Is bronchodilator response in 2-yr-old children associated with asthma risk factors?
Is bronchodilator response in 2-yr-old children associated with asthma risk factors?
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DOI：
10.1111/j.1399-3038.2004.00147.x
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发表时间：
2004-08-01
影响因子：
4.4
通讯作者：
Carlsen, KH
中科院分区：
文献类型：
--
作者：
Carlsen, KCL;Pettersen, M;Carlsen, KH
可能影响2岁时肺功能支气管扩张剂反应的因素在很大程度上是未知的，因此我们旨在奥斯陆的“环境与儿童哮喘”（ECA）研究中对此进行评估。一项平均年龄为26个月的临床研究中，516名（84%）儿童参加了巢式病例对照研究[复发性支气管阻塞（rBO）儿童]（n = 265）和对照组，无下呼吸道疾病史（n = 251）。在46%的患者中获得了吸入雾化沙丁胺醇（支气管扩张剂反应）（临床上无BO时）前后的潮气肺功能测量结果。通过结构化访谈和临床检查确定过敏性/呼吸道疾病（哮喘危险因素）的临床特征和个人及家族史。通过皮肤点刺试验/常见过敏原特异性IgE抗体分析评估过敏性致敏性。沙丁胺醇治疗前后达到峰值流量时间/总呼气时间（t（PTEF）/t（E））的平均（95% CI）百分比变化在rBO儿童中显著大于对照组[17.3（9.4-25.3）][-2.2（-7.7至3.0）]。随着哮喘危险因素的增加，支气管扩张剂反应显著增加（p = 0.001），但与过敏性致敏、父母过敏性反应或母亲单独吸烟无关。吸入皮质类固醇治疗的儿童比单独使用支气管扩张剂治疗的儿童有更大的支气管扩张反应。无症状的2岁儿童的支气管扩张反应与rBO的存在最密切相关，但哮喘危险因素数量的增加和吸入性皮质类固醇治疗与支气管扩张反应增加相关。
Factors that might influence lung function bronchodilator response by 2 yr of age is largely unknown, thus we aimed to assess this in the 'Environment and Childhood asthma' (ECA) study in Oslo. A clinical investigation at mean age 26 months was attended by 516 (84%) children included in a nested case-control study [children with recurrent bronchial obstruction (rBO)] (n = 265) and controls without a history of lower respiratory disease (n = 251). Tidal lung function measures before and after inhaled nebulized salbutamol (bronchodilator response) (when clinically without BO) were obtained in 46%. Clinical characteristics and personal and family history of allergic/respiratory diseases (asthma risk factors) were ascertained by structured interview and clinical examination. Allergic sensitization was assessed by skin prick test/specific IgE antibody analyses to common allergens. Mean (95% CI) per cent change in time to reach peak flow/total expiratory time (t(PTEF)/t(E)) from before to after salbutamol was significantly larger in children with rBO [17.3 (9.4-25.3) than controls (-2.2 (-7.7 to 3.0)]. The bronchodilator response increased significantly (p = 0.001) with increasing number of asthma risk factors, but was not significantly associated with allergic sensitization, parental 'atopy', or maternal smoking alone. Children treated with inhaled corticosteroids had greater bronchodilator response than those treated with bronchodilators alone. Bronchodilator response in asymptomatic 2-yr-old children was most closely associated with the presence of rBO, but increasing number of asthma risk factors and treatment with inhaled corticosteroids were associated with increased bronchodilator response.