De Sario Manuela, Di Domenicantonio Riccardo, Corbo Giuseppe, Forastiere Francesco, Pistelli Riccardo, Rusconi Franca, Sammarro Sandra, Serra Maria Grazia, Compagnucci Patrizia, Perucci Carlo A
Department of Epidemiology, Rome E Local Health Authority, Rome, Italy.
J Asthma. 2006 Oct;43(8):633-8. doi: 10.1080/02770900600878974.
To investigate the early determinants and characteristics of different phenotypes of wheeze in children on the basis of questionnaire data, lung function, and prick tests.
Cross-sectional survey. Setting. Rome and Fiumicino municipalities in Lazio region, Italy, within the ISAAC phase II project.
Sample of 2107 9-11 year old schoolchildren (response rate 83.5%).
We divided children into four mutually exclusive groups according to onset of wheeze: 154 early transient (birth to age 2), 51 persistent (birth to age 2 and current), 66 late onset (current only), and 1,446 control subjects (no early or current wheeze). Logistic regression models have shown that a family history of asthma and allergies is strongly associated with persistent and late onset wheezing; exposure to parental smoking--both during pregnancy and during the child's first year of life--is related to persistent wheezing; all children with wheezing show a significantly greater risk to have current respiratory symptoms other than wheeze compared with control subjects; current allergic rhinoconjunctivitis symptoms and atopy are related with both persistent and late onset wheeze. Multiple linear regression models show that forced expiratory rates at 25% to 75% of vital capacity (FEF25-75) and the ratio between forced expiratory volume in 1 second and forced vital capacity (FEV1/FVC) are significantly lower both in early transient (-305 mL/s, -1.7%) and persistent (-298 mL/s, -3.2%) wheezers; FEV1/FVC is significantly reduced in late onset wheezers too (-2.0%).
The strength of the association of family history and exposure to parental smoking varies with the three wheezing phenotypes. Moreover, early, persistent and late onset wheezers have different clinical characteristics in terms of their respiratory health and atopic status.
基于问卷调查数据、肺功能和点刺试验，调查儿童不同类型喘息的早期决定因素和特征。
横断面调查。地点：意大利拉齐奥地区罗马市和菲乌米奇诺市，在国际儿童哮喘和变应性疾病研究（ISAAC）项目的第二阶段。
2107名9至11岁学童的样本（应答率83.5%）。
根据喘息发作情况，我们将儿童分为四个相互排斥的组：154名早期短暂性喘息儿童（出生至2岁）、51名持续性喘息儿童（出生至2岁且目前仍有喘息）、66名迟发性喘息儿童（仅目前有喘息）和1446名对照儿童（无早期或目前喘息）。逻辑回归模型显示，哮喘和过敏家族史与持续性和迟发性喘息密切相关；孕期及儿童出生后第一年接触父母吸烟与持续性喘息有关；与对照儿童相比，所有喘息儿童出现除喘息外的当前呼吸道症状的风险显著更高；当前过敏性鼻结膜炎症状和特应性与持续性和迟发性喘息均有关。多元线性回归模型显示，早期短暂性喘息儿童（-305 mL/s，-1.7%）和持续性喘息儿童（-298 mL/s，-3.2%）的肺活量25%至75%时的用力呼气速率（FEF25 - 75）以及1秒用力呼气量与用力肺活量之比（FEV1/FVC）均显著降低；迟发性喘息儿童的FEV1/FVC也显著降低（-2.0%）。
家族史和接触父母吸烟之间关联的强度因三种喘息类型而异。此外，早期、持续性和迟发性喘息儿童在呼吸健康和特应性状态方面具有不同的临床特征。
