Kurukulaaratchy R J, Fenn M, Matthews S, Arshad S H
The David Hide Asthma and Allergy Research Centre, St Mary's Hospital, Newport, Isle of Wight PO30 5TG, UK.
Thorax. 2004 Jul;59(7):563-8. doi: 10.1136/thx.2003.010462.
Wheezing occurs in both atopic and non-atopic children. The characteristics of atopic and non-atopic wheeze in children at 10 years of age were assessed and attempts made to identify whether different mechanisms underlie these states.
Children were seen at birth and at 1, 2, 4 and 10 years of age in a whole population birth cohort study (n = 1456; 1373 seen at 10 years). Information was collected prospectively on inherited and early life environmental risk factors for wheezing. Skin prick testing, spirometry, and methacholine bronchial challenge were conducted at 10 years. Wheezing at 10 years of age was considered atopic or non-atopic depending on the results of the skin prick test. Independent significant risk factors for atopic and non-atopic wheeze were determined by logistic regression.
Atopic (10.9%) and non-atopic (9.7%) wheeze were equally common at 10 years of age. Greater bronchial hyperresponsiveness (p<0.001) and airways obstruction (p = 0.011) occurred in children with atopic wheeze than in those with non-atopic wheeze at 10 years. Children with atopic wheeze more often received treatment (p<0.001) or an asthma diagnosis for their disorder, although current morbidity at 10 years differed little for these states. Maternal asthma and recurrent chest infections at 2 years were independently significant factors for developing non-atopic wheeze. For atopic wheeze, sibling asthma, eczema at 1 year, rhinitis at 4 years, and male sex were independently significant.
Non-atopic wheeze is as common as atopic wheeze in children aged 10 years, but treatment is more frequent in those with atopic wheeze. Different risk factor profiles appear relevant to the presence of atopic and non-atopic wheeze at 10 years of age.
喘息在特应性和非特应性儿童中均有发生。对10岁儿童特应性和非特应性喘息的特征进行了评估,并试图确定这些状态是否存在不同的潜在机制。
在一项全人群出生队列研究中,对儿童在出生时、1岁、2岁、4岁和10岁时进行观察(n = 1456;10岁时观察到1373例)。前瞻性收集关于喘息的遗传和早期生活环境危险因素的信息。在10岁时进行皮肤点刺试验、肺功能测定和乙酰甲胆碱支气管激发试验。根据皮肤点刺试验结果,将10岁时的喘息分为特应性或非特应性。通过逻辑回归确定特应性和非特应性喘息的独立显著危险因素。
10岁时,特应性喘息(10.9%)和非特应性喘息(9.7%)同样常见。10岁时,特应性喘息儿童比非特应性喘息儿童有更高的支气管高反应性(p<0.001)和气道阻塞(p = 0.011)。特应性喘息儿童更常接受治疗(p<0.001)或被诊断为哮喘,尽管这些状态在10岁时的当前发病率差异不大。母亲哮喘和2岁时反复出现的胸部感染是发生非特应性喘息的独立显著因素。对于特应性喘息,同胞患哮喘、1岁时患湿疹、4岁时患鼻炎和男性是独立显著因素。
在10岁儿童中,非特应性喘息与特应性喘息一样常见,但特应性喘息儿童的治疗更为频繁。不同的危险因素谱似乎与10岁时特应性和非特应性喘息的存在有关。