Department of Preventive and Social Medicine, Dunedin School of Medicine, University of Otago, New Zealand.
Curr Allergy Asthma Rep. 2012 Jun;12(3):175-84. doi: 10.1007/s11882-012-0255-6.
The definition of persistent asthma in longitudinal studies reflects symptoms reported at every assessment with no substantive asymptomatic periods. Early-childhood wheezing may be transient, especially if it is of viral etiology. Longitudinal studies provide greater opportunity to confirm the diagnosis by variability of symptoms, objective measurements, and therapeutic responses. Several clinical phenotypes of childhood asthma have been identified, with general consistency between cohorts. Persistent wheezing is often associated with loss of lung function, which is evident from early-childhood and related to persistent inflammation and airway hyperresponsiveness. Female sex, atopy, airway responsiveness, and personal smoking, but not exposure to environmental tobacco smoke, are risk factors for persistence of childhood asthma into adulthood. The effect of breastfeeding remains controversial, but gene-environment interactions may partly explain outcomes. Understanding the natural history and underlying causes of asthma may lead to development of strategies for primary prevention.
在纵向研究中，持续性哮喘的定义反映了在每次评估时报告的症状，没有实质性的无症状期。幼儿喘息可能是短暂的，特别是如果它是病毒病因。纵向研究通过症状的可变性、客观测量和治疗反应提供了更大的机会来确认诊断。已经确定了几种儿童哮喘的临床表型，队列之间具有普遍一致性。持续性喘息常与肺功能丧失有关，从幼儿期开始就很明显，与持续的炎症和气道高反应性有关。女性、特应性、气道反应性和个人吸烟，但不是接触环境烟草烟雾，是儿童哮喘持续到成年的危险因素。母乳喂养的效果仍然存在争议，但基因-环境相互作用可能部分解释了结果。了解哮喘的自然史和根本原因可能会导致制定初级预防策略。
