Chan K N, Elliman A, Bryan E, Silverman M
Department of Paediatrics and Neonatal Medicine, Royal Postgraduate Medical School, Hammersmith Hospital, London, England.
Pediatr Pulmonol. 1989;7(4):251-8. doi: 10.1002/ppul.1950070411.
We report a prospective study of airway responsiveness in a cohort of 121 children of low birthweight (under 2,000 g) at 7 years and a random sample of 100 local schoolchildren of the same age. A positive airway response was defined as a 20% fall in peak expiratory flow rate in response to a cumulative histamine dose of 3 mumol or less. We found a moderate increase in airway responsiveness to inhaled histamine in the cohort (44%) compared with the reference group (22%). There was no significant association between airway responsiveness and any perinatal variables including the level of respiratory support. The findings suggested that neonatal respiratory illness or its treatment did not play a major role in determining the long-term airway responsiveness in these children. Amongst all factors examined, reduced airway function at the age of 7 was most strongly associated with airway responsiveness, independent of perinatal and familial factors. Airway responsiveness was associated with significantly more chest symptoms. We suggest that increased airway responsiveness to inhaled histamine in low birthweight children is a consequence rather than the cause of reduced airway function and argue against the presence of any other form of airway dysfunction as a cause of airway responsiveness.
我们报告了一项前瞻性研究，该研究针对121名出生体重低（低于2000克）的儿童在7岁时的气道反应性，并与100名当地同龄学童的随机样本进行了比较。气道阳性反应定义为吸入组胺累积剂量为3微摩尔或更低时，呼气峰值流速下降20%。我们发现，与对照组（22%）相比，该队列中对吸入组胺的气道反应性有适度增加（44%）。气道反应性与任何围产期变量（包括呼吸支持水平）之间均无显著关联。研究结果表明，新生儿呼吸系统疾病或其治疗在决定这些儿童的长期气道反应性方面并未起主要作用。在所有检查的因素中，7岁时气道功能降低与气道反应性的关联最为密切，且不受围产期和家族因素的影响。气道反应性与明显更多的胸部症状相关。我们认为，出生体重低的儿童对吸入组胺的气道反应性增加是气道功能降低的结果而非原因，并反对存在任何其他形式的气道功能障碍作为气道反应性的原因。
