID: 41796638.）
Abstract（Licari E, Borish LC, et, al. Prevalence and Predictors of Eosinophilic Esophagitis (EoE) Among Children with Severe Asthma. J Allergy Clin Immunol Pract. 2026 Mar 6:S2213-2198(26)00182-0. doi: 10.1016/j.jaip.2026.02.030. Epub ahead of print. PMID: 41796638.）
Background: Although previous studies have found an association between eosinophilic esophagitis (EoE) and asthma, no studies to date have assessed the prevalence or predictors of EoE among children with severe asthma.
Objective: To assess the prevalence and predictors of EoE among children with severe asthma.
Methods: This was a cross-sectional study of children with recurrent wheeze/severe asthma who underwent bronchoscopy for respiratory symptoms and esophagogastroduodenoscopy for gastrointestinal symptoms. EoE cases were defined according to consensus guidelines. Diagnostic tests included bronchoalveolar lavage (BAL) for cell count/differential and measurements of blood absolute eosinophils (AEC) and total IgE. Differences in demographic and clinical characteristics were compared using chi-square and student's t-tests; predictors of EoE were assessed using logistic regression and Receiver Operating Characteristic (ROC) curves.
Results:A total of 214 children with problematic wheeze or poorly controlled asthma and gastrointestinal symptoms were included. EoE prevalence was 23.4%. EoE was associated with BAL eosinophilia (OR 2.61; 95% CI 1.13-6.00; p=0.001), but this did not persist in adjusted analyses. Patients with co-existing EoE had a higher prevalence of allergic comorbidities and higher blood AEC (672.0±1043.4/μL vs. 235.4±216.9; p value<0.001). AEC demonstrated high diagnostic accuracy for EoE when used in combination with the presence of allergic comorbidities.
Conclusion: We found a high prevalence of co-existing EoE in pediatric severe asthmatics. Severe asthmatics with EoE were more likely to have other allergic conditions and higher blood AEC levels. Future studies should evaluate if AEC can be used to screen for EoE among children with severe asthma.
Keywords:Asthma; IgE; absolute eosinophilic counts; bronchoalveolar lavage; bronchoscopy; endoscopy; eosinophilic esophagitis; predictors; prevalence; severity.
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