The OLIN Studies, Norrbotten County Council, Luleå, Sweden.
Pediatrics. 2013 Aug;132(2):e435-42. doi: 10.1542/peds.2013-0741. Epub 2013 Jul 29.
To date, a limited number of population-based studies have prospectively evaluated the remission of childhood asthma. This work was intended to study the remission and persistence of childhood asthma and related factors.
In 1996, a questionnaire was distributed to the parents of all children aged 7 to 8 years in 3 municipalities in northern Sweden, and 3430 (97%) participated. After a validation study, 248 children were identified as having asthma; these children were reassessed annually until age 19 years when 205 (83%) remained. During the follow-up period lung function, bronchial challenge testing, and skin prick tests were performed. Remission was defined as no use of asthma medication and no wheeze during the past 12 months as reported at endpoint and in the 2 annual surveys preceding endpoint (ie, for ≥ 3 years).
At age 19 years, 21% were in remission, 38% had periodic asthma, and 41% persistent asthma. Remission was more common among boys. Sensitization to furred animals and a more severe asthma (asthma score ≥ 2) at age 7 to 8 years were both inversely associated with remission, odds ratio 0.14 (95% confidence interval 0.04-0.55) and 0.19 (0.07-0.54), respectively. Among children with these 2 characteristics, 82% had persistent asthma during adolescence. Asthma heredity, damp housing, rural living, and smoking were not associated with remission.
The probability of remission of childhood asthma from age 7- to 8-years to age 19 years was largely determined by sensitization status, particularly sensitization to animals, asthma severity, and female gender, factors all inversely related to remission.
迄今为止，仅有少数基于人群的研究前瞻性评估了儿童哮喘的缓解情况。本研究旨在研究儿童哮喘的缓解和持续情况及其相关因素。
1996 年，在瑞典北部的 3 个城市向所有 7 至 8 岁儿童的家长发放了一份调查问卷，3430 名（97%）家长参与了调查。经过验证性研究，确定 248 名儿童患有哮喘；这些儿童每年接受一次评估，直到 19 岁时，其中 205 名（83%）儿童仍在接受评估。在随访期间，对他们的肺功能、支气管激发试验和皮肤点刺试验进行了检测。缓解定义为：在终点时以及在终点前的 2 次年度调查中，过去 12 个月未使用哮喘药物且无喘息报告（即，≥3 年）。
在 19 岁时，21%的儿童处于缓解状态，38%的儿童为间歇性哮喘，41%的儿童为持续性哮喘。男孩中缓解更为常见。7 至 8 岁时对皮毛动物过敏以及更严重的哮喘（哮喘评分≥2）与缓解呈负相关，比值比分别为 0.14（95%置信区间 0.04-0.55）和 0.19（0.07-0.54）。在具有这两种特征的儿童中，82%在青春期仍患有持续性哮喘。哮喘遗传、潮湿的住房、农村居住和吸烟与缓解无关。
从 7 至 8 岁到 19 岁，儿童哮喘缓解的可能性在很大程度上取决于致敏状态，特别是对动物的致敏、哮喘严重程度和性别，这些因素均与缓解呈负相关。
