Peak flow variability, methacholine responsiveness and atopy as markers for detecting different wheezing phenotypes in childhood
Peak flow variability, methacholine responsiveness and atopy as markers for detecting different wheezing phenotypes in childhood
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DOI：
10.1136/thx.52.11.946
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发表时间：
1997-11-01
期刊：
影响因子：
10
通讯作者：
Martinez, FD
中科院分区：
文献类型：
--
作者：
Stein, RT;Holberg, CJ;Martinez, FD
背景-越来越多的证据表明，儿童期喘息可能是一种异质性疾病，不同形式的喘息可能与不同的危险因素和预后有关。本研究的目的是确定气道不稳定性和特应性的测量是否可以识别不同的喘息表型在childhood.Methods -在一个队列的儿童出生后的峰值流量变异性（n = 600）进行了评估和乙酰甲胆碱激发反应性（n = 397）在11岁时测量与三岁之前的喘息，在6岁和11岁时测定总血清IgE和皮肤试验对过敏原的反应性。结果：11岁时测得的阳性峰值变异性和乙酰甲胆碱高反应性均与仅在生命的前三年发生的喘息有关。乙酰甲胆碱高反应性和阳性峰值变异性与6岁和11岁时的喘息相关（OR分别为5.1（95%CI 2.4至10.6）和2.3（1.2至4.5））。此外，在非特应性儿童中，阳性峰值变异性与6岁以下的喘息相关，但与11岁时的喘息无关（OR 2.9（95%CI 1.0至8.8））。11岁时测得的乙酰甲胆碱高反应性在男孩中更常见（OR 2.1（95%CI 1.2 - 3.5）），并与6岁和11岁时测得的血清IgE水平密切相关（p
Background - There is increasing evidence that wheezing during childhood may be a heterogeneous condition, and that different forms of wheezing may be associated with different risk factors and prognosis. The aim of this study was to determine if measures of airway lability and of atopy could identify distinct wheezing phenotypes during childhood.Methods - In a cohort of children followed from birth peak flow variability (n = 600) was evaluated and methacholine challenge responsiveness (n = 397) was measured at age 11 in relation to wheezing before the age of three, and at age six and 11 years total serum IgE and skin test reactivity to allergens were determined.Results - Neither positive peak how variability nor methacholine hyperresponsiveness measured at age 11 were associated with wheezing occurring only during the first three years of life. Both methacholine hyperresponsiveness and positive peak how variability were associated with wheezing at both ages six and 11 (OR 5.1 (95% CI 2.4 to 10.6) and 2.3 (1.2 to 4.5), respectively). In addition, positive peak how variability was associated with wheezing up to the age of six but not at age 11 in non-atopic children (OR 2.9 (95% CI 1.0 to 8.8)). Methacholine hyperresponsiveness measured at age 11 was more frequently observed in boys (OR 2.1 (95% CI 1.2 to 3.5)) and was strongly associated with serum IgE levels measured at ages six and 11 (p