Castro-Rodríguez J A, Holberg C J, Wright A L, Martinez F D
Respiratory Sciences Center, University of Arizona, College of Medicine, Tucson, Arizona, USA.
Am J Respir Crit Care Med. 2000 Oct;162(4 Pt 1):1403-6. doi: 10.1164/ajrccm.162.4.9912111.
Because most cases of asthma begin during the first years of life, identification of young children at high risk of developing the disease is an important public health priority. We used data from the Tucson Children's Respiratory Study to develop two indices for the prediction of asthma. A stringent index included frequent wheezing during the first 3 yr of life and either one major risk factor (parental history of asthma or eczema) or two of three minor risk factors (eosinophilia, wheezing without colds, and allergic rhinitis). A loose index required any wheezing during the first 3 yr of life plus the same combination of risk factors described previously. Children with a positive loose index were 2.6 to 5.5 times more likely to have active asthma between ages 6 and 13 than children with a negative loose index. Risk of having subsequent asthma increased to 4.3 to 9.8 times when a stringent index was used. We found that 59% of children with a positive loose index and 76% of those with a positive stringent index had active asthma in at least one survey during the school years. Over 95% of children with a negative stringent index never had active asthma between ages 6 and 13. We conclude that the subsequent development of asthma can be predicted with reasonable accuracy using simple, clinically based parameters.
由于大多数哮喘病例始于生命的最初几年，识别有患该疾病高风险的幼儿是一项重要的公共卫生优先事项。我们使用了图森儿童呼吸研究的数据来制定两个预测哮喘的指标。一个严格指标包括在生命的前3年频繁喘息，以及一个主要风险因素（父母有哮喘或湿疹病史）或三个次要风险因素中的两个（嗜酸性粒细胞增多、无感冒时喘息和过敏性鼻炎）。一个宽松指标要求在生命的前3年有任何喘息，再加上上述相同的风险因素组合。宽松指标呈阳性的儿童在6至13岁之间患活动性哮喘的可能性是宽松指标呈阴性儿童的2.6至5.5倍。当使用严格指标时，患后续哮喘的风险增加到4.3至9.8倍。我们发现，宽松指标呈阳性的儿童中有59%，严格指标呈阳性的儿童中有76%在学年期间的至少一次调查中有活动性哮喘。严格指标呈阴性的儿童中超过95%在6至13岁之间从未患过活动性哮喘。我们得出结论，使用简单的基于临床的参数可以相当准确地预测哮喘的后续发展。
