Is asymptomatic bronchial hyperresponsiveness an indication of potential asthma? A two-year follow-up of young students with bronchial hyperresponsiveness.
Is asymptomatic bronchial hyperresponsiveness an indication of potential asthma? A two-year follow-up of young students with bronchial hyperresponsiveness.
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DOI：
10.1378/chest.102.4.1104
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发表时间：
1992-10
期刊：
影响因子：
9.6
通讯作者：
N. Zhong;Rongchang Chen;Ming Yang;Zhen Ying Wu;Jin Ping Zheng;Yan Fen Li
中科院分区：
文献类型：
--
作者：
N. Zhong;Rongchang Chen;Ming Yang;Zhen Ying Wu;Jin Ping Zheng;Yan Fen Li
为了确定无症状支气管高反应性（BHR）发展为症状性哮喘的可能性，对在3，067例人群调查中发现患有BHR的81名学生（BHR组）进行了为期两年的随访研究。88名年龄相匹配的学生（48名男性，40名女性）正常支气管反应作为对照组。记录每日症状卡。症状发生时测定24 h呼气峰流速。在研究开始时以及第一年和第二年结束时进行组胺吸入试验。在BHR组中，58名学生在随访结束时仍有支气管高反应。31名初诊为支气管哮喘的学生中有9名症状完全缓解，但有10名无症状的学生发展为哮喘。BHR组新诊断哮喘的发生率（12.5%）和总确诊率（39.5%）均显著高于对照组（2.27%和2.27%）。FVC、FEV 1两组间差异无统计学意义。新诊断的哮喘患者的PD 20 FEV 1值在开始时（3.05 +/- 1.56 mumol vs 6.14 +/- 1.60 mumol，p < 0.05）或结束时（3.47 +/- 1.73 mumol vs 6.55 +/- 1.51 mumol，p < 0.05）均显著低于无症状学生。新诊断的哮喘患儿早期呼吸道疾病的发生率（80%）显著高于无症状组（22.3%），但过敏性指数和父母哮喘的发生率在两组间无差异。在9名哮喘患者中，在2年的随访中症状完全缓解，其中3名学生的PD 20 FEV 1在累积剂量为7.8 mumol的组胺范围内检测不到，其余6名学生的PD 20 FEV 1从4.58 +/- 1.85 mumol上升到7.62 +/- 1.02 mumol。BHR越高，学生患哮喘的可能性越大。大约45%的PD 20 ≤ 3.2 mumol的无症状学生在接下来的两年中发展为哮喘，其中80%有早期呼吸道疾病史，这表明他们可能患有亚临床或潜在的哮喘。
To determine the possibility that asymptomatic bronchial hyperresponsiveness (BHR) develops into symptomatic asthma, a two-year follow-up study was conducted in 81 students (48 male, 33 female; 11 to 17 years) who were found to have BHR in a 3,067 population survey (BHR group). Eighty-eight age-matched students (48 male, 40 female) with normal bronchial responsiveness served as control subjects. Daily symptom cards were recorded. Peak expiratory flow rate was measured for 24 h when symptoms occurred. Histamine inhalation tests were performed at the beginning of the study and at the end of the first and the second year. In the BHR group, 58 students remained bronchial hyperresponsive at the end of follow-up. Nine of 31 students with initially diagnosed bronchial asthma had their symptoms relieved entirely, but ten asymptomatic students developed asthma. The incidence of newly diagnosed asthma (12.5 percent in the BHR group or 20 percent in the asymptomatic BHR group) and the total percentage of diagnosed asthma (39.5 percent) in the BHR group were significantly higher than those (2.27 percent, 2.27 percent) in the control group. FVC and FEV1 showed no significant difference between two groups. PD20 FEV1 values in newly diagnosed asthmatics were significantly lower than those in asymptomatic students both at the beginning (3.05 +/- 1.56 mumol vs 6.14 +/- 1.60 mumol, p < 0.05) or the end (3.47 +/- 1.73 mumol vs 6.55 +/- 1.51 mumol, p < 0.05). The percentage of early respiratory illness was significantly higher in those with newly diagnosed asthma (80 percent) than in asymptomatic students (22.3 percent), but atopic index and the percentage of parental asthma showed no difference between two groups. In nine asthmatics whose symptoms were relieved entirely in the two-year follow-up, PD20 FEV1 was undetectable within the cumulative dose of 7.8 mumol of histamine in three students and rose from 4.58 +/- 1.85 mumol to 7.62 +/- 1.02 mumol in the remaining six. The higher the BHR, the more likely the students developed asthma. About 45 percent of asymptomatic students with PD20 < or = 3.2 mumol developed asthma in the following two years and 80 percent of them had a history of early respiratory illness, suggesting that they may have subclinical or potential asthma.