Wegienka Ganesa, Havstad Suzanne, Zoratti Edward M, Ownby Dennis R, Johnson Christine Cole
Department of Biostatistics and Research Epidemiology, Henry Ford Hospital, Detroit, Michigan, USA.
Ann Allergy Asthma Immunol. 2009 Jan;102(1):29-34. doi: 10.1016/S1081-1206(10)60104-4.
The incidence of wheeze is unknown and the role of early life wheeze in subsequent health is not clearly understood.
To calculate the age-specific incidence of wheeze and determine whether wheezing at particular times in early life was predictive of abnormal airway hyperresponsiveness (AHR), percentage of predicted forced expiratory volume in 1 second (FEV1), and current asthma at the age of 6 years.
Using data from a birth cohort study with annual report of wheezing (Childhood Allergy Study) and spirometry and methacholine challenge at the age of 6 years, the age-specific incidence of wheeze was determined using Kaplan-Meier estimates. Logistic and linear regression models were used to assess the associations between the presence of age-specific wheezing and the outcomes of current asthma, AHR, and percentage of predicted FEV1 at the age of 6 years.
A total of 724 children had parents who completed at least the first annual interview and were therefore included in the study. The 6-year cumulative incidence of wheezing was higher for boys (66.2%; 95% confidence interval, 59.8%- 72.6%) than for girls (47.6%; 95% confidence interval, 41.4%-53.8%). There was no age when wheezing was more strongly associated with either AHR or percentage of predicted FEV1 at 6 years. Only wheeze in the fifth year among boys and wheezing in both the fourth and fifth years in girls were positively predictive of current asthma at the age of 6 years. This is likely because of the definition of current asthma (ever physician diagnosis and either medication or symptoms in last year). Eczema, parental asthma history, and total cord blood IgE did not affect these associations.
Wheezing at any particular time in early life may not be predictive of early childhood lung function.
喘息的发病率尚不清楚，且早年喘息在后续健康中的作用也未得到明确理解。
计算特定年龄的喘息发病率，并确定早年特定时期的喘息是否可预测6岁时的气道高反应性（AHR）异常、预计第1秒用力呼气容积（FEV1）百分比及当前哮喘情况。
利用一项出生队列研究的数据，该研究有喘息的年度报告（儿童过敏研究）以及6岁时的肺功能测定和乙酰甲胆碱激发试验，采用Kaplan-Meier估计法确定特定年龄的喘息发病率。使用逻辑回归和线性回归模型评估特定年龄喘息的存在与6岁时当前哮喘、AHR及预计FEV1百分比结果之间的关联。
共有724名儿童的父母至少完成了首次年度访谈，因此被纳入研究。男孩的6年累积喘息发病率（66.2%；95%置信区间，59.8%-72.6%）高于女孩（47.6%；95%置信区间，41.4%-53.8%）。在任何年龄，喘息与6岁时的AHR或预计FEV1百分比均无更强的关联。仅男孩在第5年的喘息以及女孩在第第4年和第5年的喘息可正向预测6岁时的当前哮喘。这可能是由于当前哮喘的定义（曾有医生诊断且在过去一年使用药物或有症状）。湿疹、父母哮喘病史和脐血总IgE不影响这些关联。
早年任何特定时间的喘息可能无法预测儿童早期肺功能。
