Lowe L, Murray C S, Martin L, Deas J, Cashin E, Poletti G, Simpson A, Woodcock A, Custovic A
North West Lung Research Centre, Wythenshawe Hospital, Southmoor Road, Manchester M23 9LT, UK.
Arch Dis Child. 2004 Jun;89(6):540-3. doi: 10.1136/adc.2003.038539.
To investigate the relation between parentally reported wheeze (unconfirmed), physician confirmed wheeze, and subsequent lung function.
Children at risk of allergic disease (one parent atopic) were recruited antenatally and followed prospectively from birth. During the first three years of life parents were asked to contact the study team if their child was wheezy. The presence of wheeze was confirmed or not by the primary care or study physician. Respiratory questionnaire and specific airway resistance measurement (sR(aw), body plethysmograph) were completed at age 3 years.
A total of 454 children were followed from birth to 3 years of age. One hundred and eighty six (40.9%) of the parents reported their child wheezing in the first three years of life, and in 130 (28.6%) the wheeze was confirmed. A total of 428 children attended the three year clinic review, of whom 274 (64%) successfully carried out lung function tests. There was no significant difference in sR(aw) (kPa.s; geometric mean, 95% CI) between children who had never wheezed (n = 152; 1.03, 1.00 to 1.06) and those with a parentally reported but unconfirmed wheeze (n = 36; 1.02, 0.96 to 1.07, p = 1.00). sR(aw) was significantly higher in children with a physician confirmed wheeze (n = 86; 1.17, 1.11 to 1.22, p < 0.001) compared to those with no history of wheeze or with unconfirmed wheeze.
Children with physician confirmed wheeze have significantly poorer lung function compared to those with parentally reported but unconfirmed and those who have never wheezed. A proportion of parents may have little understanding of what medical professionals mean by the term "wheeze".
研究家长报告的喘息(未经证实)、医生确诊的喘息与后续肺功能之间的关系。
招募有过敏性疾病风险的儿童(父母一方为特应性体质),从出生开始进行前瞻性随访。在儿童生命的前三年中,如果孩子出现喘息,要求家长联系研究团队。由初级保健医生或研究医生确认喘息是否存在。在3岁时完成呼吸问卷和特异性气道阻力测量(sR(aw),体容积描记法)。
共有454名儿童从出生随访至3岁。186名(40.9%)家长报告其孩子在生命的前三年出现喘息,其中130名(28.6%)的喘息得到确诊。共有428名儿童参加了3年的门诊复查,其中274名(64%)成功进行了肺功能测试。从未喘息的儿童(n = 152;1.03,1.00至1.06)与家长报告但未经证实喘息的儿童(n = 36;1.02,0.96至1.07,p = 1.00)之间的sR(aw)(kPa.s;几何平均数,95%可信区间)无显著差异。与无喘息病史或未经证实喘息的儿童相比,医生确诊喘息的儿童(n = 86;1.17,1.11至1.22,p < 0.001)的sR(aw)显著更高。
与家长报告但未经证实喘息的儿童以及从未喘息的儿童相比,医生确诊喘息的儿童肺功能明显较差。一部分家长可能对医学专业人员所说的“喘息”一词理解甚少。