Wang Junying, Mochizuki Hiroyuki, Muramatsu Reiko, Mizuno Takahisa, Arakawa Hirokazu, Tokuyama Kenichi, Morikawa Akihiro
Gunma University, Graduate School of Medicine, Department of Pediatrics and Developmental Medicine, Maebashi, Gunma, Japan.
J Asthma. 2006 Oct;43(8):607-12. doi: 10.1080/02770900600878628.
An association between asthma and bronchial hyperresponsiveness (BHR) has been demonstrated. It is possible that the relationship between asthma severity and BHR in children with asthma is different in infants and in adolescents. The aim of this study is therefore to evaluate the effect of aging on the relationship between the severity of asthma and BHR in children with asthma. We measured BHR in 386 subjects ranging from 2 to 20 years of age. The subjects consisted of 323 children with asthma (boys:girls = 193:130, mean age 9.7 years) and 63 age-matched controls (boys:girls = 25:38, mean age 8.2 years). BHR was measured using the methacholine inhalation challenge by measuring the transcutaneous oxygen pressure (tcPO2) in children less than 6 years of age (Dmin-PO2) and by measuring the respiratory resistance (Rrs) in children 6 years of age and older (Dmin-Rrs). Throughout the whole age range, both the Dmin-PO2 and Dmin-Rrs in each asthma severity group were higher than those in the controls. In the asthmatics aged 2-5 years, the Dmin-PO2 levels in the mild asthma group were higher than those in the moderate and severe asthma groups (p < 0.001, p < 0.001, respectively), and the Dmin-PO2 levels in the moderate asthma group were also higher than those in the severe asthma group. This tendency was also found in the age ranges of 6-9 years and 10-13 years. In the asthmatics aged 14-20 years, the Dmin-Rrs levels were not significantly different among the three groups. Taken together, these data show that aging has an effect on the relationship between the severity of asthma and BHR during childhood and that BHR may not be the sole determinant for the severity of asthma in adolescence.
哮喘与支气管高反应性（BHR）之间的关联已得到证实。哮喘患儿中，哮喘严重程度与BHR之间的关系在婴儿和青少年中可能有所不同。因此，本研究的目的是评估年龄增长对哮喘患儿哮喘严重程度与BHR之间关系的影响。我们测量了386名年龄在2至20岁之间受试者的BHR。受试者包括323名哮喘患儿（男：女 = 193：130，平均年龄9.7岁）和63名年龄匹配的对照组（男：女 = 25：38，平均年龄8.2岁）。对于6岁以下儿童，通过测量经皮氧分压（tcPO2）（Dmin-PO2）来进行乙酰甲胆碱吸入激发试验以测量BHR；对于6岁及以上儿童，则通过测量呼吸阻力（Rrs）（Dmin-Rrs）来进行该试验。在整个年龄范围内，每个哮喘严重程度组的Dmin-PO2和Dmin-Rrs均高于对照组。在2至5岁的哮喘患儿中，轻度哮喘组的Dmin-PO2水平高于中度和重度哮喘组（分别为p < 0.001，p < 0.001），中度哮喘组的Dmin-PO2水平也高于重度哮喘组。在6至9岁和10至13岁的年龄范围内也发现了这种趋势。在14至20岁的哮喘患儿中，三组之间的Dmin-Rrs水平无显著差异。综上所述，这些数据表明年龄增长对儿童期哮喘严重程度与BHR之间的关系有影响，并且BHR可能不是青少年哮喘严重程度的唯一决定因素。
