学前儿童喘鸣的远期预后： 纵向邮寄问卷研究1993～2004.
2009/05/18
为了了解家长报告的儿童喘鸣的预后及其重要的预测因素，对一组学前儿童进行了6～11年的随访。在1993～2004年间向英国曼彻斯特南部2个全科医疗人群邮寄了5次国际儿童哮喘和变态反应研究调查问卷，628名5岁以下儿童接受了至少6年的随访，由家长填写有关呼吸道症状和相关特征的调查问卷。其中在第1次调查时（基线）家长报告有喘鸣的儿童为201名（32%），其中27%在第2次调查时症状仍然存在（持续性哮喘）。基线时可预测持续性哮喘的重要因素为活动导致的喘鸣(OR3.94, 95%CI1.72-9.00)及变应性疾病史(4.44, 1.94-10.13)。如果两个因素并存，发展为哮喘的可能性为53.2%，如果仅有一个因素存在，这一可能性就降到17.2%，如果没有这两个因素，可能性就只有10.9%。哮喘家族史并不能预测有喘鸣的学前儿童是否会发展成持续性哮喘。
因此应用两个简单的预测因素（基线时家长报告的活动后喘鸣及变应性疾病史）就可以预测有喘鸣的学龄前儿童将来发展为哮喘的可能性。
（马艳良 北京大学人民医院呼吸科 100044 摘译）
（BMJ. 2008 Jun 21;336(7658):1423-1426）
Long term prognosis in preschool children with wheeze: longitudinal postal questionnaire study 1993-2004.
BMJ. 2008 Jun 21;336(7658):1423-6.
Frank PI, Morris JA, Hazell ML, Linehan MF, Frank TL.
OBJECTIVES: To follow a population of preschool children with and without parent reported wheeze over a period of 6-11 years to determine prognosis and its important predictive factors.
DESIGN: Longitudinal series of five postal surveys based on the international study of asthma and allergies in childhood questionnaire carried out between 1993 and 2004.
SETTING: Two general practice populations, south Manchester.
PARTICIPANTS: 628 children aged less than 5 years at recruitment and those with at least six years’ follow-up data.
MAIN OUTCOME MEASURES: Parent completed questionnaire data for respiratory symptoms and associated features.
RESULTS: Of 628 children included in the study, 201 (32%) had parent reported wheeze at the first observation (baseline), of whom 27% also reported the symptom on the second occasion (persistent asthma). The only important baseline predictors of persistent asthma were exercise induced wheeze (odds ratio 3.94, 95% confidence interval 1.72 to 9.00) and a history of atopic disorders (4.44, 1.94 to 10.13). The presence of both predictors indicated a likelihood of 53.2% of developing asthma; if only one feature was present this decreased to 17.2%, whereas if neither was present the likelihood was 10.9%. Family history of asthma was not predictive of persistent asthma among children with preschool wheeze.
CONCLUSION: Using two simple predictive factors (baseline parent reported exercise induced wheeze and a history of atopic disorders), it is possible to estimate the likelihood of future asthma in children presenting with preschool wheeze. The absence of baseline exercise induced wheeze and a history of atopic disorders reduces the likelihood of subsequent asthma by a factor of five.
因此应用两个简单的预测因素（基线时家长报告的活动后喘鸣及变应性疾病史）就可以预测有喘鸣的学龄前儿童将来发展为哮喘的可能性。
（马艳良 北京大学人民医院呼吸科 100044 摘译）
（BMJ. 2008 Jun 21;336(7658):1423-1426）
Long term prognosis in preschool children with wheeze: longitudinal postal questionnaire study 1993-2004.
BMJ. 2008 Jun 21;336(7658):1423-6.
Frank PI, Morris JA, Hazell ML, Linehan MF, Frank TL.
OBJECTIVES: To follow a population of preschool children with and without parent reported wheeze over a period of 6-11 years to determine prognosis and its important predictive factors.
DESIGN: Longitudinal series of five postal surveys based on the international study of asthma and allergies in childhood questionnaire carried out between 1993 and 2004.
SETTING: Two general practice populations, south Manchester.
PARTICIPANTS: 628 children aged less than 5 years at recruitment and those with at least six years’ follow-up data.
MAIN OUTCOME MEASURES: Parent completed questionnaire data for respiratory symptoms and associated features.
RESULTS: Of 628 children included in the study, 201 (32%) had parent reported wheeze at the first observation (baseline), of whom 27% also reported the symptom on the second occasion (persistent asthma). The only important baseline predictors of persistent asthma were exercise induced wheeze (odds ratio 3.94, 95% confidence interval 1.72 to 9.00) and a history of atopic disorders (4.44, 1.94 to 10.13). The presence of both predictors indicated a likelihood of 53.2% of developing asthma; if only one feature was present this decreased to 17.2%, whereas if neither was present the likelihood was 10.9%. Family history of asthma was not predictive of persistent asthma among children with preschool wheeze.
CONCLUSION: Using two simple predictive factors (baseline parent reported exercise induced wheeze and a history of atopic disorders), it is possible to estimate the likelihood of future asthma in children presenting with preschool wheeze. The absence of baseline exercise induced wheeze and a history of atopic disorders reduces the likelihood of subsequent asthma by a factor of five.
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