Department of Paediatrics, Division of Woman and Child, Oslo University Hospital, Ullevål, Oslo, Norway.
Pediatr Allergy Immunol. 2010 Aug;21(5):814-22. doi: 10.1111/j.1399-3038.2009.00973.x. Epub 2009 Nov 13.
Early intervention with inhaled corticosteroid (ICS) treatment for lung function development in childhood is debated. In view of lung function at birth, we aimed to assess if early use of ICS influenced lung function at 10 yrs of age. A 10-yr follow-up study of 614/802 children (mean age 10.9 +/- 0.9 yrs) with lung function measurements at birth in the Environment and Childhood Asthma study in Oslo included information on ICS treatment (124 with history of asthma) obtained at 2 and 10 yrs by parental interviews. Main outcomes at 10 yrs were the best values (% predicted and Z-scores) of forced expiratory volume in 1 s (FEV(1)) and mid-expiratory flow. The main explanatory factors were never, past or current use of ICS and Z-scores of the tidal flow-volume ratio t(PTEF)/t(E) [time to peak expiratory flow (t(PTEF)) and total expiratory time (t(E))] at birth. ICS treatment, reported by 11.9% of children in the population sample and 71.6% with current asthma, did not significantly influence lung function from birth to 10 yrs. The best values (and Z-scores) of FEV(1), and mid-expiratory flow were similar (p > 0.1) in subjects receiving ICS during and after 0-3 yrs of age, after 3 yrs only or currently compared with steroid naïve children. Almost half of the change in lung function 0-10 yrs was explained by gender, a history of asthma and t(PTEF)/t(E) at birth. ICS treatment for asthma, reported in every eighth child by age 10 yrs, did not significantly improve lung function from birth to 10 yrs.
儿童期早期干预吸入性皮质类固醇（ICS）治疗对肺功能发育的影响存在争议。鉴于出生时的肺功能，我们旨在评估早期使用 ICS 是否会影响 10 岁时的肺功能。一项为期 10 年的随访研究，纳入了 802 名儿童中的 614 名（平均年龄 10.9±0.9 岁），他们在奥斯陆环境和儿童哮喘研究中进行了出生时的肺功能测量，并通过父母访谈获得了 2 岁和 10 岁时的 ICS 治疗（124 名有哮喘史）信息。10 岁时的主要结局是 1 秒用力呼气量（FEV1）和 mid-expiratory flow 的最佳值（%预测值和 Z 评分）。主要解释因素是从未、过去或目前使用 ICS 以及出生时的潮气量流量比 t（PTEF）/t（E）[呼气峰流量（t（PTEF））和呼气总时间（t（E））]的 Z 评分。在人群样本中，11.9%的儿童和 71.6%有哮喘的儿童报告了 ICS 治疗，但从出生到 10 岁，ICS 治疗并未显著影响肺功能。在 0-3 岁期间和之后、仅在 3 岁之后或目前接受 ICS 治疗的受试者中，FEV1 和 mid-expiratory flow 的最佳值（和 Z 评分）相似（p＞0.1），与未使用类固醇的儿童相比。0-10 岁期间肺功能变化的近一半可以通过性别、哮喘史和出生时的 t（PTEF）/t（E）来解释。10 岁时，近八分之一的儿童报告了哮喘的 ICS 治疗，但从出生到 10 岁，ICS 治疗并未显著改善肺功能。
