Chinn Susan, Janson Christer, Svanes Cecilie, Dharmage Shyamali, Jarvis Deborah
Department Public Health Sciences, King's College London, 5th floor Capital House, 42 Weston Street, London SE1 3QD, UK.
Respir Med. 2007 May;101(5):983-8. doi: 10.1016/j.rmed.2006.09.004. Epub 2006 Oct 16.
Respiratory symptoms in adulthood have been found to be associated with childhood respiratory infection, but few studies have analyzed adult bronchial responsiveness (BHR) with adequate adjustment for known risk factors.
To estimate the relation of BHR with serious childhood respiratory infections in a large population study.
The European Community Respiratory Health Survey (ECRHS) was a cross-sectional population-based survey in 34 centers. Data on serious respiratory infections before the age of 5 years and possible confounders were obtained from a questionnaire administered in the clinic. Blood samples were taken for measurement of total immunoglobulin E (IgE) and specific IgE to four common allergens, and spirometry and bronchial challenge with methacholine were performed. A continuous measure of BHR was analyzed by multiple regression, in 11,282 participants, in relation to serious respiratory infection and other potential risk factors, adjusted for center and major determinants of adult BHR.
Those reporting a serious childhood respiratory infection had greater BHR, by an amount corresponding to approximately 0.23 doubling doses (95% confidence interval 0.02-0.44) of the amount of methacholine causing a 20% fall (PD(20)) in forced expiratory volume in 1s (FEV(1)). All childhood factors explained less than 0.3% of variation in BHR in addition to over 20% by factors measured in adulthood. The relation of BHR to BMI was confined to smokers.
We found an effect of serious childhood respiratory infection on adult BHR, but this was small in comparison to relations of BHR to IgE-sensitization and airway caliber.
已发现成年期的呼吸道症状与儿童期呼吸道感染有关，但很少有研究在对已知风险因素进行充分校正的情况下分析成人支气管反应性（BHR）。
在一项大型人群研究中评估BHR与儿童期严重呼吸道感染之间的关系。
欧洲共同体呼吸健康调查（ECRHS）是一项在34个中心开展的基于人群的横断面调查。5岁前严重呼吸道感染及可能的混杂因素的数据通过在诊所发放的问卷获得。采集血样以测定总免疫球蛋白E（IgE）及针对四种常见变应原的特异性IgE，并进行肺量测定和乙酰甲胆碱支气管激发试验。在11282名参与者中，通过多元回归分析BHR的连续测量值与严重呼吸道感染及其他潜在风险因素的关系，并对中心及成人BHR的主要决定因素进行校正。
报告有儿童期严重呼吸道感染的人群BHR更高，相当于使1秒用力呼气容积（FEV₁）下降20%（PD₂₀）的乙酰甲胆碱量增加约0.23倍剂量（95%置信区间0.02 - 0.44）。除成年期测量的因素可解释BHR超过20%的变异外，所有儿童期因素解释的BHR变异均小于0.3%。BHR与体重指数（BMI）的关系仅限于吸烟者。
我们发现儿童期严重呼吸道感染对成人BHR有影响，但与BHR和IgE致敏及气道管径的关系相比，这种影响较小。
