Effect of pneumonia and whooping cough in childhood on adult lung function
Effect of pneumonia and whooping cough in childhood on adult lung function
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DOI：
10.1056/nejm199802263380904
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发表时间：
1998-02-26
影响因子：
158.5
通讯作者：
Anderson, HR
中科院分区：
文献类型：
--
作者：
Johnston, IDA;Strachan, DP;Anderson, HR
背景先前的研究表明，儿童时期的呼吸道感染与成年后的呼吸道疾病相关，但由于对儿童感染的回顾性确定、选择偏差和混杂因素，这种联系尚不清楚。方法我们对1392名英国成年人从1958年出生开始的儿童肺炎和百日咳的影响进行了研究。其中，193人在7岁之前有肺炎史，215人有百日咳史。在受试者34岁和35岁时，分别测定吸入沙丁胺醇前后的1秒用力呼气量（FEV1）和用力肺活量（FVC）。结果肺炎史与FEV1 （102+/-73 ml， P=0.006）和FVC （173+/-70 ml， P=0.001）的缺陷（+/- 95%置信限）相关，当分析调整性别、身高和吸烟时，FEV1 / FVC的比值没有变化。这些缺陷在吸入沙丁胺醇后持续存在。无喘息史受试者FEV1赤字为155+/-122 ml (P=0.01)，既往有喘息者FEV1赤字为41+/-128 ml (P=0.53)，当前有喘息者FEV1赤字为119+/-133 ml （P=0.08）。两岁以下肺炎患者的效果并不比两岁至七岁之间肺炎患者的效果更大，在多种混杂因素的控制下，效果也没有减弱。与百日咳相关的缺陷较小（FEV1, 41+/-70 ml， P=0.25； FVC, 81+/-76 ml， P=0.04）。结论儿童肺炎与成人通气功能降低相关。这种减少与喘息病史无关，也不能用其他混杂因素来解释。(C) 1998年，马萨诸塞州医学协会。
Background Previous studies have suggested that respiratory infection during childhood is associated with respiratory disease in adulthood, but the link is unclear because of retrospective ascertainment of childhood infection, selection bias, and confounding factors.Methods We studied the effects of childhood pneumonia and whooping cough in 1392 British adults followed from their births in 1958. Of these, 193 had a history of pneumonia and 215 a history of whooping cough by the age of seven years. When the subjects were 34 or 35 years old, their forced expiratory volume in one second (FEV1) and forced vital capacity (FVC) were measured before and after they inhaled albuterol.Results A history of pneumonia was associated with deficits (+/-95 percent confidence limits) in both FEV1 (102+/-73 ml, P=0.006) and FVC (173+/-70 ml, P=0.001) when the analysis was adjusted for sex, height, and smoking, with no change in the ratio of FEV1 to FVC. These deficits persisted after inhalation of albuterol. In subjects with no history of wheezing, the deficit in FEV1 was 155+/-122 ml (P=0.01), in those with past wheezing it was 41+/-128 ml (P=0.53), and in those with current wheezing it was 119+/-133 ml (P=0.08). The effect was no greater for the subjects who had pneumonia at less than two years of age than for those who had it between the ages of two and seven years and was not diminished after control for multiple confounding factors. The deficits associated with whooping cough were smaller (FEV1, 41+/-70 ml; P=0.25; FVC, 81+/-76 ml; P=0.04).Conclusions Childhood pneumonia is associated with reduced ventilatory function in adults. This reduction is independent of a history of wheezing and is not explained by other confounding factors. (C) 1998, Massachusetts Medical Society.