年龄因素对儿童哮喘严重恶化风险和哮喘控制的影响
2011/03/28
摘要
背景：哮喘是一种异质性疾病，但在儿童中，哮喘有成年后消失的趋势。
目的：本试验特异性评价年龄因素对哮喘儿童严重哮喘恶化（至少3天全身使用皮质激素治疗；2009年定义）发生和哮喘控制（GINA指南）的影响。本研究中对治疗方案和季节因素进行了控制。
方法：秋季和春季的2个月内，入选吸入性皮质激素治疗(ICS)患儿。记录前2个月的口服激素治疗时间和症状持续时间、ICS和长效β受体激动剂的剂量。
结果：359名儿童（110名女童）入选（48名<2岁；116名为2～6岁，107名为6～10岁；88名>10岁），其中秋季入选175名，春季入选184名。所有患者采用ICS治疗（平均每日剂量378 ± 250 μg）。359名儿童中，133名(37%)存在至少1次严重恶化，111名(31%)儿童出现哮喘控制。多变量logistic回归分析显示，年龄、季节和ICS剂量是哮喘恶化的独立危险因素，而年龄是哮喘控制的唯一预测因素。哮喘恶化和控制的优势比分别为每年0.85 (95% CI, 0.78-0.92, P<0.0001)和0.85 (95% CI, 0.79-0.91, P<0.0001)。
结论：对于治疗期哮喘儿童，从婴儿至青少年，哮喘恶化的每年风险下降15%，而哮喘控制随之增加。
（刘国梁 审校）
J Asthma. 2011 Feb;48(1):65-8. Epub 2010 Nov 1.
Influence of age on the risk of severe exacerbation and asthma control in childhood.
Mahut B, Trinquart L, Delclaux C.
Cabinet La Berma, Antony, France.
Abstract
Background. Asthma is a heterogeneous disease but it is a common observation that children tend to "grow out of their asthma." Objective. The aim was to specifically assess the influence of age on the occurrence of a severe exacerbation (at least 3 days use of systemic corticosteroid - international 2009 definition) and of the achievement of control (GINA guidelines) in children treated for asthma. Our study was controlled for amount of therapy and for season.
Methods. Children under inhaled corticosteroid (ICS) were enrolled over two 2-month periods (autumn, spring). Duration of oral steroid treatment and of symptoms, dose of ICS and long-acting beta-agonist were recorded for the past 3 months.
Results. Three hundred and fifty-nine children (110 girls) were included (48 [<2 years], 116 [2-6 years], 107 [6-10 years], 88 [>10 years]) during autumn (n = 175) and spring (n = 184), all treated by ICS (mean daily dose ± SD = 378 ± 250 μg). Among the 359 children, 133 (37%) experienced at least one severe exacerbation, and control was observed in 111 (31%) children. A multivariate logistic regression model demonstrated that age, season, and ICS dose are independent risk factors for exacerbation, whereas age is the only predictor of control. The odds ratio of exacerbation and control are 0.85 (95% CI, 0.78-0.92, p < .0001) and 0.85 (95% CI, 0.79-0.91, p < .0001) per year of increase in age, respectively.
Conclusions. From infancy to adolescence, each year of life reduces per se the risk of a severe exacerbation by 15% and similarly increases the achievement of control in children treated for asthma.
J Asthma. 2011 Feb;48(1):65-8. Epub 2010 Nov 1.
背景：哮喘是一种异质性疾病，但在儿童中，哮喘有成年后消失的趋势。
目的：本试验特异性评价年龄因素对哮喘儿童严重哮喘恶化（至少3天全身使用皮质激素治疗；2009年定义）发生和哮喘控制（GINA指南）的影响。本研究中对治疗方案和季节因素进行了控制。
方法：秋季和春季的2个月内，入选吸入性皮质激素治疗(ICS)患儿。记录前2个月的口服激素治疗时间和症状持续时间、ICS和长效β受体激动剂的剂量。
结果：359名儿童（110名女童）入选（48名<2岁；116名为2～6岁，107名为6～10岁；88名>10岁），其中秋季入选175名，春季入选184名。所有患者采用ICS治疗（平均每日剂量378 ± 250 μg）。359名儿童中，133名(37%)存在至少1次严重恶化，111名(31%)儿童出现哮喘控制。多变量logistic回归分析显示，年龄、季节和ICS剂量是哮喘恶化的独立危险因素，而年龄是哮喘控制的唯一预测因素。哮喘恶化和控制的优势比分别为每年0.85 (95% CI, 0.78-0.92, P<0.0001)和0.85 (95% CI, 0.79-0.91, P<0.0001)。
结论：对于治疗期哮喘儿童，从婴儿至青少年，哮喘恶化的每年风险下降15%，而哮喘控制随之增加。
（刘国梁 审校）
J Asthma. 2011 Feb;48(1):65-8. Epub 2010 Nov 1.
Influence of age on the risk of severe exacerbation and asthma control in childhood.
Mahut B, Trinquart L, Delclaux C.
Cabinet La Berma, Antony, France.
Abstract
Background. Asthma is a heterogeneous disease but it is a common observation that children tend to "grow out of their asthma." Objective. The aim was to specifically assess the influence of age on the occurrence of a severe exacerbation (at least 3 days use of systemic corticosteroid - international 2009 definition) and of the achievement of control (GINA guidelines) in children treated for asthma. Our study was controlled for amount of therapy and for season.
Methods. Children under inhaled corticosteroid (ICS) were enrolled over two 2-month periods (autumn, spring). Duration of oral steroid treatment and of symptoms, dose of ICS and long-acting beta-agonist were recorded for the past 3 months.
Results. Three hundred and fifty-nine children (110 girls) were included (48 [<2 years], 116 [2-6 years], 107 [6-10 years], 88 [>10 years]) during autumn (n = 175) and spring (n = 184), all treated by ICS (mean daily dose ± SD = 378 ± 250 μg). Among the 359 children, 133 (37%) experienced at least one severe exacerbation, and control was observed in 111 (31%) children. A multivariate logistic regression model demonstrated that age, season, and ICS dose are independent risk factors for exacerbation, whereas age is the only predictor of control. The odds ratio of exacerbation and control are 0.85 (95% CI, 0.78-0.92, p < .0001) and 0.85 (95% CI, 0.79-0.91, p < .0001) per year of increase in age, respectively.
Conclusions. From infancy to adolescence, each year of life reduces per se the risk of a severe exacerbation by 15% and similarly increases the achievement of control in children treated for asthma.
J Asthma. 2011 Feb;48(1):65-8. Epub 2010 Nov 1.
上一篇：
严重难以控制的哮喘采用奥玛珠单抗治疗7年的临床疗效
下一篇：
多症状哮喘与鼻塞、流涕和慢性鼻炎及鼻窦炎症状紧密相关---来自瑞典西部哮喘研究的证据
