哮喘联盟

    目的：对目前有关儿童早期喘息长期预后方面的研究进行综述。对哮喘和肺功能异常进行了评估，特别关注早期的危险因素。
    近期研究结果：在支气管炎发作后的研究中发现，24个月以内的幼儿因为喘息而住院治疗的患者中有30％～40％在17～20岁时出现了哮喘。在Tucson 出生队列研究中，小于36个月的喘息儿童在22岁时有30％出现了哮喘。多年无症状后的复发也很常见。在支气管炎发作后研究中发现，患儿的肺功能下降31％～36％，与支气管扩张剂后测量的一样。而且正如Tucson研究所发现的，从婴儿期到成人期，呼吸道产生了结构性变化。双亲哮喘、反复的早期喘息以及早期被动吸烟是成人期哮喘和肺功能异常的最重要的早期预测因素。
    总结：儿童早期喘息增加成人后的哮喘发生风险和肺功能异常风险。一些儿童慢性哮喘能持续到成人期，而且成人早期出现的哮喘也有可能来源于儿童早期。

（苏楠 审校）
Piippo-Savolainen E, et al. Curr Opin Allergy Clin Immunol. 2009 Mar 21. [Epub ahead of print]

Long-term outcomes of early childhood wheezing.

PURPOSE OF REVIEW: To summarize the currently available data on the long-term outcome until young adulthood after early childhood wheezing. Asthma and lung function abnormalities were evaluated, with special attention to early-life risk factors.
RECENT FINDINGS: In postbronchiolitis studies, 30-40% of the patients hospitalized for wheezing at less than 24 months of age have had asthma at 17-20 years of age. In the Tucson birth cohort study, the respective figure after wheezing at less than 36 months of age was 30% at 22 years of age. Relapses after many nonsymptomatic years have been common. In postbronchiolitis studies, lung function has been reduced in 31-36%, concerning also postbronchodilator measurements. Thus, the changes in airways seem to be structural, being present from infancy until adulthood, as found in the Tucson study. Parental asthma, repeated early-life wheezing and early passive smoking have been the most important early-life predictors of both adulthood asthma and lung function abnormalities.
SUMMARY: Early childhood wheezing increases the risk for asthma and lung function abnormalities in young adulthood. Not only chronic childhood asthma continuing until adulthood but also asthma beginning in early adulthood seems to have its origin in early childhood.