van Wonderen K E, Geskus R B, van Aalderen W M C, Mohrs J, Bindels P J E, van der Mark L B, Ter Riet G
Health Inspectorate, The Hague, The Netherlands.
Department of Clinical Epidemiology, Biostatistics and Bioinformatics, Academic Medical Center, Amsterdam, The Netherlands.
Clin Exp Allergy. 2016 Jun;46(6):837-47. doi: 10.1111/cea.12660.
In 2008, the European Respiratory Society Task Force proposed the terms multiple-trigger wheeze (MTW) and episodic (viral) wheeze (EVW) for children with wheezing episodes. We determined MTW and EVW prevalence, their 24-month stability and predictiveness for asthma.
In total, 565 preschoolers (1-, 2- and 3-year-olds) in primary care with respiratory symptoms were followed until the age of 6 years when asthma was diagnosed. MTW status and EVW status were determined using questionnaire data collected at baseline and after one and 2 years. We distinguished 3 phenotypes and determined their 24-month stability, also accounting for treatment with inhaled corticosteroids (ICS). Logistic regression was used to analyse the phenotypes' associations with asthma.
Two hundred and eighty-one children had complete information. MTW and EVW were stable in 10 of 281 (3.6%) and 24 of 281 (8.5%), respectively. The odds of developing asthma for children with stable MTW and stable EVW were 14.4 (1.7-119) and 3.6 (1.2-11.3) times greater than those for children free of wheeze (for at least 1 year). ICS was associated with increased stability of MTW and EVW.
Stable multiple-trigger and stable episodic viral wheeze are relatively uncommon. However, 1- to 3-year-olds with stable MTW are at much increased risk of asthma.
2008年，欧洲呼吸学会特别工作组针对有喘息发作的儿童提出了多重触发喘息（MTW）和发作性（病毒性）喘息（EVW）这两个术语。我们确定了MTW和EVW的患病率、它们在24个月内的稳定性以及对哮喘的预测性。
共有565名有呼吸道症状的初级保健机构中的学龄前儿童（1岁、2岁和3岁）被随访至6岁，此时诊断哮喘。MTW状态和EVW状态通过在基线以及1年和2年后收集的问卷数据来确定。我们区分了3种表型并确定了它们在24个月内的稳定性，同时也考虑了吸入性糖皮质激素（ICS）治疗。采用逻辑回归分析这些表型与哮喘的关联。
281名儿童有完整信息。MTW和EVW分别在281名中的10名（3.6%）和281名中的24名（8.5%）中保持稳定。MTW稳定和EVW稳定的儿童患哮喘的几率分别是无喘息儿童（至少1年）的14.4倍（1.7 - 119）和3.6倍（1.2 - 11.3）。ICS与MTW和EVW稳定性增加有关。
稳定的多重触发和稳定的发作性病毒性喘息相对不常见。然而，MTW稳定的1至3岁儿童患哮喘的风险大幅增加。
