Lung function and clinical risk factors for asthma in infants and young children with recurrent wheeze
Lung function and clinical risk factors for asthma in infants and young children with recurrent wheeze
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DOI：
10.1136/thx.2008.099903
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发表时间：
2009-03-01
期刊：
影响因子：
10
通讯作者：
Hoo, F.
中科院分区：
文献类型：
--
作者：
Borrego, L. M.;Stocks, J.;Hoo, F.
背景资料：尽管在反复喘息的婴幼儿中已经确定了几个哮喘的危险因素，但评估肺功能在这一人群中的相关性仍不清楚。在有或没有发展为随后哮喘的临床危险因素的情况下，反复喘息儿童在最初2年内肺功能是否降低本研究评估了与健康对照组相比（即父母哮喘、个人过敏性鼻炎史、无感冒的喘息和/或嗜酸性粒细胞水平>4%）的情况。方法：使用潮气量和提高容量的快速胸腹按压动作测量了8-20个月的未使用过类固醇且有≥ 3次经医生证实的喘息发作的幼儿和健康对照组的用力呼气流量和容量。在50例喘息儿童和30例对照组中，采用潮气快速胸腹按压获得了技术上可接受的结果，在44例喘息儿童和29例对照组中，采用提高容量技术获得了技术上可接受的结果。校正性别、年龄、测试时的身长和母亲吸烟后，0.5秒用力呼气量的z评分显著降低，（平均差异（95% CI）-1.0（-1.5至-0.5）），呼出75%用力肺活量（FVC）后的用力呼气流量（FEF 25）与对照组相比，在反复喘息患者中观察到平均用力呼气流量（-0.6（-1.0至-0.2））和用力呼气流量超过FVC的中间50%（FEF 25 -75）（-0.8（-1.2至-0.4））。有哮喘危险因素的喘息儿童（n= 15）FVC的z评分显著降低（-0.7（-1.4至-0.04））和FEF 25 -75（20.6（-1.2 ~-0.1））。结论：与健康对照组相比，反复喘息的幼儿气道功能降低，特别是那些有继发哮喘风险的幼儿。这些发现为临床风险因素与生命早期呼吸功能受损之间的关联提供了进一步的证据。
Background: Although several risk factors for asthma have been identified in infants and young children with recurrent wheeze, the relevance of assessing lung function in this group remains unclear. Whether lung function is reduced during the first 2 years in recurrently wheezy children, with and without clinical risk factors for developing subsequent asthma (ie, parental asthma, personal history of allergic rhinitis, wheezing without colds and/or eosinophil level >4%) compared with healthy controls was assessed in this study.Methods: Forced expiratory flows and volumes in steroid naive young children with >= 3 episodes of physician confirmed wheeze and healthy controls, aged 8-20 months, were measured using the tidal and raised volume rapid thoracoabdominal compression manoeuvres.Results: Technically acceptable results were obtained in 50 wheezy children and 30 controls using tidal rapid thoracoabdominal compression, and 44 wheezy children and 29 controls with the raised volume technique. After adjustment for sex, age, body length at test and maternal smoking, significant reductions in z scores for forced expiratory volume at 0.5 s (mean difference (95% CI) -1.0 (-1.5 to -0.5)), forced expired flow after 75% forced vital capacity (FVC) has been exhaled (FEF25) (-0.6 (-1.0 to -0.2)) and average forced expired flow over the mid 50% of FVC (FEF25-75) (-0.8 (-1.2 to -0.4)) were observed in those with recurrent wheeze compared with controls. Wheezy children with risk factors for asthma (n= 15) had significantly lower z scores for FVC (-0.7 (-1.4 to -0.04)) and FEF25-75 (20.6 (-1.2 to -0.1)) than those without such risk factors (n= 29).Conclusions: Compared with healthy controls, airway function is reduced in young children with recurrent wheeze, particularly those at risk for subsequent asthma. These findings provide further evidence for associations between clinical risk factors and impaired respiratory function in early life.