Noble V, Murray M, Webb M S, Alexander J, Swarbrick A S, Milner A D
Department of Child Health, University Hospital, Nottingham.
Arch Dis Child. 1997 Apr;76(4):315-9. doi: 10.1136/adc.76.4.315.
In order to evaluate further the relationship between acute bronchiolitis in infancy and subsequent respiratory problems, children prospectively followed up from the time of their admission to hospital were reviewed along with a group of matched controls recruited at the previous five and a half year assessment. Sixty one index children and 47 controls took part. The groups were well matched for age, height, parental smoking, and social class. Although the prevalence of respiratory symptoms had fallen when related to the previous review, there remained an excess of coughing (48 and 17% in index and control children respectively; odds ratio 4.02) and wheezing (34 and 13% in index and control children respectively; odds ratio 3.59). Bronchodilator therapy was used by 33% of index children compared with 3% of controls. Lung function tests revealed no significant differences in the measurements of lung growth-for example, forced vital capacity, functional residual capacity, and total lung capacity-but the index children had significant reductions in measurements of airways obstruction-for example, forced expiratory volume in one second, maximum expiratory flow at 75, 50 and 25% of vital capacity, and airways resistance. Family history and personal skin tests showed no excess of atopy in the index group. This study supports the claim that the excess respiratory symptoms after acute bronchiolitis are not due to familial or personal susceptibility to atopy.
为了进一步评估婴儿期急性细支气管炎与随后呼吸系统问题之间的关系,对自入院起就进行前瞻性随访的儿童以及一组在之前五年半评估时招募的匹配对照组儿童进行了复查。61名指标儿童和47名对照儿童参与了研究。两组在年龄、身高、父母吸烟情况和社会阶层方面匹配良好。尽管与之前的复查相比,呼吸道症状的患病率有所下降,但咳嗽(指标儿童和对照儿童分别为48%和17%;优势比为4.02)和喘息(指标儿童和对照儿童分别为34%和13%;优势比为3.59)仍然过多。33%的指标儿童使用了支气管扩张剂治疗,而对照儿童中这一比例为3%。肺功能测试显示,在肺生长指标方面,如用力肺活量、功能残气量和肺总量,没有显著差异,但指标儿童在气道阻塞指标方面有显著降低,如一秒用力呼气量、肺活量75%、50%和25%时的最大呼气流量以及气道阻力。家族史和个人皮肤试验显示指标组中特应性并无增加。这项研究支持了以下观点:急性细支气管炎后呼吸道症状过多并非由于家族性或个人对特应性的易感性。