目的 评价儿童哮喘及应用吸入性糖皮质激素(ICS)对其成年终身高的影响。方法 在PubMed、BCI、EMbase、Web of Science、中国知网和万方数据库中收集2014年10月前有关儿童哮喘和ICS治疗与成年终身高之间关系的研究,并进行系统评价和Meta分析。结果 最终纳入儿童哮喘与成年终身高的相关研究共6项,其中3项研究表明儿童哮喘不影响成年终身高,2项研究表明有轻微影响,且和哮喘严重程度相关,1项研究仅在未接受高等教育的黑人女性亚组发现身高降低。纳入儿童ICS治疗与成年终身高的相关研究共4项,通过ICS治疗组与非ICS治疗组、健康对照组及自身预期终身高的对比,发现哮喘患儿ICS治疗对成年终身高无明显影响。结论 儿童哮喘不会或者仅轻微降低成年终身高,而ICS治疗并不会明显影响成年终身高,但这些结论需要研究进一步验证。
Abstract
Objective To evaluate the effects of asthma and inhaled corticosteroids (ICS) in children on the final adult height. Methods A search was performed to collect studies evaluating the relationship between asthma and ICS in children and the final adult height in PubMed, BCI, EMbase, Web of Science, CNKI and Wanfang databases, then a systemic review and Meta analysis were conducted. Results Six studies evaluating the relationship between childhood asthma and the final adult height were enrolled. Three of them indicated that the final adult height was not influenced by childhood asthma. Two of them suggested a mild effect, and the effect was correlated with severity of childhood asthma. One of them indicated that a lower final adult height related to childhhod asthma was found only in black females without a high school education. Four studies evaluating the relationship between ICS and the final adult height were included. Compared with the non-ICS treatment group, healthy control group and the target height, ICS treatment had no effects on the final adult height. Conclusions Childhood asthma does not or only mildly decrease the final adult height. ICS treatment does not significantly affect the final adult height.
关键词
哮喘 /
身高 /
吸入性糖皮质激素 /
Meta分析 /
系统评价
Key words
Asthma /
Height /
Inhaled corticosteroid /
Meta analysis /
Systemic review
{{custom_sec.title}}
{{custom_sec.title}}
{{custom_sec.content}}
参考文献
[1] 全国儿科哮喘协作组, 中国疾病预防控制中心环境与健康相关产品安全所. 第三次中国城市儿童哮喘流行病学调查[J]. 中华儿科杂志, 2013, 51(10): 729-735.
[2] 中国哮喘儿童家长知信行调查项目组. 中国大陆29个城市哮喘患儿病情控制状况及影响因素[J]. 中华儿科杂志, 2013, 51(2): 90-95.
[3] 宗心南, 李辉. 中国儿童身高与体重的生长模式及简单数学模型的建立[J]. 中华儿科杂志, 2009, 47(5): 371-375.
[4] Martin AJ, Landau LI, Phelan PD. The effect on growth of childhood asthma[J]. Acta Paediatr Scand, 1981, 70(5): 683-688.
[5] Arrighi HM, Boyd BK, Casty FE. Childhood asthma and adult height: Data from NHANES II[J]. Pediatr Asthma Allergy Immunol, 1995, 9(3): 157-163.
[6] Silverstein MD, Yunginger JW, Reed CE, et al. Attained adult height after childhood asthma: effect of glucocorticoid therapy[J]. J Allergy Clin Immunol, 1997, 99(4): 466-474.
[7] Norjavaara E, Gerhardsson De Verdier M, Lindmark B. Reduced height in swedish men with asthma at the age of conscription for military service[J]. J Pediatr, 2000, 137(1): 25-29.
[8] Norjavaara E, Gerhardsson de Verdier M, Lindmark B. Adult height in women with childhood asthma--a population-based study[J]. Pharmacoepidemiol Drug Saf, 2001, 10(2): 121-125.
[9] Rona RJ, Smeeton NC, Vargas C, et al. Untreated asthma, final height and sitting height/leg length ratio in Chile[J]. Respiratory Medicine, 2006, 100(5): 911-917.
[10] Van Bever HP, Desager KN, Lijssens N, et al. Does treatment of asthmatic children with inhaled corticosteroids affect their adult height?[J]. Pediatric Pulmonology, 1999, 27(6): 369-375.
[11] Agertoft L, Pedersen S. Effect of long-term treatment with inhaled budesonide on adult height in children with asthma[J]. N Engl J Med, 2000, 343(15): 1064-1069.
[12] Larsson L, Gerhardsson de Verdier M, Lindmark B, et al. Budesonide-treated asthmatic adolescents attain target height: a population-based follow-up study from Sweden[J]. Pharmacoepidemiol Drug Saf, 2002, 11(8): 715-720.
[13] Kelly HW, Sternberg AL, Lescher R, et al. Effect of inhaled glucocorticoids in childhood on adult height[J]. N Engl J Med, 2012, 367(10): 904-912.
[14] Giannini C, Mohn A, Chiarelli F. Growth abnormalities in children with type 1 diabetes, juvenile chronic arthritis, and asthma[J]. Int J Endocrinol, 2014, 2014: 265954.
[15] Global Strategy for Asthma Management and Prevention. 2014 Global Initiative for Asthma[R/OL]. http://www.ginasthma.org/.
[16] 中华医学会儿科学会呼吸学组, 《中华儿科杂志》编辑委员会. 儿童支气管哮喘诊断与防治指南[J]. 中华儿科杂志, 2008, 46(10): 745-753.
[17] Martinez FD, Chinchilli VM, Morgan WJ, et al. Use of beclomethasone dipropionate as rescue treatment for children with mild persistent asthma (TREXA): a randomised, double-blind, placebo-controlled trial[J]. The Lancet, 2011, 377(9766): 650-657.
[18] Zhang L, Prietsch SO, Ducharme FM. Inhaled corticosteroids in children with persistent asthma: effects on growth[J]. Evid Based Child Health, 2014, 9(4): 829-930.
[19] Turpeinen M, Nikander K, Pelkonen AS, et al. Daily versus as-needed inhaled corticosteroid for mild persistent asthma (The Helsinki early intervention childhood asthma study)[J]. Arch Dis Child, 2008, 93(8): 654-659.
PDF(1622 KB)
