Pulmonary Medicine Division, Department of Pediatrics, Cincinnati Children's Hospital, Cincinnati, Ohio.
Department of Health Evaluation Sciences, Pennsylvania State University, Hershey, Pa.
J Allergy Clin Immunol Pract. 2014 Nov-Dec;2(6):664-70. doi: 10.1016/j.jaip.2014.09.010. Epub 2014 Nov 6.
Wheezing is a fairly common symptom in early childhood, but only some of these toddlers will experience continued wheezing symptoms in later childhood. The definition of the asthma-predictive phenotype is in children with frequent, recurrent wheezing in early life who have risk factors associated with the continuation of asthma symptoms in later life. Several asthma-predictive phenotypes were developed retrospectively based on large, longitudinal cohort studies; however, it can be difficult to differentiate these phenotypes clinically as the expression of symptoms, and risk factors can change with time. Genetic, environmental, developmental, and host factors and their interactions may contribute to the development, severity, and persistence of the asthma phenotype over time. Key characteristics that distinguish the childhood asthma-predictive phenotype include the following: male sex; a history of wheezing, with lower respiratory tract infections; history of parental asthma; history of atopic dermatitis; eosinophilia; early sensitization to food or aeroallergens; or lower lung function in early life.
喘息是儿童早期相当常见的症状,但只有其中一些幼儿会在以后的儿童期持续出现喘息症状。哮喘预测表型的定义是指在生命早期频繁、反复喘息的儿童中,存在与以后生命中哮喘症状持续相关的危险因素。一些哮喘预测表型是基于大型纵向队列研究回顾性地制定的;然而,由于症状和危险因素随时间而变化,临床上很难区分这些表型。遗传、环境、发育和宿主因素及其相互作用可能会导致哮喘表型随时间的推移而发展、加重和持续存在。区分儿童哮喘预测表型的关键特征包括以下几个方面:男性;喘息史,伴有下呼吸道感染;父母哮喘史;特应性皮炎史;嗜酸性粒细胞增多症;早期对食物或过敏原致敏;或生命早期肺功能较低。