学龄前儿童复发性喘息及其与肺功能和气道炎症的关系：韩国的一项横断面研究
Recurrent wheeze and its relationship with lung function and airway inflammation in preschool children: a cross-sectional study in South Korea.
作者信息
Soh Ji Eun, Kim Kyung-Moon, Kwon Ji-Won, Kim Hyung Young, Seo Ju-Hee, Kim Hyo-Bin, Lee So-Yeon, Jang Gwang-Cheon, Song Dae-Jin, Kim Woo Kyung, Jung Young-Ho, Hong Soo-Jong, Shim Jung Yeon
机构信息
Department of Pediatrics, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea.
Department of Pediatrics, Seoul National University Bundang Hospital, Seongnam, Republic of Korea.
出版信息
BMJ Open. 2017 Oct 8;7(10):e018010. doi: 10.1136/bmjopen-2017-018010.
BACKGROUND
Relationship between recurrent wheeze and airway function and inflammation in preschool children is not fully known.
OBJECTIVE
To investigate the relationship between recurrent wheeze and airway inflammation, lung function, airway hyper-reactivity (AHR) and atopy in preschool children.
DESIGN
Observational study, comparing forced expiratory volume in 1 s (FEV), forced vital capacity (FVC) and mid-forced expiratory flow (FEF), dose-response slope (DRS), exhaled nitric oxide (eNO) and atopic sensitisation between children with recurrent wheeze and those without.
SETTING
Population-based, cross-sectional study in Seoul and the Gyeonggi province of Korea conducted as a government-funded programme to perform standardised measurement of the prevalence of allergic diseases, and related factors, in preschool children.
PARTICIPANTS
900 children aged 4-6 years. PRIMARY AND SECONDARY OUTCOME MEASURES: eNO, FEV/FVC, FEF, DRS, atopic sensitisation and allergic diseases.
METHODS
Children completed the modified International Study of Asthma and Allergies in Childhood questionnaire and underwent eNO assessments, spirometry, methacholine bronchial provocation tests and skin prick tests. Recurrent wheeze was defined as having a lifetime wheeze of more than three episodes, based on the questionnaire. The frequency of hospitalisation and emergency room visits was also obtained by means of the questionnaire. 'Current' wheeze was defined as having symptoms or treatments within the past 12 months.
RESULTS
The prevalence of recurrent wheeze was 13.4%. Children with recurrent wheeze showed a higher prevalence of lifetime or current allergic rhinitis (p=0.01 and p=0.002, respectively) and lifetime atopic dermatitis (p=0.007). Children with recurrent wheeze showed lower FEV/FVC (p=0.033) and FEF (p=0.004), and higher eNO levels (p=0.013) than those without recurrent wheeze. However, the DRS, prevalence of atopic sensitisation and serum IgE levels were not significantly different between the two groups.
CONCLUSIONS
Recurrent wheeze in preschool children may be associated with airway inflammation and diminished airway function, but not with AHR or atopy.
背景
学龄前儿童复发性喘息与气道功能及炎症之间的关系尚不完全清楚。
目的
探讨学龄前儿童复发性喘息与气道炎症、肺功能、气道高反应性（AHR）及特应性之间的关系。
设计
观察性研究，比较复发性喘息儿童与非复发性喘息儿童的1秒用力呼气容积（FEV）、用力肺活量（FVC）和用力呼气中期流速（FEF）、剂量反应斜率（DRS）、呼出一氧化氮（eNO）及特应性致敏情况。
背景
在韩国首尔和京畿道开展的一项基于人群的横断面研究，该研究作为一项政府资助项目，旨在对学龄前儿童过敏性疾病的患病率及相关因素进行标准化测量。
参与者
900名4 - 6岁儿童。主要和次要观察指标：eNO、FEV/FVC、FEF、DRS、特应性致敏及过敏性疾病。
方法
儿童完成改良版儿童哮喘与过敏国际研究问卷，并接受eNO评估、肺功能测定、乙酰甲胆碱支气管激发试验及皮肤点刺试验。根据问卷，复发性喘息定义为一生中喘息发作超过3次。还通过问卷获取住院和急诊就诊频率。“当前”喘息定义为在过去12个月内有症状或接受治疗。
结果
复发性喘息的患病率为13.4%。复发性喘息儿童一生中或当前过敏性鼻炎的患病率较高（分别为p = 0.01和p = 0.002），一生中特应性皮炎的患病率较高（p = 0.007）。与非复发性喘息儿童相比，复发性喘息儿童的FEV/FVC较低（p = 0.033），FEF较低（p = 0.004），eNO水平较高（p = 0.013）。然而，两组之间的DRS、特应性致敏患病率及血清IgE水平无显著差异。
结论
学龄前儿童复发性喘息可能与气道炎症和气道功能减退有关，但与AHR或特应性无关。
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