宫内胚胎时期接触农作物有利于预防哮喘、干草热和湿疹
2009/03/06
关键词：哮喘；农村；卫生假说；出生前；时间点
为了评价影响农村儿童下呼吸道过敏性疾病发病的因素及接触时间点的重要性，Douwes等进行了一项交叉-分层问卷调查。调查1333例农村儿童和566例5～17岁对照儿童的哮喘、干草热和湿疹症状，以及他们现在、早期和出生前对农作物的接触情况。
调查发现，农村儿童哮喘和湿疹的发生率均较低。现在和孕期接触农作物（包括农畜和谷物）可以减少哮喘、干草热和湿疹的发病危险。对大多数指标而言，孕期接触的接触-反应的关系为非线性相关。经过相互性校正后，孕期接触对发病率的影响没有变化，而现在接触仅对哮喘治疗、以往哮喘和干草热等方面存在保护作用。扣除孕期接触影响，2岁内与农作物的接触与哮喘症状无关。孕期和现在都接触农作物与喘息(OR 0.48, 95% CI 0.28–0.80)、哮喘治疗药物(OR 0.50, 95% CI 0.30–0.82)、既往哮喘(OR 0.50, 95% CI 0.33–0.76)、干草热(OR 0.47, 95% CI 0.30–0.73)和湿疹(OR 0.46, 95% CI 0.30–0.70)的发生密切相关。
因此作者认为，农村儿童在孕期接触农作物有助于减少哮喘、干草热和湿疹的发病，但需要持续接触农作物以获得最佳的保护效果。
（韩伟 青岛大学医学院附属青岛市市立医院呼吸科 266071 摘译）
（Eur Respir J 2008; 32:603-611）
Eur Respir J 2008; 32:603-611
Farm exposure in utero may protect against asthma, hay fever and eczema
J. Douwes, S. Cheng, N. Travier,
Keywords: Asthma, farming, hygiene hypothesis, prenatal, timing
The aim of the present study was to assess which factors contribute to the lower prevalence of allergic diseases in farmers’ children, and the importance of timing of exposure.
In a cross-sectional questionnaire survey, asthma symptoms, hay fever and eczema were assessed, as well as current, early and prenatal farm-related exposures in 1,333 farmers’ children and 566 reference children aged 5–17 yrs.
Farmers’ children had a lower incidence of asthma symptoms and eczema. Current and maternal exposure during pregnancy to animals and/or grain and hay reduced the risk of asthma symptoms, hay fever and eczema. The exposure–response association for maternal exposure was nonlinear for most outcomes. After mutual adjustment, the effects of prenatal exposure remained unchanged whereas current exposure remained protective only for asthma medication, asthma ever and hay fever. Exposure during the first 2 yrs was not associated with symptoms, after controlling for prenatal exposure. A combination of prenatal and current exposure was most strongly associated with wheeze (odds ratio (OR) 0.48, 95% confidence interval (CI) 0.28–0.80), asthma medication (OR 0.50, 95% CI 0.30–0.82), asthma ever (OR 0.50, 95% CI 0.33–0.76), hay fever (OR 0.47, 95% CI 0.30–0.73) and eczema (OR 0.46, 95% CI 0.30–0.70).
Prenatal exposure may contribute to the low prevalence of asthma, hay fever and eczema in farmers’ children, but continued exposure may be required to maintain optimal protection.
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青春期室外游泳和哮喘的关系
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围产期死亡率的风险与妊娠期哮喘的关系
