哮喘联盟

   摘要
   背景:近期的研究显示成年期哮喘起源于儿童早期。
   目的:本研究的目的是评估哮喘的患病率和婴儿期住院治疗过细支气管炎或肺炎的成人30年里呼吸健康相关的生命质量
   方法:对1981～1982年间年龄小于24个月住院治疗细支气管炎或肺炎的患者进行多次访问。在2010年，83例既往患有细支气管炎的患者中48例有支气管炎(57.8%)，44例既往患有肺炎的患者中22人有肺炎(50.0%)，另纳入了138例年龄28～31岁的受试者作为对照组。受试者完成一份关于呼吸系统症状的结构性问卷和圣乔治呼吸问卷(SGRQ)，并接受2周的呼吸流量峰值监测。由医生诊断和自述为哮喘来确定哮喘患者，自述为哮喘的患者要基于哮喘的医生处方药物、存在的哮喘假定症状和家中呼吸流量峰值的监测。
   结果:与对照组相比，既往患有细支气管炎患者中目前经医生诊断(31.3% vs. 10.9% 调整后的 P = 0.002)和自述为哮喘(35.4% vs. 14.5% 0.003)的患者，以及重复按需使用支气管扩张药物(35.4% vs. 14.5% 0.002)和规律使用吸入糖皮质激素 (20.8% vs. 8.7% 0.023) 的患者更普遍。既往细支气管炎和肺炎患者较对照组具有更高的SGRQ分数。细支气管炎组的中位评分为5.4(IQ25-75 0.0-14.7, P < 0.001)，肺炎组为4.9 (1.3-14.8, 0.012)，对照组为1.5 (0.0-6.0)。
   结论:婴儿期细支气管炎住院治疗显著增加28～31岁成年期的哮喘风险和哮喘药物的使用。通过SGRQ测量显示，婴儿期细支气管炎和肺炎患者会损坏成年期呼吸健康相关生命质量。
 

（林江涛 审校）
Pediatr Pulmonol. 2013 Jul 8. doi: 10.1002/ppul.22842. [Epub ahead of print]

 

Increased asthma risk and impaired quality of life after bronchiolitis or pneumonia in infancy.
 

Backman K, Piippo-Savolainen E, Ollikainen H, Koskela H, Korppi M.
 

Abstract
BACKGROUND: Recent studies have revealed that adulthood asthma has its origin in early childhood.
AIM: The aim of the present study was to evaluate the prevalence of asthma and respiratory health-related quality of life in adults 30 years after hospitalization for bronchiolitis or pneumonia in infancy.
METHODS: Patients who were hospitalized for bronchiolitis or pneumonia at age under 24 months in 1981-1982 have been followed in repeated visits. In 2010, 48 of the 83 former patients with bronchiolitis (57.8%), 22 of the 44 former patients with pneumonia (50.0%), and 138 matched controls participated in the clinical study at the age of 28-31 years. The participants completed a structured questionnaire on respiratory symptoms, the Saint George's Respiratory Questionnaire (SGRQ), and underwent 2-week peak expiratory flow (PEF) monitoring. Asthma was defined as doctor-diagnosed and self-reported asthma based on doctor-prescribed medication for asthma, the presence of asthma-presumptive symptoms, and the results of home PEF monitoring.
RESULTS: Both doctor-diagnosed asthma (31.3% vs. 10.9% adjusted P = 0.002) and self-reported asthma (35.4% vs. 14.5% 0.003), as well as repeated on-demand use of bronchodilators (35.4% vs. 14.5% 0.002), and regular use of inhaled corticosteroids (20.8% vs. 8.7% 0.023) were more common in former bronchiolitis patients than in controls. Former bronchiolitis and pneumonia patients had higher total SGRQ scores than controls. The median scores were 5.4 (IQ25-75 0.0-14.7, P < 0.001) in bronchiolitis group, 4.9 (1.3-14.8, 0.012) in pneumonia group compared to controls 1.5 (0.0-6.0).
CONCLUSION: Hospitalization for bronchiolitis in infancy is associated with an increased risk of asthma, and an increased use of asthma medication in adulthood at the age of 28-31 years. Impaired respiratory health-related quality of life in adulthood as measured by the SGRQ is present after bronchiolitis and pneumonia in infancy.
 

Pediatr Pulmonol. 2013 Jul 8. doi: 10.1002/ppul.22842. [Epub ahead of print]