Strachan D P, Anderson H R, Bland J M, Peckham C
Department of Community Medicine, Medical School, University of Edinburgh.
Br Med J (Clin Res Ed). 1988 Mar 26;296(6626):890-3. doi: 10.1136/bmj.296.6626.890.
The link between chest illnesses in childhood to age 7 and the prevalence of cough and phlegm in the winter reported at age 23 was investigated in a cohort of 10,557 British children born in one week in 1958 (national child development study). Both pneumonia and asthma or wheezy bronchitis to age 7 were associated with a significant excess in the prevalence of chronic cough and phlegm at age 23 after controlling for current smoking. This excess was largely attributable to the association of cough and phlegm at age 23 with a history of asthma or wheezy bronchitis from age 16. When adjustment was made for recent wheezing, current cigarette consumption, previous smoking habit, and passive exposure to smoke the relative odds of cough or phlegm, or both, in subjects with a history of childhood chest illness was 1.11 (95% confidence interval 0.97 to 1.27). When analysed separately asthma, wheezy bronchitis, and pneumonia up to age 7 did not significantly increase the prevalence of either cough or phlegm. The explanation for the observed continuity between chest illness in childhood and respiratory symptoms in later life may lie more in the time course of functional disturbances related to asthma than in the persistence of structural lung damage.
在一项针对1958年某一周出生的10557名英国儿童的队列研究（全国儿童发展研究）中，调查了7岁前儿童胸部疾病与23岁时报告的冬季咳嗽和咳痰患病率之间的联系。在控制当前吸烟情况后，7岁前的肺炎以及哮喘或喘息性支气管炎都与23岁时慢性咳嗽和咳痰患病率显著增加有关。这种增加很大程度上归因于23岁时的咳嗽和咳痰与16岁以来的哮喘或喘息性支气管炎病史有关。当对近期喘息、当前吸烟量、既往吸烟习惯和被动吸烟暴露进行调整后，有儿童期胸部疾病史的受试者出现咳嗽或咳痰或两者皆有的相对比值比为1.11（95%置信区间0.97至1.27）。当分别分析时，7岁前的哮喘、喘息性支气管炎和肺炎并未显著增加咳嗽或咳痰的患病率。儿童期胸部疾病与后期生活中呼吸道症状之间观察到的连续性，其解释可能更多地在于与哮喘相关的功能障碍的时间进程，而非肺部结构损伤的持续存在。
