Dodge R, Cline M G, Lebowitz M D, Burrows B
Respiratory Sciences Center, University of Arizona College of Medicine, Tucson 85724.
J Allergy Clin Immunol. 1994 Nov;94(5):831-5. doi: 10.1016/0091-6749(94)90150-3.
Asthma is a poorly understood disease. Risk factors are not established, and the natural history of the disease is unknown.
Using subjects of a community-based study, we have prospectively compared young adults destined to develop asthma with control subjects to determine differences between them before diagnosis.
Subjects were participants of the Tucson Epidemiologic Study of Airways Obstructive Disease. They were studied between the ages of 15 and 19 and subsequently every 1 to 2 years until they were at least 21 years old with questionnaire, spirometry, allergy skin testing, and serum IgE testing.
Logistic regression showed that "wheeze" and "attacks of shortness of breath with wheeze" were independently predictive of asthma. Positive allergy skin test results occurred more frequently among subjects who later received a diagnosis of asthma, and initially these subjects had higher serum IgE levels than control subjects (geometric mean IgE = 173.8 IU/ml vs 52.5 IU/ml for control subjects; p < 0.005). Although initial spirometric testing did not distinguish between future asthmatic subjects and control subjects, repeat testing after diagnosis did show significant differences in flows at low lung volumes.
These data suggest that symptoms and findings suggestive of asthma may be present for many years before diagnosis.
哮喘是一种了解甚少的疾病。其危险因素尚未明确，疾病的自然史也不清楚。
通过一项基于社区的研究对象，我们前瞻性地比较了注定会患哮喘的年轻成年人与对照对象，以确定在诊断前他们之间的差异。
研究对象为图森气道阻塞性疾病流行病学研究的参与者。他们在15至19岁之间接受研究，随后每1至2年进行一次研究，直至至少21岁，期间进行问卷调查、肺功能测定、过敏皮肤试验和血清IgE检测。
逻辑回归显示，“喘息”和“伴有喘息的呼吸急促发作”可独立预测哮喘。在后来被诊断为哮喘的受试者中，过敏皮肤试验阳性结果出现得更为频繁，并且最初这些受试者的血清IgE水平高于对照对象（几何平均IgE = 173.8 IU/ml，对照对象为52.5 IU/ml；p < 0.005）。尽管最初的肺功能测定未能区分未来的哮喘受试者和对照对象，但诊断后的重复检测确实显示在低肺容量时气流存在显著差异。
这些数据表明，在诊断前许多年可能就已出现提示哮喘的症状和体征。
