Kurukulaaratchy Ramesh J, Matthews Sharon, Waterhouse Linda, Arshad S Hasan
David Hide Asthma and Allergy Research Centre, St Mary's Hospital, Newport, Isle of Wight, United Kingdom.
J Allergy Clin Immunol. 2003 Aug;112(2):311-6. doi: 10.1067/mai.2003.1623.
We sought to identify factors associated with wheezing symptoms in children found to have bronchial hyperresponsiveness (BHR) at 10 years of age.
Children were seen at birth, 1, 2, 4 and 10 years of age in an entire population birth cohort study (n = 1456). At each stage information was collected prospectively on genetic and environmental risk factors for BHR. Skin prick testing was performed at 4 and 10 years of age. Spirometry and methacholine bronchial challenge were conducted at 10 years of age when BHR was considered present if PC(20) FEV(1) was < 4.0 mg/mL. In children with BHR at 10 years of age, factors independently associated with current wheezing were determined by logistic regression.
BHR was identified in 169 10-year-olds at bronchial challenge, 55.6% of whom manifested current wheeze. In children with BHR, current wheezers had higher Log(10) total IgE and greater BHR than those who had never wheezed. Symptomatic BHR was independently associated with atopic sensitization (P <.001) and maternal asthma (P =.011) at 10 years of age. If only factors present in the first 4 years of life were considered, parental smoking at 4 years of age (P =.021), maternal asthma (P =.017), and atopic sensitization at 4 years of age (P =.004) were independently associated with symptomatic BHR at 10 years of age.
Symptomatic BHR is associated with greater degrees of BHR and higher total IgE. Heredity, atopy, and environmental exposure might influence symptom expression in children with BHR.
我们试图确定在10岁时被发现有支气管高反应性（BHR）的儿童中与喘息症状相关的因素。
在一项整群出生队列研究（n = 1456）中，对儿童在出生时、1岁、2岁、4岁和10岁时进行观察。在每个阶段前瞻性收集有关BHR的遗传和环境危险因素的信息。在4岁和10岁时进行皮肤点刺试验。在10岁时进行肺功能测定和乙酰甲胆碱支气管激发试验，当PC（20）FEV（1）< 4.0 mg/mL时认为存在BHR。对于10岁时有BHR的儿童，通过逻辑回归确定与当前喘息独立相关的因素。
在169名10岁儿童的支气管激发试验中发现了BHR，其中55.6%表现为当前喘息。在有BHR的儿童中，当前喘息者的Log（10）总IgE水平更高，BHR也比从未喘息者更严重。有症状的BHR在10岁时与特应性致敏（P <.001）和母亲哮喘（P =.011）独立相关。如果仅考虑生命最初4年中存在的因素，4岁时父母吸烟（P =.021）、母亲哮喘（P =.017）和4岁时特应性致敏（P =.004）与10岁时有症状的BHR独立相关。
有症状的BHR与更高程度的BHR和更高的总IgE相关。遗传、特应性和环境暴露可能影响有BHR儿童的症状表现。
