Chatkin Moema Nudilemon, Menezes Ana Maria Baptista, Macedo Silvia Elaine Cardozo, Fiss Edgar
Universidade Católica de Pelotas, Pelotas, RS, Brasil.
J Bras Pneumol. 2008 Oct;34(10):764-71. doi: 10.1590/s1806-37132008001000003.
Asthma and respiratory symptoms are common in children, and many studies have shown associations between childhood symptoms and impaired lung function in adult life. The aim of the present study was to investigate the association of various respiratory symptoms with wheezing patterns (persistent, early, and late-onset) and lung function, as well as to determine whether lung function was associated with atopy or with demographic, socioeconomic, environmental, and gestational factors, in a birth cohort at 6-7 years of age.
The target population consisted of children aged 6-7 years from a birth cohort of 5,304 children born in southern Brazil in 1993. For this follow-up evaluation, 532 of those children were randomly selected, and a sub-sample was submitted to spirometry and skin prick tests. A questionnaire was administered to the parent(s) or legal guardian(s) of each child.
Spirometric values were lower in the children with respiratory symptoms or asthma. Mean forced expiratory volume in one second/forced vital capacity ratio (FEV1/FVC ratio) was lower in children with any of the following: current wheezing and asthma; asthma ever; four or more episodes of wheezing within the preceding 12 months; sleep disturbance due to wheezing; and exercise-induced wheezing. Persistent wheezing was associated with lower FEV1/FVC ratio. After multiple linear regression, exercise-induced wheezing was also associated with reduced FEV1/FVC ratio. Nonwhite skin color and wheezing severe enough to limit speech were associated with lower FEV1.
Children with persistent wheezing and symptoms of severe asthma have impaired lung function at 6-7 years of age.
哮喘和呼吸道症状在儿童中很常见，许多研究表明儿童期症状与成年后肺功能受损之间存在关联。本研究的目的是调查6至7岁出生队列中各种呼吸道症状与喘息模式（持续性、早发性和迟发性）及肺功能之间的关联，并确定肺功能是否与特应性或人口统计学、社会经济、环境和妊娠因素相关。
目标人群包括1993年出生在巴西南部的5304名儿童出生队列中的6至7岁儿童。在本次随访评估中，随机选择了其中532名儿童，并对一个子样本进行了肺活量测定和皮肤点刺试验。向每个儿童的父母或法定监护人发放了一份问卷。
有呼吸道症状或哮喘的儿童肺活量测定值较低。以下任何一种情况的儿童一秒用力呼气容积/用力肺活量比值（FEV1/FVC比值）较低：当前喘息和哮喘；曾患哮喘；在过去12个月内有四次或更多次喘息发作；因喘息导致睡眠障碍；以及运动诱发性喘息。持续性喘息与较低的FEV1/FVC比值相关。经过多元线性回归分析，运动诱发性喘息也与FEV1/FVC比值降低相关。非白色肤色和严重到足以限制说话的喘息与较低的FEV1相关。
患有持续性喘息和严重哮喘症状的儿童在6至7岁时肺功能受损。
