急性毛细支气管炎后的空气污染是学龄前哮喘的危险因素:一项巢式病例对照研究
2024/01/26
摘要
背景：急性毛细支气管炎和空气污染是儿童哮喘的危险因素。本研究旨在评估与急性毛细支气管炎患儿发生学龄前哮喘相关的后续空气污染物暴露。
方法：本研究为巢式病例对照回顾性研究，于2009至2019年在高雄医科大学附属医院系统进行。收集首次感染后3、6、12个月PM10、PM2.5、SO2、NO、NO2、NOX的平均浓度。采用调整后的回归模型评估毛细支气管炎后哮喘与空气污染暴露的关联。
结果：共纳入2637例急性毛细支气管炎患儿。研究发现，在毛细支气管炎发作后的3个月、6个月和12个月暴露于PM10、PM2.5、SO2、NO、NO2和NOX显著增加有毛细支气管炎病史的婴儿发生学龄前哮喘的风险。(OR, 95%CI: PM10 = 1.517-1.559, 1.354-1.744; PM2.5 = 2.510-2.603, 2.148-3.061; SO2 = 1.970-2.040, 1.724-2.342; ; NO = 1.915-1.950, 1.647-2.272; NO2 = 1.915-1.950, 1.647-2.272; NOX = 1.752-1.970, 1.508-2.252)在住院婴儿的敏感分析中，仅PM10、PM2.5、SO2和NO在所有时间段均有显著影响。(OR, 95%CI: PM10 = 1.613-1.650, 1.240-2.140; PM2.5 = 2.208-2.286, 1.568-3.061; SO2 = 1.679-1.622, 1.197-2.292; NO = 1.525-1.557, 1.094-2.181)
结论：急性毛细支气管炎发作后3个月、6个月和12个月的环境PM10、PM2.5、SO2和NO的存在与有急性毛细支气管炎病史的婴儿发生学龄前哮喘相关。
Air pollution after acute bronchiolitis is a risk factor for preschool asthma: a nested case-control study
H. W. Chung, H. M. Hsieh, C. H. Lee, Y. C. Lin, Y. H. Tsao, M. C. Feng, et al.
Abstract
BACKGROUND：Acute bronchiolitis and air pollution are both risk factor of pediatric asthma. This study aimed to assess subsequent exposure to air pollutants related to the inception of preschool asthma in infants with acute bronchiolitis.
METHODS：A nested case-control retrospective study was performed at the Kaohsiung Medical University Hospital systems between 2009 and 2019. The average concentration of PM10, PM2.5, SO2, NO, NO2, and NOX was collected for three, six, and twelve months after the first infected episode. Adjusted regression models were employed to evaluate the association between asthma and air pollution exposure after bronchiolitis.
RESULTS：Two thousand six hundred thirty-seven children with acute bronchiolitis were included. Exposure to PM10, PM2.5, SO2, NO, NO2, and NOX in the three, six, and twelve months following an episode of bronchiolitis was found to significantly increase the risk of preschool asthma in infants with a history of bronchiolitis.(OR, 95%CI: PM10 = 1.517-1.559, 1.354-1.744; PM2.5 = 2.510-2.603, 2.148-3.061; SO2 = 1.970-2.040, 1.724-2.342; ; NO = 1.915-1.950, 1.647-2.272; NO2 = 1.915-1.950, 1.647-2.272; NOX = 1.752-1.970, 1.508-2.252) In a sensitive analysis of hospitalized infants, only PM10, PM2.5, SO2, and NO were found to have significant effects during all time periods. (OR, 95%CI: PM10 = 1.613-1.650, 1.240-2.140; PM2.5 = 2.208-2.286, 1.568-3.061; SO2 = 1.679-1.622, 1.197-2.292; NO = 1.525-1.557, 1.094-2.181)
CONCLUSION：The presence of ambient PM10, PM2.5, SO2 and NO in the three, six, and twelve months following an episode of acute bronchiolitis has been linked to the development of preschool asthma in infants with a history of acute bronchiolitis.
背景：急性毛细支气管炎和空气污染是儿童哮喘的危险因素。本研究旨在评估与急性毛细支气管炎患儿发生学龄前哮喘相关的后续空气污染物暴露。
方法：本研究为巢式病例对照回顾性研究，于2009至2019年在高雄医科大学附属医院系统进行。收集首次感染后3、6、12个月PM10、PM2.5、SO2、NO、NO2、NOX的平均浓度。采用调整后的回归模型评估毛细支气管炎后哮喘与空气污染暴露的关联。
结果：共纳入2637例急性毛细支气管炎患儿。研究发现，在毛细支气管炎发作后的3个月、6个月和12个月暴露于PM10、PM2.5、SO2、NO、NO2和NOX显著增加有毛细支气管炎病史的婴儿发生学龄前哮喘的风险。(OR, 95%CI: PM10 = 1.517-1.559, 1.354-1.744; PM2.5 = 2.510-2.603, 2.148-3.061; SO2 = 1.970-2.040, 1.724-2.342; ; NO = 1.915-1.950, 1.647-2.272; NO2 = 1.915-1.950, 1.647-2.272; NOX = 1.752-1.970, 1.508-2.252)在住院婴儿的敏感分析中，仅PM10、PM2.5、SO2和NO在所有时间段均有显著影响。(OR, 95%CI: PM10 = 1.613-1.650, 1.240-2.140; PM2.5 = 2.208-2.286, 1.568-3.061; SO2 = 1.679-1.622, 1.197-2.292; NO = 1.525-1.557, 1.094-2.181)
结论：急性毛细支气管炎发作后3个月、6个月和12个月的环境PM10、PM2.5、SO2和NO的存在与有急性毛细支气管炎病史的婴儿发生学龄前哮喘相关。
（中日友好医院呼吸与危重症医学科 李春晓 摘译 林江涛 审校）
（Environmental Health 2023 Vol. 22 Issue 1 DOI: ARTN 8310.1186/s12940-023-01035-1）
（Environmental Health 2023 Vol. 22 Issue 1 DOI: ARTN 8310.1186/s12940-023-01035-1）
Air pollution after acute bronchiolitis is a risk factor for preschool asthma: a nested case-control study
H. W. Chung, H. M. Hsieh, C. H. Lee, Y. C. Lin, Y. H. Tsao, M. C. Feng, et al.
Abstract
BACKGROUND：Acute bronchiolitis and air pollution are both risk factor of pediatric asthma. This study aimed to assess subsequent exposure to air pollutants related to the inception of preschool asthma in infants with acute bronchiolitis.
METHODS：A nested case-control retrospective study was performed at the Kaohsiung Medical University Hospital systems between 2009 and 2019. The average concentration of PM10, PM2.5, SO2, NO, NO2, and NOX was collected for three, six, and twelve months after the first infected episode. Adjusted regression models were employed to evaluate the association between asthma and air pollution exposure after bronchiolitis.
RESULTS：Two thousand six hundred thirty-seven children with acute bronchiolitis were included. Exposure to PM10, PM2.5, SO2, NO, NO2, and NOX in the three, six, and twelve months following an episode of bronchiolitis was found to significantly increase the risk of preschool asthma in infants with a history of bronchiolitis.(OR, 95%CI: PM10 = 1.517-1.559, 1.354-1.744; PM2.5 = 2.510-2.603, 2.148-3.061; SO2 = 1.970-2.040, 1.724-2.342; ; NO = 1.915-1.950, 1.647-2.272; NO2 = 1.915-1.950, 1.647-2.272; NOX = 1.752-1.970, 1.508-2.252) In a sensitive analysis of hospitalized infants, only PM10, PM2.5, SO2, and NO were found to have significant effects during all time periods. (OR, 95%CI: PM10 = 1.613-1.650, 1.240-2.140; PM2.5 = 2.208-2.286, 1.568-3.061; SO2 = 1.679-1.622, 1.197-2.292; NO = 1.525-1.557, 1.094-2.181)
CONCLUSION：The presence of ambient PM10, PM2.5, SO2 and NO in the three, six, and twelve months following an episode of acute bronchiolitis has been linked to the development of preschool asthma in infants with a history of acute bronchiolitis.
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母亲罹患哮喘的婴幼儿的呼出气一氧化氮与空气污染物之间相关性分析
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瑞士阿尔卑斯山儿科队列中的环境暴露和致敏模式
