Marossy Agnes E, Strachan David P, Rudnicka Alicja R, Anderson H Ross
Division of Community Health Sciences, St George's, University of London, Cranmer Terrace, London, UK.
Am J Respir Crit Care Med. 2007 Feb 15;175(4):355-9. doi: 10.1164/rccm.200607-1023OC. Epub 2006 Oct 5.
There is an association between childhood chest illness and impairment of adult ventilatory function. It has not yet been established whether respiratory illness in childhood predisposes to chronic obstructive pulmonary disease by accelerating the decline in adult lung function.
To determine the effects of childhood chest illness and smoking on the rate of decline of adult ventilatory function from the age of 35 to 45 yr in a large, nationally representative sample of British adults.
Spirometry measurements were compared at 35 and 45 yr of age in 1,158 adults participating in the British 1958 Birth Cohort. Multiple regression analysis was used to measure the association between childhood chest illness and within-person change in spirometric volumes between age 35 and 45 yr, adjusting for potential confounding factors.
The mean reduction in FEV(1) between ages 35 and 45 yr was 35 ml/yr. Compared with subjects without the relevant respiratory history, the rate of decline was not significantly associated with pneumonia (mean difference, -0.2; 95% confidence interval, -6.1 to +5.8 ml/yr), whooping cough (0.7, -5.1 to +6.5 ml/yr), wheeze by age 7 yr (0.4, -5 to +5.9 ml/yr), or wheeze onset by age 8 to 16 yr (-3.4, -10.5 to +3.6 ml/yr). A similar pattern emerged for forced vital capacity.
Childhood chest illness does not adversely affect the rate of decline of lung function in mid-adult life.
儿童期胸部疾病与成人通气功能受损之间存在关联。儿童期呼吸系统疾病是否通过加速成人肺功能下降而导致慢性阻塞性肺疾病尚未确定。
在一个具有全国代表性的英国成年人大样本中，确定儿童期胸部疾病和吸烟对35至45岁成人通气功能下降速率的影响。
对参与英国1958年出生队列研究的1158名成年人在35岁和45岁时的肺活量测定结果进行比较。采用多元回归分析来衡量儿童期胸部疾病与35至45岁之间肺活量测定值的个体内变化之间的关联，并对潜在的混杂因素进行调整。
35至45岁之间第一秒用力呼气容积（FEV₁）的平均下降幅度为每年35毫升。与没有相关呼吸病史的受试者相比，下降速率与肺炎（平均差异为-0.2；95%置信区间为-6.1至+5.8毫升/年）、百日咳（0.7，-5.1至+6.5毫升/年）、7岁时的喘息（0.4，-5至+5.9毫升/年）或8至16岁时喘息发作（-3.4，-10.5至+3.6毫升/年）均无显著关联。用力肺活量也呈现出类似的模式。
儿童期胸部疾病不会对成年中期肺功能的下降速率产生不利影响。
