基于社区的前瞻性队列研究：儿童肺功能与支气管和哮喘发病的关系。

Pulmonary function and incident bronchitis and asthma in children: a community-based prospective cohort study.

机构信息

Institute of Epidemiology and Preventive Medicine, College of Public Health, National Taiwan University, Taipei, Taiwan.

出版信息

PLoS One. 2012;7(3):e32477. doi: 10.1371/journal.pone.0032477. Epub 2012 Mar 23.

DOI:10.1371/journal.pone.0032477

PMID:22457716

原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC3311633/

Abstract

BACKGROUND

Previous studies revealed that reduction of airway caliber in infancy might increase the risks for wheezing and asthma. However, the evidence for the predictive effects of pulmonary function on respiratory health in children was still inconsistent.

METHODS

We conducted a population-based prospective cohort study among children in 14 Taiwanese communities. There were 3,160 children completed pulmonary function tests in 2007 and follow-up questionnaire in 2009. Poisson regression models were performed to estimate the effect of pulmonary function on the development of bronchitis and asthma.

RESULTS

After adjustment for potential confounders, pulmonary function indices consistently showed protective effects on respiratory diseases in children. The incidence rate ratios of bronchitis and asthma were 0.86 (95% CI 0.79-0.95) and 0.91 (95% CI 0.82-0.99) for forced expiratory volume in 1 second (FEV₁). Similar adverse effects of maximal mid-expiratory flow (MMEF) were also observed on bronchitis (RR = 0.73, 95% CI 0.67-0.81) and asthma (RR = 0.85, 95% CI 0.77-0.93). We found significant decreasing trends in categorized FEV₁ (p for trend = 0.02) and categories of MMEF (p for trend = 0.01) for incident bronchitis. Significant modification effects of traffic-related air pollution were noted for FEV₁ and MMEF on bronchitis and also for MMEF on asthma.

CONCLUSIONS

Children with high pulmonary function would have lower risks on the development of bronchitis and asthma. The protective effect of high pulmonary function would be modified by traffic-related air pollution exposure.

摘要

背景

先前的研究表明，婴儿期气道口径缩小可能会增加喘息和哮喘的风险。然而，关于肺功能对儿童呼吸健康的预测作用的证据仍然不一致。

方法

我们在台湾 14 个社区进行了一项基于人群的前瞻性队列研究。共有 3160 名儿童于 2007 年完成了肺功能检查，并于 2009 年进行了随访问卷调查。采用泊松回归模型来估计肺功能对支气管炎和哮喘发展的影响。

结果

在调整了潜在混杂因素后，肺功能指标始终显示出对儿童呼吸道疾病的保护作用。一秒用力呼气量（FEV₁）的支气管炎和哮喘的发病率比（RR）分别为 0.86（95%CI 0.79-0.95）和 0.91（95%CI 0.82-0.99）。最大呼气中期流量（MMEF）也观察到类似的对支气管炎（RR=0.73，95%CI 0.67-0.81）和哮喘（RR=0.85，95%CI 0.77-0.93）的不良影响。FEV₁（趋势检验 p 值=0.02）和 MMEF（趋势检验 p 值=0.01）的分类与支气管炎的发生呈显著下降趋势。交通相关空气污染对 FEV₁和 MMEF 与支气管炎以及 MMEF 与哮喘的相关性具有显著的修饰作用。