哮喘联盟

   摘要
   对于幼儿期呼吸道感染在儿童哮喘以及其他过敏性疾病发病中所扮演的角色,既往的研究提供的证据存在矛盾。我们通过一项长达20年的前瞻性队列研究(Espoo 队列研究, 1991-2011)发现早期呼吸道感染是哮喘发病的预测因素。我们通过由父母完成的基线调查问卷来收集患儿之前12个月上呼吸道感染(URTIs)和下呼吸道感染(LRTIs)的信息(第一部分; n = 2,228)，而因下呼吸道感染导致住院的信息则从国立医院出院登记处获得(第二部分; n = 2,568)。研究基于6年和20年的随访问卷来对哮喘的发病率进行评估。校正的风险比使用Cox 比例风险模型进行估算。幼儿期URTIs(校正风险比(HR) = 1.64, 95%置信区间 (CI): 1.22, 2.19)和LRTIs(校正 HR = 2.11, 95% CI: 1.48, 3.00)均是接近青年期(20-27岁)时哮喘发病率的强烈预测因素。而URTIs (P < 0.01) 和 LRTIs (P < 0.001)均显示出下降的年龄趋势。在分析的第二部分，我们发现因LRTIs需要入院治疗的患者存在显著的哮喘风险(校正HR = 1.93, 95% CI: 1.10, 3.38).这个研究结果为早期呼吸道感染预示着儿童到青年时期患哮喘的说法提供了新的证据。

（杨冬 审校）
Am J Epidemiol. 2015 Sep 10. pii: kwv093. [Epub ahead of print]

 

Early Respiratory Infections and the Development of Asthma in the First 27 Years of Life.
 

Rantala AK, Jaakkola MS, Mäkikyrö EM, Hugg TT, Jaakkola JJ.
 

Abstract
Previous studies have provided contradictory evidence on the role of early childhood respiratory infections in the development of asthma and other allergic diseases during childhood. We investigated early-life respiratory infections as predictors of the development of asthma in a 20-year prospective cohort study (the Espoo Cohort Study, 1991-2011). Information on upper respiratory tract infections (URTIs) and lower respiratory tract infections (LRTIs) was collected with a parent-administered baseline questionnaire covering the preceding 12 months (part 1; n = 2,228), and information on LRTIs leading to hospitalization was obtained from the National Hospital Discharge Registry (part 2; n = 2,568). The incidence of asthma was assessed on the basis of 6-year and 20-year follow-up questionnaires. Adjusted hazard ratios were estimated using Cox proportional hazards models. Both URTIs (adjusted hazard ratio (HR) = 1.64, 95% confidence interval (CI): 1.22, 2.19) and LRTIs (adjusted HR = 2.11, 95% CI: 1.48, 3.00) in early childhood were strong predictors of asthma incidence up to young adulthood (ages 20-27 years). A declining age trend was present for both URTIs (P-trend < 0.01) and LRTIs (P-trend < 0.001). In part 2 of our analysis, a significant risk of asthma was found in relation to LRTIs requiring hospitalization (adjusted HR = 1.93, 95% CI: 1.10, 3.38). The results provide new evidence that respiratory tract infections in early life predict the development of asthma through childhood to young adulthood.
 

Am J Epidemiol. 2015 Sep 10. pii: kwv093. [Epub ahead of print]