哮喘联盟

   摘要
   原理：幼年患有呼吸道合胞病毒(RSV)导致的下呼吸道疾病(LRI)者，在其童年期的第一个十年里后继发生哮喘样症状的风险增加，青春期时风险降低。
   目的：旨在评估幼年RSV-LRI与成年哮喘样症状的相关性，及其与成年吸烟的相互作用。
   方法：对纳入的1246例非挑选的新生婴儿进行前瞻性随访。在婴儿生长的前三年期间对病毒学上确诊为RSV-LRIs的受试者进行评估。在22、24、26、29岁时，采用调查问卷以评估目前的哮喘发生情况和吸烟习惯。26岁时评估其呼吸峰流值的变化率，并记录为平均幅度%。采用纵向分析评估RSV-LRI与主动吸烟对于成年后结果的相关性。
   评估和主要结果：RSV-LRI和主动吸烟与成年后哮喘或呼吸峰流值变化率均无直接相关性。然而，RSV-LRI与主动吸烟间存在明显的相互作用，并与当前哮喘(P相互作用= 0.004)和呼吸峰流值变化率(P相互作用= 0.004)相关。在幼年患有RSV-LRI的受试者中，主动吸烟者现患哮喘的概率是非吸烟者的1.7倍(95% CI: 1.2-2.3, p = 0.003)，且与非吸烟者比具有更高的平均变异幅度%(10.0% vs. 6.4%, p = 0.02)。在幼年未患RSV-LRI的受试者中，主动吸烟和非吸烟者间哮喘风险或呼吸峰流值变化率无差异。
   结论：在幼年患有RSV-LRI的年轻成年人中，吸烟与哮喘风险的增加相关，但在幼年期未患RSV-LRI的受试者中无此相关性。

 

（林江涛 审校）
Am J Respir Crit Care Med. 2014 Jun 13. [Epub ahead of print]


 

Risk of Current Asthma Among Adult Smokers with Respiratory Syncytial Virus Illnesses in Early Life.
 

Voraphani N1, Stern DA, Wright AL, Guerra S, Morgan WJ, Martinez FD.
 

ABSTRACT
RATIONALE:Risk of subsequent asthma-like symptoms after early life lower respiratory illness (LRI) caused by respiratory syncytial virus (RSV) is increased during the first decade of childhood and diminished thereafter by adolescence.
Objectives: To determine the relation of early life RSV-LRI on adult asthma-like symptoms and its interactive role with adult smoking.
METHODS: 1,246 non-selected infants were enrolled at birth and prospectively followed. Virologically-confirmed RSV-LRIs were assessed during the first 3 years of life. At age 22, 24, 26, and 29 years, current asthma and smoking behavior were evaluated by questionnaire. Peak flow variability was assessed at age 26 and expressed as amplitude % mean. A longitudinal analysis was used to investigate the relation of RSV-LRI and active smoking to adult outcomes.
MEASUREMENTS AND MAIN RESULTS: Neither RSV-LRI nor active smoking was directly associated with increased current adult asthma or peak flow variability. However, there was a significant interaction between RSV-LRI and active smoking in relation to current asthma (p for interaction = 0.004) and peak flow variability (p for interaction = 0.04). Among subjects with early RSV-LRI, those who actively smoked were 1.7 times more likely to have current asthma (95% CI: 1.2-2.3, p = 0.003) and had greater amplitude % mean (10.0% vs. 6.4%, p = 0.02) than non-smokers. Among subjects without early RSV-LRI, there was no difference in asthma risk or peak flow variability between active smokers and non-smokers.
CONCLUSIONS: Smoking is associated with increased risk of having asthma in young adults who had RSV-LRI in early life but not among subjects without these illnesses.
 

Am J Respir Crit Care Med. 2014 Jun 13. [Epub ahead of print]