A clinical index to define risk of asthma in young children with recurrent wheezing
A clinical index to define risk of asthma in young children with recurrent wheezing
复制标题
DOI：
10.1164/ajrccm.162.4.9912111
复制
发表时间：
2000-10-01
影响因子：
24.7
通讯作者：
Martinez, FD
中科院分区：
文献类型：
--
作者：
Castro-Rodríguez, JA;Holberg, CJ;Martinez, FD
由于大多数哮喘病例开始于生命的最初几年，因此识别处于发展疾病高风险的幼儿是一个重要的公共卫生优先事项。我们使用图森儿童呼吸研究的数据，开发了两个预测哮喘的指数。一个严格的指标包括在生命的前3年频繁的喘息和一个主要的危险因素（父母哮喘或湿疹史）或三个次要危险因素（嗜酸性粒细胞增多症，喘息无感冒，过敏性鼻炎）中的两个。一个宽松的指数要求在生命的前3年内有任何喘息，加上前面描述的相同的风险因素组合。宽松指数阳性的儿童在6至13岁之间患活动性哮喘的可能性是宽松指数阴性儿童的2.6至5.5倍。当使用严格的指数时，随后发生哮喘的风险增加到4.3至9.8倍。我们发现，59%的儿童与积极宽松的指数和76%的积极严格的指数有活动性哮喘在至少一个调查在学年。超过95%的严格指数为负的儿童在6至13岁之间从未患过活动性哮喘。我们的结论是，随后的发展哮喘可以预测合理的准确性，使用简单的，临床为基础的参数。
Because most cases of asthma begin during the first years of life, identification of young children at high risk of developing the disease is an important public health priority. We used data from the Tucson Children's Respiratory Study to develop two indices for the prediction of asthma. A stringent index included frequent wheezing during the first 3 yr of life and either one major risk factor (parental history of asthma or eczema) or two of three minor risk factors (eosinophilia, wheezing without colds, and allergic rhinitis). A loose index required any wheezing during the first 3 yr of life plus the same combination of risk factors described previously. Children with a positive loose index were 2.6 to 5.5 times more likely to have active asthma between ages 6 and 13 than children with a negative loose index. Risk of having subsequent asthma increased to 4.3 to 9.8 times when a stringent index was used. We found that 59% of children with a positive loose index and 76% of those with a positive stringent index had active asthma in at least one survey during the school years. Over 95% of children with a negative stringent index never had active asthma between ages 6 and 13. We conclude that the subsequent development of asthma can be predicted with reasonable accuracy using simple, clinically based parameters.