Kjellman B, Gustafsson P M
Department of Paediatrics, Central Hospital, Skövde, Sweden.
Respir Med. 2000 May;94(5):454-65. doi: 10.1053/rmed.1999.0764.
The course of asthma severity, clinical allergies, allergic sensitization, changes in living conditions and social outcome were studied prospectively over five follow-up visits from the mean age of 9 to 30 years in a cohort of 28 boys and 27 girls, selected randomly among asthmatic children attending a paediatric outpatient unit. Asthma severity improved from childhood to adulthood, judged by symptom and medication scores and by the number of hospital admissions, but only nine subjects (16%) had been free from symptoms and medication over the last year of follow-up. After adolescence, asthma continued to improve among the males but not among the females. This difference could not be explained by gender differences in the course of clinical allergies or sensitization (skin-prick-tests and RAST) to common inhaled allergens, or by differences in environmental or social conditions. Sensitization to relevant perennial inhaled allergens correlated with asthma severity during adulthood. In general, clinical allergies and sensitization to inhaled allergens adopted during childhood persisted into adulthood. Approximately 10% of the subjects never adopted a clinical allergy or a positive allergy test. The social outcome was good.
在一个由28名男孩和27名女孩组成的队列中，从平均9岁到30岁进行了五次随访，前瞻性地研究了哮喘严重程度的病程、临床过敏、过敏致敏、生活条件变化和社会结局。这些儿童是从一家儿科门诊就诊的哮喘儿童中随机挑选出来的。根据症状和药物评分以及住院次数判断，哮喘严重程度从儿童期到成年期有所改善，但在随访的最后一年中，只有9名受试者（16%）没有症状且未使用药物。青春期后，男性的哮喘持续改善，而女性则不然。这种差异无法用临床过敏病程或对常见吸入性过敏原的致敏（皮肤点刺试验和放射变应原吸附试验）中的性别差异，或环境或社会条件的差异来解释。对相关常年性吸入性过敏原的致敏与成年期哮喘严重程度相关。一般来说，儿童期出现的临床过敏和对吸入性过敏原的致敏会持续到成年期。约10%的受试者从未出现过临床过敏或过敏试验呈阳性。社会结局良好。
