The association between childhood asthma and adult chronic obstructive pulmonary disease
The association between childhood asthma and adult chronic obstructive pulmonary disease
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DOI：
10.1136/thoraxjnl-2013-204815
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发表时间：
2014-09-01
期刊：
影响因子：
10
通讯作者：
Robertson, Colin F.
中科院分区：
文献类型：
--
作者：
Tai, Andrew;Tran, Haily;Robertson, Colin F.
有流行病学证据表明，儿童期的事件影响肺生长，并构成成人COPD的重大风险。该研究的目的是评估儿童哮喘和成人COPD.Methods之间的关联，这种纵向的，前瞻性的研究6-7岁的儿童哮喘已定期审查，每7年到目前的分析在50岁。参与者完成了呼吸问卷调查和肺功能肺活量测定，并有支气管扩张剂后反应。在50岁时，将受试者分为以下亚组：无哮喘、哮喘缓解、当前哮喘和COPD，COPD定义为使用支气管扩张剂后FEV 1/FVC比值小于0.7。结果在剩余的存活者中，346例参与了本研究（参与率为76%），其中197例完成了问卷调查和肺功能检查。与7岁以下无喘息症状的儿童相比，（非哮喘）重度哮喘儿童发生COPD的调整后风险高32倍（95%CI 3.4 - 269）。在这个队列中，43%的COPD组从未吸烟。COPD组（17，10 ~ 23）与非哮喘组（16，12 ~ 21）、哮喘缓解组（20，16 ~ 24）和哮喘组（19，13 ~ 25）之间FEV 1（mL/year，95 th CI）下降率无明显差异。
Introduction There is epidemiological evidence to suggest that events in childhood influence lung growth and constitute a significant risk for adult COPD. The aim of the study is to evaluate for an association between childhood asthma and adult COPD.Methods This longitudinal, prospective study of 6-7-year- old children with asthma has been regularly reviewed every 7 years to the current analysis at 50 years of age. Participants completed respiratory questionnaires and lung function spirometry with postbronchodilator response. At the age of 50, subjects were classified to the following subgroups: non-asthmatics, asthma remission, current asthma and COPD which was defined by FEV1 to FVC ratio postbronchodilator of less than 0.7.Results Of the remaining survivors, 346 participated in the current study (participation rate of 76%) of whom 197 completed both questionnaire and lung function testing. As compared with children without symptoms of wheeze to the age of 7, (non-asthmatics) children with severe asthma had an adjusted 32 times higher risk for developing COPD (95% CI 3.4 to 269). In this cohort, 43% of the COPD group had never smoked. There was no evidence of a difference in the rate of decline in FEV1 (mL/year, 95th CI) between the COPD group (17, 10 to 23) and the other groups: non-asthmatics (16, 12 to 21), asthma remission (20, 16 to 24) and current asthma (19, 13 to 25).Conclusions Children with severe asthma are at increased risk of developing COPD.