成人儿童期重度哮喘的特点——60年随访研究
2024/07/30
摘要
背景：儿童哮喘是一种普遍存在的疾病，对成人生活有潜在影响。
研究问题：在一项对有重度儿童哮喘病史的成年人进行的60年随访研究中，患有持续性哮喘的个体与成年后哮喘缓解的个体在特征上的潜在差异是什么？
研究设计和方法：包括有儿童哮喘病史并在挪威孔斯伯格哮喘护理机构住院4个月（1950-1979年）的丹麦成年人。通过社交媒体和个人邀请函进行招募。参与者完成了问卷调查，并接受了肺活量测定、支气管激发、支气管扩张剂可逆实验和血液测试。哮喘缓解被定义为在过去12个月内不使用哮喘药物且没有哮喘症状，其余参与者被归类为当前哮喘。
结果：在1394名符合条件的参与者中，232人完成了随访。90%的患者目前患有哮喘，其中26%的患者在过去一年中病情加重。只有16%的参与者接受了二级护理。常见的合并症有过敏性鼻炎（60%）、高血压（21%）、湿疹（16%）和白内障（8%）。与病情缓解的参与者相比，患有持续性哮喘的参与者的总免疫球蛋白E较高（p=0.03），FEV1%pred较低（p=0.03）和FEV1/FVC比率较低（p<0.001），呼出一氧化氮和血液嗜酸性粒细胞计数在数值上较高。
解释：我们对有重度儿童哮喘病史的成年人进行了60年的随访研究，结果显示，十分之九的人目前仍患有哮喘。与哮喘缓解期相比，持续性哮喘与肺功能较低和2型炎症生物标志物水平较高有关。
Characteristics of adults with severe asthma in childhood - A 60-year Follow-up Study
Osman Savran, Klaus Bønnelykke, Charlotte Suppli Ulrik
Abstract
Background: Childhood asthma is a prevalent condition with potential impact on adult life.
Research question: In a 60-year follow-up study of adults with a history of severe childhood asthma, what are the potential differences in characteristics between individuals with persistent asthma and asthma remission in adulthood?
Study design and methods: Danish adults with a history of childhood asthma and a 4-month stay in at an asthma care facility in Kongsberg, Norway (1950-1979) in childhood were included. Recruitment was done through social media and personal invitation letters. Participants completed questionnaires and underwent spirometry, bronchial provocation, and bronchodilator reversibility and blood tests. Asthma remission was defined as no use of asthma medication and no asthma symptoms within the past 12 months with the remaining participants being classified as having current asthma.
Results: Among 1394 eligible participants, 232 completed the follow-up. Ninety percent had current asthma, of whom 26% reported exacerbations in the past year. Only 16% of all the participants were managed in secondary care. Common comorbidities were allergic rhinitis (60%), hypertension (21%), eczema (16%), and cataract (8%). Compared to participants in remission, participants with persistent asthma had higher total immunoglobulin E (p=0.03), and both lower FEV1%pred (p=0.03), and FEV1/FVC ratio (p<0.001), as well as numerically higher fractional exhaled nitric oxide and blood eosinophil count.
Interpretation: Our 60-year follow-up study of adults with a history of severe childhood asthma revealed that nine out of ten still had current asthma. Persistent asthma was associated with lower lung function and higher levels of type 2 inflammatory biomarkers compared to those with asthma remission.
背景：儿童哮喘是一种普遍存在的疾病，对成人生活有潜在影响。
研究问题：在一项对有重度儿童哮喘病史的成年人进行的60年随访研究中，患有持续性哮喘的个体与成年后哮喘缓解的个体在特征上的潜在差异是什么？
研究设计和方法：包括有儿童哮喘病史并在挪威孔斯伯格哮喘护理机构住院4个月（1950-1979年）的丹麦成年人。通过社交媒体和个人邀请函进行招募。参与者完成了问卷调查，并接受了肺活量测定、支气管激发、支气管扩张剂可逆实验和血液测试。哮喘缓解被定义为在过去12个月内不使用哮喘药物且没有哮喘症状，其余参与者被归类为当前哮喘。
结果：在1394名符合条件的参与者中，232人完成了随访。90%的患者目前患有哮喘，其中26%的患者在过去一年中病情加重。只有16%的参与者接受了二级护理。常见的合并症有过敏性鼻炎（60%）、高血压（21%）、湿疹（16%）和白内障（8%）。与病情缓解的参与者相比，患有持续性哮喘的参与者的总免疫球蛋白E较高（p=0.03），FEV1%pred较低（p=0.03）和FEV1/FVC比率较低（p<0.001），呼出一氧化氮和血液嗜酸性粒细胞计数在数值上较高。
解释：我们对有重度儿童哮喘病史的成年人进行了60年的随访研究，结果显示，十分之九的人目前仍患有哮喘。与哮喘缓解期相比，持续性哮喘与肺功能较低和2型炎症生物标志物水平较高有关。
(中日友好医院呼吸与危重症医学科 李红雯 摘译 林江涛 审校)
(Chest. 2024 Jun 28:S0012-3692(24)00806-7. doi: 10.1016/j.chest.2024.06.005.)
(Chest. 2024 Jun 28:S0012-3692(24)00806-7. doi: 10.1016/j.chest.2024.06.005.)
Characteristics of adults with severe asthma in childhood - A 60-year Follow-up Study
Osman Savran, Klaus Bønnelykke, Charlotte Suppli Ulrik
Abstract
Background: Childhood asthma is a prevalent condition with potential impact on adult life.
Research question: In a 60-year follow-up study of adults with a history of severe childhood asthma, what are the potential differences in characteristics between individuals with persistent asthma and asthma remission in adulthood?
Study design and methods: Danish adults with a history of childhood asthma and a 4-month stay in at an asthma care facility in Kongsberg, Norway (1950-1979) in childhood were included. Recruitment was done through social media and personal invitation letters. Participants completed questionnaires and underwent spirometry, bronchial provocation, and bronchodilator reversibility and blood tests. Asthma remission was defined as no use of asthma medication and no asthma symptoms within the past 12 months with the remaining participants being classified as having current asthma.
Results: Among 1394 eligible participants, 232 completed the follow-up. Ninety percent had current asthma, of whom 26% reported exacerbations in the past year. Only 16% of all the participants were managed in secondary care. Common comorbidities were allergic rhinitis (60%), hypertension (21%), eczema (16%), and cataract (8%). Compared to participants in remission, participants with persistent asthma had higher total immunoglobulin E (p=0.03), and both lower FEV1%pred (p=0.03), and FEV1/FVC ratio (p<0.001), as well as numerically higher fractional exhaled nitric oxide and blood eosinophil count.
Interpretation: Our 60-year follow-up study of adults with a history of severe childhood asthma revealed that nine out of ten still had current asthma. Persistent asthma was associated with lower lung function and higher levels of type 2 inflammatory biomarkers compared to those with asthma remission.
