Outcome measures in childhood asthma.
Outcome measures in childhood asthma.
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儿童哮喘的结果测量。
DOI：
10.1542/peds.109.se1.393
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发表时间：
2002
期刊：
影响因子：
8
通讯作者：
David Skoner
中科院分区：
文献类型：
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作者：
David Skoner
虽然有证据表明哮喘发作发生在儿童早期，但许多标准的哮喘结局指标在学龄前儿童中要么不切实际，要么不可靠。例如，在这一人群中，患者病史和症状报告依赖于照顾者的观察，他们倾向于少报孩子的哮喘症状。此外，使用肺功能的常规措施，如肺活量测定法，可能是不切实际的非常年幼的儿童。最近的临床研究已经使用了各种技术来测量症状、肺功能和炎症的细胞介质。结果如停药率和急性发作率、日间和夜间症状的频率以及护理人员对生活质量的评估可以作为评估幼儿哮喘结局的有用指标。一些措施，如体积描记法和炎症标志物分析，可能是合适的选择，评估肺功能和预测哮喘易感性的学龄前儿童。事实上，炎症标志物水平的改变，包括免疫球蛋白E，白细胞介素-10，和呼出的一氧化氮，可能是诊断哮喘，评估干预措施，并评估未来的风险，在非常年幼的儿童哮喘复发的有用工具。尽管早期的研究结果令人鼓舞，但这些结果指标中的一个或多个是否在临床上被证明对改善儿童哮喘的诊断和管理有用仍不确定。
Although evidence suggests that asthma onset occurs early in childhood, many standard asthma outcome measures are either impractical or unreliable in preschool-aged children. In this population, for instance, patient history and symptom reports rely on the observations of caregivers, who tend to underreport their child's asthma symptoms. Furthermore, the use of conventional measures of pulmonary function such as spirometry may be impractical in very young children. Recent clinical studies have used a variety of techniques to measure symptoms, pulmonary function, and cellular mediators of inflammation. Outcomes such as discontinuation and exacerbation rates, frequency of daytime and nocturnal symptoms, and caregiver assessments of quality of life can be useful measures in evaluating outcomes in young children with asthma. Some measures, such as plethysmography and inflammatory marker analysis, may be suitable options for assessing pulmonary function and predicting asthma susceptibility in preschool-aged children. Indeed, altered levels of inflammatory markers, including immunoglobulin E, interleukin-10, and exhaled nitric oxide, may be useful tools in diagnosing asthma, evaluating interventions, and assessing future risks for asthma symptomatology in very young children. Whether 1 or more of these outcome measures will prove useful clinically in improving the diagnosis and management of childhood asthma remains uncertain, although early research results are encouraging.