Guerra Stefano, Wright Anne L, Morgan Wayne J, Sherrill Duane L, Holberg Catharine J, Martinez Fernando D
Arizona Respiratory Center, University of Arizona, 1501 North Campbell Avenue, P.O. Box 245030, Tucson, AZ 85724-5030, USA.
Am J Respir Crit Care Med. 2004 Jul 1;170(1):78-85. doi: 10.1164/rccm.200309-1224OC. Epub 2004 Mar 17.
Little is known about rates and predictors of remission of childhood asthma after the onset of puberty. We used data collected at ages 6, 8, 11, 13, and 16 years from the Tucson Children's Respiratory Study, a population-based birth cohort. The onset of puberty was defined as the age of appearance of the first pubertal signs as reported by parents. Information on wheezing both before and after onset of puberty (mean +/- SD follow-up from onset of puberty, 4.2 +/- 1 year) was available for 781 children. Of these, 166 had asthma (either frequent wheezing or a physician-confirmed diagnosis plus any wheezing) in at least one survey before puberty. In this group, 58% of the children (97 of 166) reported the presence of wheezing after the onset of puberty (unremitting asthma). In contrast, only 30% (39 of 131) of the children with infrequent wheezing before puberty experienced wheezing episodes after the onset of puberty (unremitting wheezing). In addition to frequent wheezing before puberty, obesity, early onset of puberty, active sinusitis, and skin test sensitization were significant and independent predictors of unremitting asthma after the onset of puberty. Our findings from a population-based longitudinal cohort challenge the commonly held view that asthma usually remits during adolescence.
关于青春期开始后儿童哮喘缓解率及其预测因素，人们知之甚少。我们使用了图森儿童呼吸研究（一项基于人群的出生队列研究）在6岁、8岁、11岁、13岁和16岁时收集的数据。青春期开始被定义为父母报告的首个青春期体征出现的年龄。781名儿童提供了青春期开始前后喘息情况的信息（从青春期开始平均随访时间±标准差为4.2±1年）。其中，166名儿童在青春期前至少一次调查中患有哮喘（频繁喘息或医生确诊加任何喘息）。在这组儿童中，58%（166名中的97名）报告青春期开始后仍有喘息（持续性哮喘）。相比之下，青春期前喘息不频繁的儿童中只有30%（131名中的39名）在青春期开始后出现喘息发作（持续性喘息）。除青春期前频繁喘息外，肥胖、青春期早发、活动性鼻窦炎和皮肤试验致敏是青春期开始后持续性哮喘的显著且独立的预测因素。我们基于人群的纵向队列研究结果挑战了普遍观点，即哮喘通常在青春期缓解。
