Strope G L, Stewart P W, Henderson F W, Ivins S S, Stedman H C, Henry M M
Department of Pediatrics, School of Medicine, University of North Carolina, Chapel Hill 27599-7220.
Am Rev Respir Dis. 1991 Sep;144(3 Pt 1):655-62. doi: 10.1164/ajrccm/144.3_Pt_1.655.
We examined the relationship between patterns of mild lower respiratory illness (LRI) experienced in early childhood and lung function in 89 boys and 70 girls 6 to 18 yr of age. The children's histories of outpatient visits for wheezing and nonwheezing LRI during the first 6 yr of life had been documented by physicians in a single pediatric practice. Most children were reported by their parents to have been free of recurrent respiratory symptoms during the 2 yr prior to lung function testing. In sex-specific analyses, average lung function assessed by spirometry was similar in children who had made zero or one physician visit for wheezing LRI during the preschool years. Boys who had experienced two or more episodes of wheezing LRI during the preschool years had lower average FEV1, FEV1/FVC, FEF25-75, Vmax50, and Vmax75 than did boys who had zero or one preschool wheezing illness. The association between recurrent preschool wheezing LRI and later lung function remained after exclusion of data from seven boys who were reported to have wheezed in the 2 yr prior to study. Girls who had experienced two or more preschool wheezing LRI had lower average FEF25-75 and Vmax50 than girls with a history of zero or one such illness, but differences were not statistically significant. Recurrent nonwheezing LRI during the preschool years was not significantly associated with subsequent lung function in either sex, regardless of preschool wheezing LRI history. Detailed information concerning early childhood LRI experience is valuable in epidemiologic studies of factors influencing lung function in children.
我们研究了89名6至18岁男孩和70名6至18岁女孩在幼儿期经历的轻度下呼吸道疾病(LRI)模式与肺功能之间的关系。在一家儿科诊所中,医生记录了这些儿童在生命最初6年中因喘息性和非喘息性LRI进行门诊就诊的病史。大多数儿童的父母报告称,在进行肺功能测试前的2年里,他们没有反复出现呼吸道症状。在按性别进行的分析中,通过肺活量测定法评估的平均肺功能在学龄前因喘息性LRI就诊零次或一次的儿童中相似。在学龄前经历过两次或更多次喘息性LRI发作的男孩,其平均第一秒用力呼气容积(FEV1)、FEV1/用力肺活量(FVC)、25%至75%用力呼气流量(FEF25 - 75)、最大呼气中期流量(Vmax50)和最大呼气后期流量(Vmax75)均低于学龄前喘息性疾病就诊零次或一次的男孩。在排除了7名据报告在研究前2年有喘息症状的男孩的数据后,学龄前反复喘息性LRI与后期肺功能之间的关联仍然存在。经历过两次或更多次学龄前喘息性LRI的女孩,其平均FEF25 - 75和Vmax50低于有零次或一次此类疾病史的女孩,但差异无统计学意义。学龄前反复出现的非喘息性LRI与后续肺功能在两性中均无显著关联,无论其学龄前喘息性LRI病史如何。关于幼儿期LRI经历的详细信息在影响儿童肺功能因素的流行病学研究中很有价值。