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儿童和成人慢性支气管炎:定义、病理生理学、患病率、危险因素及后果

Chronic Bronchitis in Children and Adults: Definitions, Pathophysiology, Prevalence, Risk Factors, and Consequences.

作者信息

Zhang Jingwen, Wurzel Danielle F, Perret Jennifer L, Lodge Caroline J, Walters E Haydn, Dharmage Shyamali C

机构信息

Allergy and Lung Health Unit, Centre for Epidemiology and Biostatistics, Melbourne School of Population and Global Health, The University of Melbourne, Melbourne, VIC 3053, Australia.

Murdoch Children's Research Institute, The Royal Children's Hospital, Melbourne, VIC 3052, Australia.

出版信息

J Clin Med. 2024 Apr 20;13(8):2413. doi: 10.3390/jcm13082413.

Abstract

The complex nature of chronic bronchitis (CB) and changing definitions have contributed to challenges in understanding its aetiology and burden. In children, CB is characterised by persistent airway inflammation often linked to bacterial infections and is therefore termed "protracted bacterial bronchitis" (PBB). Longitudinal studies suggest that CB in childhood persists into adulthood in a subgroup. It can also be associated with future chronic respiratory diseases including asthma, bronchiectasis, and chronic obstructive pulmonary disease (COPD). Adult CB is traditionally associated with smoking, occupational exposures, and lower socioeconomic status. The interplay between risk factors, childhood CB, adult CB, and other chronic respiratory diseases is intricate, requiring comprehensive longitudinal studies for a clearer understanding of the natural history of CB across the lifespan. Such longitudinal studies have been scarce to date given the logistic challenges of maintaining them over time. In this review, we summarise current evidence on the evolution of the definitions, pathophysiology, risk factors, and consequences of childhood and adulthood chronic bronchitis.

摘要

慢性支气管炎(CB)的复杂性质以及定义的不断变化,给理解其病因和负担带来了挑战。在儿童中,CB的特征是持续性气道炎症,常与细菌感染有关,因此被称为“迁延性细菌性支气管炎”(PBB)。纵向研究表明,儿童期的CB在亚组中会持续到成年期。它还可能与未来的慢性呼吸道疾病有关,包括哮喘、支气管扩张和慢性阻塞性肺疾病(COPD)。传统上,成人CB与吸烟、职业暴露和较低的社会经济地位有关。危险因素、儿童期CB、成人CB和其他慢性呼吸道疾病之间的相互作用错综复杂,需要进行全面的纵向研究,以更清楚地了解CB在整个生命周期的自然史。鉴于长期维持这类纵向研究存在后勤方面的挑战,迄今为止此类研究很少。在本综述中,我们总结了关于儿童期和成年期慢性支气管炎的定义演变、病理生理学、危险因素和后果的现有证据。

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