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婴儿期喘息后成人哮喘:27 岁时的问卷调查研究。

Adulthood asthma after wheezing in infancy: a questionnaire study at 27 years of age.

机构信息

Department of Pediatrics, Kuopio University and Kuopio University Hospital, Finland.

出版信息

Allergy. 2010 Apr;65(4):503-9. doi: 10.1111/j.1398-9995.2009.02212.x.

Abstract

BACKGROUND

Wheezing in early childhood is a heterogeneous condition, the longterm prognosis varying from total recovery to chronic asthma. Though short-term outcome has been actively studied, there is lack of data on long-term outcome until adulthood. The aim of the study was to evaluate the prevalence and risk factors of asthma at 26-29 years of age after early-life wheezing.

METHODS

At the median age of 27.3 years (range 26.3-28.6), a questionnaire was sent to 78 study subjects hospitalized for wheezing at <24 months of age, and 59 (76%) answered. Asthma, allergy and weight status were compared with selected controls followed up from birth and with non-selected population controls recruited for this adulthood study.

RESULTS

Doctor-diagnosed asthma was present in 20% of the former bronchiolitis patients, compared with 5% in the two control groups (OR 2.1, 95% CI 0.3-17.9 vs selected controls; OR 5.2, 95% CI 1.7-15.8 vs nonselected controls). The respective figures for current self-reported asthma were 41% and 7-10% (OR 11.4, 95% CI 2.3-56.1 vs selected controls; OR 12.2, 95% CI 4.4-33.7 vs nonselected controls). Current allergic rhinitis and current smoking were significantly associated with asthma, but current overweight or obesity was not. In multivariate analyses, early-life wheezing was an independent risk factor of adulthood asthma.

CONCLUSION

An increased asthma risk in early-life wheezers continues, even after many symptom-free years at school age, at least until 27 years of age.

摘要

背景

儿童早期喘息是一种异质性疾病,其长期预后从完全康复到慢性哮喘不等。虽然短期预后已得到积极研究,但直到成年期才有关于长期预后的数据。本研究的目的是评估早期生命喘息后 26-29 岁时哮喘的患病率和危险因素。

方法

在中位数年龄为 27.3 岁(范围 26.3-28.6)时,向因喘息于<24 个月龄住院的 78 名研究对象发送了一份问卷,其中 59 名(76%)回答了问卷。比较了哮喘、过敏和体重状况,以及从出生开始随访的选定对照组和为此成年期研究招募的非选择性人群对照组。

结果

在以前的细支气管炎患者中,医生诊断的哮喘为 20%,而在两个对照组中为 5%(OR 2.1,95%CI 0.3-17.9 与选定对照组相比;OR 5.2,95%CI 1.7-15.8 与非选定对照组相比)。目前自我报告的哮喘分别为 41%和 7-10%(OR 11.4,95%CI 2.3-56.1 与选定对照组相比;OR 12.2,95%CI 4.4-33.7 与非选定对照组相比)。目前的过敏性鼻炎和目前的吸烟与哮喘显著相关,但目前的超重或肥胖与哮喘无关。在多变量分析中,早期生命喘息是成年期哮喘的独立危险因素。

结论

即使在学龄期有多年无症状,早期喘息者的哮喘风险仍会增加,至少持续到 27 岁。

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