Introduction Adult spirometry following community-acquired childhood pneumonia has variably been reported as showing obstructive or non-obstructive deficits. We analysed associations between doctor-diagnosed childhood pneumonia/pleurisy and more comprehensive lung function in a middle-aged general population cohort born in 1961. Methods Data were from the prospective population-based Tasmanian Longitudinal Health Study cohort. Analysed lung function was from ages 7 years (prebronchodilator spirometry only, n=7097), 45 years (postbronchodilator spirometry, carbon monoxide transfer factor and static lung volumes, n=1220) and 53 years (postbronchodilator spirometry and transfer factor, n=2485). Parent-recalled histories of doctor-diagnosed childhood pneumonia and/or pleurisy were recorded at age 7. Multivariable linear and logistic regression were used. Results At age 7, compared with no episodes, childhood pneumonia/pleurisy-ever was associated with reduced FEV1:FVC for only those with current asthma (beta-coefficient or change in z-score=−0.20 SD, 95% CI −0.38 to –0.02, p=0.028, p interaction=0.036). At age 45, for all participants, childhood pneumonia/pleurisy-ever was associated with a restrictive pattern: OR 3.02 (1.5 to 6.0), p=0.002 for spirometric restriction (FVC less than the lower limit of normal plus FEV1:FVC greater than the lower limit of normal); total lung capacity z-score −0.26 SD (95% CI −0.38 to –0.13), p<0.001; functional residual capacity −0.16 SD (−0.34 to –0.08), p=0.001; and residual volume −0.18 SD (−0.31 to –0.05), p=0.008. Reduced lung volumes were accompanied by increased carbon monoxide transfer coefficient at both time points (z-score +0.29 SD (0.11 to 0.49), p=0.001 and +0.17 SD (0.04 to 0.29), p=0.008, respectively). Discussion For this community-based population, doctor-diagnosed childhood pneumonia and/or pleurisy were associated with obstructed lung function at age 7 for children who had current asthma symptoms, but with evidence of ‘smaller lungs’ when in middle age.

中文翻译：

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儿童肺炎、胸膜炎和肺功能：从生命的第 1 个到第 6 个十年的队列研究

引言 社区获得性儿童肺炎后的成人肺活量测定已被不同程度地报告为显示阻塞性或非阻塞性缺陷。我们在 1961 年出生的中年普通人群队列中分析了医生诊断的儿童肺炎/胸膜炎与更全面的肺功能之间的关联。方法数据来自基于前瞻性人群的塔斯马尼亚纵向健康研究队列。分析的肺功能来自 7 岁（仅支气管扩张剂前肺活量测定，n=7097）、45 岁（支气管扩张剂后肺活量测定、一氧化碳转移因子和静态肺容量，n=1220）和 53 岁（支气管扩张剂后肺活量测定和转移因子，n=2485 ）。父母回忆起医生诊断出的儿童肺炎和/或胸膜炎的病史是在 7 岁时记录的。使用多变量线性回归和逻辑回归。结果 在 7 岁时，与没有发作相比，儿童期肺炎/胸膜炎仅与当前哮喘患者的 FEV1:FVC 降低相关（β 系数或 z 评分变化 = -0.20 SD，95% CI -0.38 至–0.02，p=0.028，p 交互作用=0.036）。在 45 岁时，对于所有参与者，儿童期肺炎/胸膜炎与限制模式相关：OR 3.02（1.5 至 6.0），肺活量限制 p=0.002（FVC 低于正常下限加上 FEV1：FVC 大于正常的下限）；总肺活量 z 评分 -0.26 SD（95% CI -0.38 至 –0.13），p<0.001；功能剩余容量 -0.16 SD（-0.34 至 –0.08），p=0.001；和残余体积 -0.18 SD（-0.31 至 –0.05），p=0.008。在两个时间点，肺容量减少都伴随着一氧化碳转移系数的增加（z 分数 +0.29 SD（0.11 至 0.49），p=0.001 和 +0.17 SD（0.04 至 0.29），p=0.008，分别）。讨论 对于这个以社区为基础的人群，医生诊断出的儿童肺炎和/或胸膜炎与目前有哮喘症状的儿童在 7 岁时肺功能受阻有关，但在中年时有“肺变小”的证据。