Turner Stephen W, Palmer Lyle J, Rye Peter J, Gibson Neil A, Judge Parveenjeet K, Cox Moreen, Young Sally, Goldblatt Jack, Landau Louis I, Le Souëf Peter N
School of Paediatrics and Child Health, University of Western Australia, and Department of Respiratory Medicine, Princess Margaret Hospital for Children, Perth, Australia.
Am J Respir Crit Care Med. 2004 Apr 15;169(8):921-7. doi: 10.1164/rccm.200307-891OC. Epub 2004 Feb 5.
The relationship between reduced pulmonary function in early life and persistent wheeze (PW) in school-aged children remains uncertain. In this study, VmaxFRC was assessed at 1 month of age, and the presence of wheeze up to 11 years of age was prospectively identified. At 11 years of age, airway responsiveness (AR) to inhaled histamine and atopy were assessed. Recent wheeze at 11 years of age was associated with a reduced mean z score for VmaxFRC at 1 month of age (-0.41 [SD 0.91], n = 31) compared with no recent wheeze (0.04 [SD 1.00], n = 153, p = 0.03). Wheeze between 4 and 6 years that persisted at 11 years (PW) was most prevalent among those with reduced VmaxFRC at 1 month and atopy aged 11 years (p = 0.002) or reduced VmaxFRC and increased AR aged 11 years (p = 0.015). When all factors were considered, reduced VmaxFRC at 1 month (p = 0.03) and increased AR aged 11 years (p < 0.001) were independently associated with PW (n = 17) compared with other outcomes (n = 129). Reduced airway function present in early infancy is associated with PW at 11 years of age, and this relationship is independent of the effect of increased AR and atopy in childhood.
生命早期肺功能降低与学龄儿童持续性喘息（PW）之间的关系仍不确定。在本研究中，在1月龄时评估功能残气量时的最大呼气流速（VmaxFRC），并前瞻性确定直至11岁时喘息的存在情况。在11岁时，评估对吸入组胺的气道反应性（AR）和特应性。与近期无喘息者（0.04[标准差1.00]，n = 153，p = 0.03）相比，11岁时近期有喘息者1月龄时VmaxFRC的平均z评分降低（-0.41[标准差0.91]，n = 31）。4至6岁时出现且持续至11岁的喘息（PW）在1月龄时VmaxFRC降低且11岁时有特应性者中最为普遍（p = 0.002），或在1月龄时VmaxFRC降低且11岁时AR增加者中最为普遍（p = 0.015）。当考虑所有因素时，与其他结局（n = 129）相比，1月龄时VmaxFRC降低（p = 0.03）和11岁时AR增加（p < 0.001）与PW（n = 17）独立相关。婴儿期早期出现的气道功能降低与11岁时的PW相关，且这种关系独立于儿童期AR增加和特应性的影响。
