Abstract：
Most patients with childhood asthma present their first symptoms at preschool age. Identifying modifiable risks and protective factors at an early age may help develop asthma prevention and control strategies. This study aimed to identify factors at preschool age that are associated with persistent asthma at school age. This retrospective observational study included preschool children with asthma from 2015 to 2020 at a university hospital in Southern Thailand. In total, 189 eligible participants (70.9% boys; median age, 7.6 [6.7, 8.5] years) were included. Wheeze characteristics included early transient wheeze, persistent wheeze, and late-onset wheeze that accounted for 55%, 27.5%, and 19.5% of the patients, respectively. Approximately 20% of the participants had persistent asthma. Breastfeeding was a protective factor (odds ratio [OR] 0.4 [0.2, 0.9], p = 0.04). The modifiable risk factors were siblings living in the same household (OR 2.6 [1.1, 6.2], p = 0.02) and residence in an industrial area (OR 3.8 [1.4, 10.5], p = 0.009). Additionally, presence of allergic rhinitis was associated with an increased risk of persistent asthma at school age (OR 3.6 [1.6, 8.2], p = 0.002). Early therapeutic interventions targeting modifiable factors provide a window of opportunity to prevent persistent asthma at school age.
摘要：
大多数儿童哮喘患者在学龄前时出现首发症状。早期识别可改变的风险和保护因素可能有助于制定哮喘预防和控制策略。这项研究旨在确定与学龄期持续哮喘相关的学龄前因素。这项回顾性观察研究包括2015年至2020年泰国南部一所大学医院的学龄前哮喘儿童。总的来说,189名符合条件的参与者（70.9%为男孩；平均年龄，7.6[6.7，8.5]年）。喘息特征包括早期短暂的喘息，持续的喘息,迟发性喘息占55%，27.5%,和19.5%的病人,分别。大约20%的参与者患有持续性哮喘。母乳喂养是一个保护因素(比值比[OR]0.4[0.2，0.9]，p=0.04)。可改变的危险因素是生活在同一家庭的兄弟姐妹(OR2.6[1.1，6.2]，p=0.02)和在工业区居住(OR3.8[1.4，10.5]，p=0.009)。此外,过敏性鼻炎的存在与学龄期持续性哮喘的风险增加相关(OR3.6[1.6,8.2],p=0.002)。针对可改变因素的早期治疗干预为预防学龄期持续哮喘提供了机会之窗。
