학동기 천식에서 성인 초기까지 천식의 지속에 미치는인자들 : 폐기능 및 기관지 과민성을 중심으로
The Risk Factors for Persistence of Asthma Symptoms fromLate Childhood to Early Adult Life: The Effects of PulmonaryFunction and Bronchial Hyperresponsiveness
2
조회
0
다운로드
4
인용
0
참고문헌
키워드
초록
Purpose:We performed this study to evaluate the effect of pulmonary function and bronchial hyperresponsiveness (BHR) on the persistence of asthma symptoms from late childhood to early adult life. Methods:One-hundred thirty-one children with asthma treated at our hospital during the past 10 years were divided into 2 groups according to the persistence of symptoms in early adult life: the persistent and remission groups. Information about symptoms, body mass index, serum ECP, serum IgE and skin test reactivity in late childhood were obtained and prebronchodilator FEV1, FEV1/FVC (expressed as % of predicted) and BHR to methacholine were measured in late childhood and early adult life, and compared the 2 groups. Results:The persistent group was accounted for 45.8% of the subjects and FEV1, FEV1/ FVC and BHR to methacholine in late childhood were associated with the persistence of symptoms. We found a positive correlation between FEV1 in late childhood and early adult.(r=0.250, P=0.013) Also we found a positive correlation between FEV1/FVC in late childhood and early adult.(r=0.285, P=0.018) BHR and FEV1% of 60% to 79% of late childhood were associated with BHR in early adult.(Odds ratio; 95% confidence interval=3.8; 1.7-8.7, 4.6; 1.0-20.2) Conclusion:Low pulmonary function and increased BHR in childhood asthma were associated with persistence of symptom, degree of pulmonary function and BHR in early adult life.
Abstract
Purpose:We performed this study to evaluate the effect of pulmonary function and bronchial hyperresponsiveness (BHR) on the persistence of asthma symptoms from late childhood to early adult life. Methods:One-hundred thirty-one children with asthma treated at our hospital during the past 10 years were divided into 2 groups according to the persistence of symptoms in early adult life: the persistent and remission groups. Information about symptoms, body mass index, serum ECP, serum IgE and skin test reactivity in late childhood were obtained and prebronchodilator FEV1, FEV1/FVC (expressed as % of predicted) and BHR to methacholine were measured in late childhood and early adult life, and compared the 2 groups. Results:The persistent group was accounted for 45.8% of the subjects and FEV1, FEV1/ FVC and BHR to methacholine in late childhood were associated with the persistence of symptoms. We found a positive correlation between FEV1 in late childhood and early adult.(r=0.250, P=0.013) Also we found a positive correlation between FEV1/FVC in late childhood and early adult.(r=0.285, P=0.018) BHR and FEV1% of 60% to 79% of late childhood were associated with BHR in early adult.(Odds ratio; 95% confidence interval=3.8; 1.7-8.7, 4.6; 1.0-20.2) Conclusion:Low pulmonary function and increased BHR in childhood asthma were associated with persistence of symptom, degree of pulmonary function and BHR in early adult life.
참고문헌 (39)
- Roorda RJ, "Risk factors for the persistence of respiratory symptoms in childhood asthma", Am Rev Respir Dis, 148, pp.1490~1495 (1993)
- Buffum WP, "Prognosis of asthma in childhood", Am J Dis Child, 112, pp.214~217 (1966)
- Korean academy of pediatric allergy and respiratory diseases, "Prevalences of allergic diseases in Korean children: a nationwide questionnaire survey: asthma. Committee of the Korean academy of pediatric allergy and respiratory disease for epidemiologic study", Pediatr Allergy Respir Dis, 12, pp.S49~S53 (2001)
- Lee SI, "Prevalence of symptoms of asthma and other allergic diseases in Korean children: a nationwide questionnaire survey", J Korean Med Sci, 16, pp.155~164 (2001)
- Jenkins MA, "Factors in childhood as predictors of asthma in adult life", BMJ, 309, pp.90~93 (1994)
- Johnstone DE, "A study of the natural history of bronchial asthma in children", Am J Dis Child, 115, pp.213~216 (1968)
- Gerritsen J, "Prognosis of asthma from childhood to adulthood", Am Rev Respir Dis, 140, pp.1325~1330 (1989)
- Strachan DP, "Ventilatory function in British adults after asthma or wheezing illness at ages 0-35", Am J Respir Crit Care Med, 154, pp.1629~1635 (1996)
- Gold DR, "Body-mass index as a predictor of incident asthma in a prospective cohort of children", Pediatr Pulmonol, 36, pp.514~521 (2003)
- Rasmussen F, "Risk factors for airway remodeling in asthma menifested by a low postbronchodilator FEV1", vital capacity ratio: a longitudinal population study from childhood to adulthood, 2002, pp.165, 1480~1488
- Limb SL, "Irreversible lung function deficits in young adults with a history of childhood asthma", J Allergy Clin Immunol, 116, pp.1213~1219 (2005)
- Roorda JJ, "Follow-up of asthma from childhood to adulthood: influence of potential childhood risk factors in the outcome of pulmonary function and bronchial responsiveness in adulthood", J Allergy Clin Immunol, 93, pp.575~584 (1994)
- Jenkins HA, "Histopathology of severe childhood asthma: a case series", Chest, 124, pp.32~41 (2003)
- Oswald H, "Childhood asthma and lung function in mid-adult life", Pediatr Pulmonol, 23, pp.14~20 (1997)
- Liu AH, "Childhood asthma. In: Nelson textbook of pediatrics", pp.953~970 (2007), Philadelphia: Saunders
- Global strategy for asthma management and prevention, "Global Initiative for Asthma", National Institutes of Health, ~, pp.NIH publication no. 02-3659. (2002)
- Burrows B, "Relationship of bronchial responsiveness to allergy skin test reactivity, lung function, respiratory symptoms, and diagnoses in thirteen-year-old New Zealand children", J Allergy Clin Immunol, 95, pp.548~556 (1995)
- Mete N, "The determinants of bronchial hyperresponsiveness in patients with allergic rhinitis", Ann Allergy Asthma Immunol, 93, pp.193~199 (2004)
- Sulit LG, "Associations of obesity, sleep-disordered breathing, and wheezing in children", Am J Respir Crit Care Med, 171, pp.659~664 (2005)
- Sears MR, "Evolution of asthma through childhood", Clin Exp Allergy, 28(5), pp.82~89 (1998)
- Toelle BG, "Childhood factors that predict asthma in young adulthood", Eur Respir J, 23, pp.66~70 (2004)
- Blair H, "Natural history of childhood asthma. 20-year follow-up", Arch Dis Child, 52, pp.613~619 (1977)
- Biring MS, "Pulmonary physiologic changes of morbid obesity", Am J Med Sci, 318, pp.293~297 (1999)
- Roche WR, "Inflammatory and structural changes in the small airways in bronchial asthma", Am J Respir Crit Care Med, 157(5), pp.191S~194S (1998)
- Van Eerdewegh P, "Association of the ADAM33 gene with asthma and bronchial hyperresponsiveness", Nature, 418, pp.426~430 (2002)
- O’Connor GT, "The role of allergy and nonspecific airway hyperresponsiveness in the pathogenesis of chronic obstructive pulmonary disease", Am Rev Respir Dis, 140, pp.225~252 (1989)
- Kim DK, "Methacholine and adenosine 5`-monophosphate challenge tests in children with asthma: relationship to eosinophil markers in blood", Korean J Asthma Allergy Clin Immunol, 26, pp.52~58 (2006)
- Gerritsen J, "Allergy in subjects with asthma from childhood to adulthood", J Allergy Clin Immunol, 85, pp.116~125 (1990)
- Elias JA, "Airway remodeling in asthma. Unanswered questions", Am J Respir Crit Care Med, 161(3), pp.168S~171S (2000)
- Agertoft L, "Effects of long-term treatment with an inhaled corticostroid on growth and pulmonary function in asthmatic children", Respir Med, 88, pp.373~381 (1994)
- Kerrebijn KF, "Effect of long-term treatment with inhaled corticosteroids and beta-agonists on the bronchial responsiveness in children with asthma", J Allergy Clin Immunol, 79, pp.653~659 (1987)
- Sont JK, "Relationship between the inflammatory infiltrate in bronchial biopsy specimens and clinical severity of asthma in patients treated with inhaled steroids", Thorax, 51, pp.496~502 (1996)
- Godden DJ, "Outcome of wheeze in childhood. Symptoms and pulmonary function 25 years later", Am J Respir Crit Care Med, 149, pp.106~112 (1994)
- Lange P, "A 15-year follow-up study of ventilatory function in adults with asthma", N Engl J Med, 339, pp.1194~1200 (1998)
- Bacharier LB, "Classifying asthma severity in children: mismatch between symptoms, medication use, and lung function", Am J Respir Crit Care Med, 170, pp.426~432 (2004)
- Laprise C, "relationships with airway inflammation and remodelling", Eur Respir J, 14, pp.63~73 (1999)
- Forastiere F, "A longitudinal evaluation of bronchial responsiveness to methacholine in children; Role of baseline lung function, gender, and change in atopic status", Am J Respir Crit Care Med, 153, pp.1098~1104 (1996)
- Ulrik CS, "Factors associated with increased bronchial responsiveness in adolescents and young adults: the importance of adjustment for prechallenge FEV1", J Allergy Clin Immunol, 97, pp.761~767 (1996)
- Lim DH, "Airway remodelling in asthma", Korean J Pediatr, 48, pp.1038~1049 (2005)