Van Bever H P, Wieringa M H, Weyler J J, Nelen V J, Fortuin M, Vermeire P A
Department of Epidemiology, University of Antwerp, Belgium.
Eur J Pediatr. 1999 Mar;158(3):253-7. doi: 10.1007/s004310051062.
The cumulative incidence (i.e. lifetime prevalence) of croup and recurrent croup (RC) was investigated by questionnaire in a large group (n = 5756) of 5-8-year-old children (mean age: 6.8 +/- 0.6 years) and the risk for asthma and/or wheezing in children with croup and RC assessed. In a random sample of the children, skin prick testing with common inhalant allergens (n = 614) and spirometry (n = 305) were performed and the results were compared between children with or without croup or RC. Of the children, 15.5% had suffered from croup, while 5.0% had had RC. The cumulative incidence was higher in boys than in girls (P < 0.05). In the children with croup or RC an increased risk for wheezing, asthma, usage of anti-asthma medication, rhinitis and hay fever was found (P < 0.01). There was no difference in the prevalence of positive skin prick tests between children with and without croup or RC. Mean percentage predicted forced expiratory volume in 1 s, forced vital capacity and peak expiratory flow was not different between children with and without croup or RC. However, children who had suffered from croup (with or without wheezing) had a lower mean percentage predicted forced expiratory flow at both 50% and 75% of forced vital capacity than those without croup (P = 0.002). A family history of hay fever, chronic bronchitis and eczema was associated with the presence of croup or RC (P < 0.01), while this was hardly the case for a family history of asthma.
Croup and recurrent croup are associated with bronchial asthma. The association seems essentially based on the presence of hyperreactive airways and less on the presence of atopy, although the latter can be considered an aggravating factor.
通过问卷调查对一大群（n = 5756）5至8岁儿童（平均年龄：6.8±0.6岁）进行了哮吼和复发性哮吼（RC）的累积发病率（即终生患病率）调查，并评估了哮吼和RC患儿患哮喘和/或喘息的风险。在儿童随机样本中，对常见吸入性变应原进行了皮肤点刺试验（n = 614）和肺功能测定（n = 305），并比较了有或无哮吼或RC儿童的结果。在这些儿童中，15.5%曾患哮吼，而5.0%曾患RC。累积发病率男孩高于女孩（P < 0.05）。在患有哮吼或RC的儿童中，发现喘息、哮喘、使用抗哮喘药物、鼻炎和花粉症的风险增加（P < 0.01）。有或无哮吼或RC的儿童皮肤点刺试验阳性率无差异。有或无哮吼或RC的儿童一秒用力呼气容积、用力肺活量和呼气峰值流速的预测平均百分比无差异。然而，曾患哮吼（有或无喘息）的儿童在用力肺活量的50%和75%时的用力呼气流量预测平均百分比低于未患哮吼的儿童（P = 0.002）。花粉症、慢性支气管炎和湿疹的家族史与哮吼或RC的存在相关（P < 0.01），而哮喘家族史情况则几乎并非如此。
哮吼和复发性哮吼与支气管哮喘相关。这种关联似乎主要基于气道高反应性的存在，而较少基于特应性的存在，尽管后者可被视为一个加重因素。
