Cold air challenge at age 6 and subsequent incidence of asthma - A longitudinal study
Cold air challenge at age 6 and subsequent incidence of asthma - A longitudinal study
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DOI：
10.1164/ajrccm.156.6.9612066
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发表时间：
1997-12-01
影响因子：
24.7
通讯作者：
Martinez, FD
中科院分区：
文献类型：
--
作者：
Lombardi, E;Morgan, WJ;Martinez, FD
本研究的目的是评估6岁时支气管对干燥冷空气的高反应性与随后哮喘发病率之间的关系。在本研究纳入的360名6至11岁儿童中，新诊断哮喘的累积发病率为12.0%。生存分析显示，6岁时对冷空气的高反应性与随后发生哮喘的风险增加相关（风险比= 2.6,95% CI = 1.2-5.4; p = 0.01）。然而，在校正潜在混杂因素后，只有6岁时轻度喘息（校正风险比= 7.5,95% CI = 3.6-15.9; p < 0.001）和6岁时皮肤试验对过敏原的反应性（校正风险比= 3.6,95% CI = 1.5-8.5; p < 0.01），而对冷空气的高反应性（校正风险比= 0.9,95% CI = 0.4-2.2; p = 0.8）仍然是哮喘后续发展的重要预测因素。在对3岁前的喘息疾病进行分层后，这些发现得到了实质性的证实。我们得出结论，6岁时对冷空气的高反应性与随后哮喘诊断的发展有关，但这种影响并非独立于6岁时的特应性和轻度喘息。
The aim of this study was to assess the relation between bronchial hyperresponsiveness to dry, cold air at age 6 and the subsequent incidence of asthma. The cumulative incidence of newly diagnosed asthma between ages 6 and 11 among 360 children included in this study was 12.0%. Survival analysis showed that hyperresponsiveness to cold air at age 6 was associated with an increased risk of developing subsequent asthma (hazard ratio = 2.6, 95% CI = 1.2-5.4; p = 0.01). However, after adjusting for potential confounders, only mild wheezing at age 6 (adjusted hazard ratio = 7.5, 95% CI = 3.6-15.9; p < 0.001) and skin test reactivity to allergens at age 6 (adjusted hazard ratio = 3.6, 95% CI = 1.5-8.5; p < 0.01), but not hyperresponsiveness to cold air (adjusted hazard ratio = 0.9, 95% CI = 0.4-2.2; p = 0.8), remained significant predictors of subsequent development of asthma. These findings were substantially confirmed after stratifying for wheezing illnesses before age 3. We conclude that hyperresponsiveness to cold air at age 6 was associated with subsequent development of a diagnosis of asthma but this effect was not independent of atopy and mild wheezing at age 6.