Morgan Wayne J, Stern Debra A, Sherrill Duane L, Guerra Stefano, Holberg Catharine J, Guilbert Theresa W, Taussig Lynn M, Wright Anne L, Martinez Fernando D
Arizona Respiratory Center, P.O. Box 245030, Tucson, Arizona 85724, USA.
Am J Respir Crit Care Med. 2005 Nov 15;172(10):1253-8. doi: 10.1164/rccm.200504-525OC. Epub 2005 Aug 18.
The effect of early life wheezing on respiratory function and continued symptoms through adolescence has not been fully described. Using data from a population-based birth cohort in Tucson, Arizona, we previously described four phenotypes based on the occurrence of wheezing lower respiratory illnesses before age 3 yr and active wheeze at age 6 yr: never wheezers (n = 425), transient early wheezers (n = 164), persistent wheezers (n = 113), and late-onset wheezers (n = 124).
We sought to determine the prognosis for these phenotypes, with reference to lung function and symptoms, through adolescence.
Current wheeze was assessed by questionnaire, lung function was measured by conventional spirometry, and atopy was determined by skin prick tests.
The prevalence of atopy and wheeze by age 16 yr was similar for never and transient wheezers and for persistent and late-onset wheezers. Both transient early, and persistent wheezers had significantly lower FEF(25-75) (-259 ml/s, p < 0.001, and -260 ml/s, p = 0.001, respectively), FEV1 (-75 ml, p = 0.02, and -87 ml, p = 0.03, respectively), and FEV1:FVC ratio (-1.9%, p = 0.002, and -2.5%, p = 0.001, respectively) through age 16 yr compared with never wheezers. Late-onset wheezers had levels of lung function similar to those of never wheezers through age 16 yr. There was no significant change in lung function among subjects with any of the four phenotypes, relative to their peers, from age 6 to 16 yr.
Patterns of wheezing prevalence and levels of lung function are established by age 6 yr and do not appear to change significantly by age 16 yr in children who start having asthma-like symptoms during the preschool years.
早年喘息对呼吸功能以及青春期持续症状的影响尚未得到充分描述。利用来自亚利桑那州图森市一项基于人群的出生队列研究的数据，我们之前根据3岁前喘息性下呼吸道疾病的发生情况以及6岁时的活动性喘息描述了四种表型：从不喘息者（n = 425）、短暂早期喘息者（n = 164）、持续性喘息者（n = 113）和迟发性喘息者（n = 124）。
我们试图通过青春期来确定这些表型在肺功能和症状方面的预后情况。
通过问卷评估当前喘息情况，用传统肺量计测量肺功能，通过皮肤点刺试验确定特应性。
16岁时，从不喘息者和短暂喘息者以及持续性喘息者和迟发性喘息者的特应性和喘息患病率相似。与从不喘息者相比，短暂早期喘息者和持续性喘息者在16岁时的FEF(25 - 75)（分别为-259 ml/s，p < 0.001和-260 ml/s，p = 0.001）、FEV1（分别为-75 ml，p = 0.02和-87 ml，p = 0.03）以及FEV1:FVC比值（分别为-1.9%，p = 0.002和-2.5%，p = 0.001）均显著降低。迟发性喘息者在16岁时的肺功能水平与从不喘息者相似。在6至16岁期间，四种表型中的任何一种表型的受试者相对于其同龄人，肺功能均无显著变化。
喘息患病率模式和肺功能水平在6岁时就已确立，对于在学龄前开始出现哮喘样症状的儿童，到16岁时似乎没有显著变化。
