Abstract
The distinction between episodic viral wheeze (EVW) and multitrigger wheeze (MTW) is used to guide management of preschool wheeze. It has been questioned whether these phenotypes are stable over time. We examined the temporal stability of MTW and EVW in two large population-based cohorts.
We classified children from the Avon Longitudinal Study of Parents and Children (n=10 970) and the Leicester Respiratory Cohorts ((LRCs), n=3263) into EVW, MTW and no wheeze at ages 2, 4 and 6 years based on parent-reported symptoms. Using multinomial regression, we estimated relative risk ratios for EVW and MTW at follow-up (no wheeze as reference category) with and without adjusting for wheeze severity.
Although large proportions of children with EVW and MTW became asymptomatic, those that continued to wheeze showed a tendency to remain in the same phenotype: among children with MTW at 4 years in the LRCs, the adjusted relative risk ratio was 15.6 (95% CI 8.3–29.2) for MTW (stable phenotype) compared to 7.0 (95% CI 2.6–18.9) for EVW (phenotype switching) at 6 years. The tendency to persist was weaker for EVW and from 2–4 years. Results were similar across cohorts.
这表明MTW和较小程度的evw,无论喘息的严重程度如何持续存在。
Abstract
MultiTrigger和IniSodic病毒喘息趋于持续存在于幼儿早期,并且可能反映不同的疾病过程http:///wly/kqrk30fvxmj.
脚注
支持声明:本研究得到了瑞士国家基金会(授予NoS。SNF32003B_162820和SNF32003B_144068)的支持。英国医学研究委员会和惠康信托(授予第092731号)和布里斯托大学为Alspac(父母和儿童的Avon纵向研究)提供了核心支持。在Leicester呼吸队队列研究中,数据收集由英国国家哮喘竞选资助,大学医院的莱斯特NHS信托(研发),莱斯特郡和Rutland Partnership Trust,Medisearch,Trent NHS区域卫生管理局以及英国卫生部。B.D.Spycher是欧洲呼吸协会(ERS)/ Marie Cur188bet官网地址ie联合研究奖学金的收件人(授予号码MC 1614-2010)。导致这些结果的研究已收到欧洲社区的第七框架计划FP7 / 2007-2013-Marie Curie行动的资金,PCOFUND-GA-2008-229571。B.D Spycher还获得了瑞士国家科学基金会奖学金的支持(Grant No.PZ00P3_147987)。R. Granell由英国医学研究委员会提供支持(授予No.G0902125)。J.A.C.Sterne由国家卫生研究所资助高级调查员奖NF-SI-0611-10168。 The funders had no role in the study design, data collection and analysis, the decision to publish or the preparation of the manuscript. Funding information for this article has been deposited with theCrossref Funder Registry。
Conflict of interest: Disclosures can be found alongside this article atwww.qdcxjkg.com
本文提供了补充材料www.qdcxjkg.com
编辑评论在:EUR RESPIR J.2017年;50:1701283。
- 已收到January 4, 2017.
- Accepted2017年7月29日。
- 版权所有©ers 2017