哮喘联盟

    儿童期喘息是与哮喘有关的常见症状，但该名词常被误用。该研究旨在调查青少年哮喘患者特异性呼吸音对哮喘的预测价值。在这项前瞻性研究中，对6个特异性呼吸音在预测哮喘中的作用进行了评价。向父母询问最初无哮喘的儿童的呼吸音情况，并让其以特定的名词进行描述。本研究对德国1569名5～14岁自述已经经医生确诊的哮喘患者，在基线状态和随后最长12年随访期内进行评价。除了干罗音（17％），喘息和抽泣声具有较高的阳性预测值，分别为15％和11％。这两种呼吸音在哮喘发病时上升程度最大，OR分别为3.18（95% CI, 1.46-6.94）和2.09（95% CI, 1.00-4.37）。6个呼吸音中，喘息和抽泣声是哮喘发作的最好预测因素。
    研究结果表明，父母能明显区分这些呼吸音，虽然这些呼吸音并不都是哮喘的最佳预测因素，但鉴别这些呼吸音在临床上具有重要意义。

（苏楠 审校）
Hunger T, et al. Eur J Pediatr. 2009 Mar 25. [Epub ahead of print]

Prognostic values of specific respiratory sounds for asthma in adolescents.

Childhood wheezing is a common condition associated with asthma, but the term is often misapplied. The present study aimed to investigate the prognostic values of specific respiratory sounds for asthma onset in adolescence. In a prospective study, six specific respiratory sounds were evaluated for their prediction of asthma. Parents were asked for respiratory sounds of their initially asthma-free children and to describe them in specified terms. Self-reported doctor-diagnosed asthma of 1,569 children aged 5 to 14 years from Germany was assessed at baseline and at follow-up for up to 12 years later. Except for ’ronchus’ (17%), reported ’gasp’ and ’whimper’ had the highest positive predictive values of 15% and 11%, respectively. These sounds also showed the greatest increase in asthma incidence (odds ratio = 3.18; 95%CI, 1.46-6.94 and odds ratio = 2.09; 95%CI, 1.00-4.37). It could be shown that from six respiratory sounds, ’gasp’ and ’whimper’ were the expressions with the best prediction for asthma onset. This study suggests that parents can sensibly distinguish between respiratory sounds and that it is important to specify breathing sounds, as not all are good predictors for asthma.