Mostgaard G, Siersted H C, Hansen H S, Hyldebrandt N, Oxhøj H
Odense Schoolchild Study Group, Odense University Hospital, Denmark.
Respir Med. 1997 Sep;91(8):443-8. doi: 10.1016/s0954-6111(97)90108-6.
In the present population-based study, spirometric lung function was assessed in symptomatic schoolchildren with and without asthma as compared to an asymptomatic reference group. The primary aim was to investigate if impaired lung function could be demonstrated in symptomatic schoolchildren, even in the absence of diagnosed asthma. Spirometry [forced vital capacity (FVC), forced expiratory volume in 1 s (FEV1), 50% of forced expiratory flow (FEF 50%) and 75% of forced expiratory flow (FEF 75%)] and anthropometric measures (standing height, weight, skin fold thickness, and length and circumference of the upper arm) were obtained from 1369 8-10-year-old children (81.5% of the eligible population) during the school year 1985-86. In 1321 of those subjects (96.5% of those examined), a self-administered questionnaire was completed. Thirty-five children belonging to ethnic minorities were excluded, thus 1286 subjects were included for further analysis. Point prevalences concerning asthma and respiratory symptoms (wheeze, cough and shortness of breath) were obtained. Thirty-seven children reported asthma and one or more asthma-like symptoms (symptomatic asthmatics), whereas 40 children denied having asthma, although claiming one or more asthma-like symptoms (symptomatic non-asthmatics). In both symptomatic groups, FEF 50% and FEF 75% were reduced relative to the reference group, the deficit being larger in the symptomatic asthmatics. FEF 75% was found to be more reduced than FEF 50%. FEV1 and FVC did not differ significantly between groups. It is concluded that only half of the schoolchildren with respiratory symptoms usually associated with the presence of asthma actually reported having this disease. These results demonstrate the presence of reduced lung function in symptomatic, reportedly non-asthmatic, children, suggesting clinically important underdiagnosis of asthma. More severe impairment of lung function was found in known asthmatics, also implying some degree of undertreatment.
在这项基于人群的研究中，对有症状的学龄儿童（无论是否患有哮喘）以及无症状的参照组儿童进行了肺功能肺活量测定评估。主要目的是调查在有症状的学龄儿童中，即使没有确诊哮喘，是否也能证明存在肺功能受损。在1985 - 1986学年，从1369名8 - 10岁儿童（占符合条件人群的81.5%）中获取了肺活量测定数据[用力肺活量（FVC）、第1秒用力呼气容积（FEV1）、用力呼气流量的50%（FEF 50%）和用力呼气流量的75%（FEF 75%）]以及人体测量指标（身高、体重、皮褶厚度、上臂长度和周长）。在这些受试者中的1321名（占受检者的96.5%）完成了一份自我填写的问卷。35名属于少数民族的儿童被排除，因此1286名受试者被纳入进一步分析。获得了关于哮喘和呼吸道症状（喘息、咳嗽和呼吸急促）的点患病率。37名儿童报告患有哮喘以及一种或多种哮喘样症状（有症状的哮喘患者），而40名儿童否认患有哮喘，但声称有一 种或多种哮喘样症状（有症状的非哮喘患者）。在两个有症状的组中，相对于参照组，FEF 50%和FEF 75%均降低，有症状的哮喘患者中这种不足更大。发现FEF 75%比FEF 50%降低得更多。FEV1和FVC在各组之间无显著差异。得出的结论是，通常与哮喘存在相关的有呼吸道症状的学龄儿童中，实际上只有一半报告患有这种疾病。这些结果表明，在有症状、据报告无哮喘的儿童中存在肺功能降低，提示哮喘在临床上存在重要的诊断不足。在已知的哮喘患者中发现了更严重的肺功能损害，这也意味着存在一定程度的治疗不足。
