哮喘联盟

   摘要
   背景：以前的调查研究，对于一般人群的肺炎支原体和哮喘事件之间的关系，尚无定论。
   目的：我们以全国性队列研究去阐明这种关系。
   方法：在台湾全民健康保险研究资料库中，我们选出了在2000年至2008年确诊的1591例肺炎支原体感染患者（国际疾病分类，第9版，临床修订代码4830）。然后我们根据频次配比了6364例未感染肺炎支原体的患者，主要根据年龄、性别和检索年限。采用Cox比例风险回归分析，在感染肺炎支原体的队列和未感染肺炎支原体的队列中，分析校正的哮喘发生风险比（aHR）。
   结果：不考虑合并症及使用抗生物或类固醇激素治疗等因素，与未感染肺炎支原体的患者相比，感染肺炎支原体患者发生哮喘的风险明显升高。感染肺炎支原体患者队列中哮喘aHR为3.35%（(95% CI, 2.71-4.15)，将患者根据年龄、性别、随访时间和合并症，包括过敏性鼻炎，特应性皮炎，或过敏性结膜炎分层，风险明显升高。感染肺炎支原体患者早发性哮喘（年龄<12岁; AHR，2.87）和晚发性哮喘（年龄≥12岁; AHR，3.95）风险明显升高。在不到2年的随访期，与未感染患者相比，感染肺炎支原体的aHR明显升高（AHR，4.41;95％CI，3.40-5.74）。
   结论：本研究得出，早发性和晚发性哮喘的发病病例与感染肺炎支原体密切相关，甚至包括非特应性患者。
 

（杨冬 审校）
JAllergyClinImmunol. 2015Nov13.pii:S0091-6749(15)01419-0.doi:10.1016/j.jaci.2015.09.032. [Epub ahead of print]

 

Incident asthma and Mycoplasma pneumoniae: A nationwide cohort study.
 

Yeh JJ1, Wang YC2, Hsu WH3, Kao CH4.
 

Abstract
BACKGROUND:Previous studies investigating the relationship between Mycoplasma pneumoniae and incident asthma in the general population have been inconclusive.
OBJECTIVE:We conducted a nationwide cohort study to clarify this relationship.
METHODS:Using the National Health Insurance Research Database of Taiwan, we identified 1591 patients with M pneumoniae infection (International Classification of Diseases, Ninth Revision, Clinical Modification code 4830) given diagnoses between 2000 and 2008. We then frequency matched 6364 patients without M pneumoniae infection from the general population according to age, sex, and index year. Cox proportional hazards regression analysis was performed to determine the adjusted hazard ratio (aHR) of the occurrence of asthma in the M pneumoniae cohort compared with that in the non-M pneumoniae cohort.
RESULTS:Regardless of comorbidities and the use of antibiotic or steroid therapies, patients with M pneumonia infection had a higher risk of incident asthma than those without it. The aHR of asthma was 3.35 (95% CI, 2.71-4.15) for the M pneumoniae cohort, with a significantly higher risk when patients were stratified by age, sex, follow-up time, and comorbidities, including allergic rhinitis, atopic dermatitis, or allergic conjunctivitis. Patients with M pneumoniae infection had a higher risk of having early-onset (age, <12 years; aHR, 2.87) and late-onset (age, ≥12 years; aHR, 3.95) asthma. The aHR was also higher within the less than 2-year follow-up in the M pneumoniae cohort (aHR, 4.41; 95% CI, 3.40-5.74) than in the cohort without the infection.
CONCLUSION:This study found that incident cases of early-onset and late-onset asthma are closely related to M pneumoniae infection, even in nonatopic patients.
 

JAllergyClinImmunol. 2015Nov13.pii:S0091-6749(15)01419-0.doi:10.1016/j.jaci.2015.09.032. [Epub ahead of print]