哮喘联盟

   摘要
   哮喘的发病年龄通常被用于区分成人哮喘的不同表型；然而，迄今为止还没有对成人哮喘早发和迟发间异同点的概述。在2921例记录中发现，12例研究对成人现患哮喘的早发和迟发进行了比较。12岁通常用来描述两个早发年龄的表型。早发现患哮喘成人多为特应性哮喘，且有着更高的哮喘发作频率，而晚发哮喘的成人常为女性、吸烟者，且具有由呼吸量测定法测定的较高水平气流阻塞。两组重度哮喘的患病率相似，并且无论发病年龄如何，重度哮喘患者间几乎无表型差异。包括肺功能在内的几个关键特征在研究间是矛盾的。总之，哮喘发病年龄间存在独特的表型差异。虽然早发成人哮喘可能更多的归因于特异性和潜在的遗传因素，但晚发成人哮喘似乎与环境危险因素更相关，因此预防策略才有更好的针对性。为了更好的描述这些表型的特点以及阐明潜在的临床意义，还需要更详尽的研究。
 

（林江涛 审校）
Expert Rev Respir Med. 2015 Feb;9(1):109-23. doi: 10.1586/17476348.2015.1000311.


 

Age-of-asthma onset as a determinant of different asthma phenotypes in adults: a systematic review and meta-analysis of the literature.
 

Tan DJ1, Walters EH, Perret JL, Lodge CJ, Lowe AJ, Matheson MC, Dharmage SC.
 

Abstract
Age-of-asthma onset is often used to distinguish different adult asthma phenotypes; however, similarities and differences between early- and late-onset adult asthma have not been summarized to date. Of the 2921 records found, we identified 12 studies comparing early- and late-onset current asthma in adults. Age 12 was most commonly used to delineate the two age-of-onset phenotypes. Adults with early-onset current asthma were more likely to be atopic and had a higher frequency of asthma attacks, whereas adults with late-onset disease were more likely to be female, smokers and had greater levels of spirometrically defined fixed airflow obstruction. The prevalence of severe asthma was similar in both groups, and, in general, there were few phenotypic differences between severe asthmatics regardless of age of onset. Findings for several key characteristics, including lung function, were inconsistent between studies. Overall, there appears to be distinctive phenotypic differences with age of asthma onset. Although early-onset adult asthma is likely more attributable to atopy and potentially genetic factors, late-onset adult asthma appears to be more related to environmental risk factors, and so may be better targeted by preventive strategies. More detailed research is required to better characterize these phenotypes and to clarify potential clinical implications.
 

Expert Rev Respir Med. 2015 Feb;9(1):109-23. doi: 10.1586/17476348.2015.1000311.