成年新患哮喘的危险因素：以群体为基础的国际队列研究
2010/12/07
摘要
背景：成人期新发哮喘比较常见，但是人们对于导致其发生的决定因素，包括特应性的作用，还是不够了解。
目的：对于中年成人新患哮喘发展的危险因素进行评估并根据特应性进行比较。
方法：对9175名分别加入欧洲共同体呼吸情况调查的两组青年持续九年的调查进行纵向分析。
发现：在4588名未曾患哮喘并在起初的随访中未患哮喘的参与者中有179例新患哮喘者（平均每年4.5‰）。我们对对该部分对象进行了观察，经过回归分析，发现以下危险因素会增加罹患哮喘的危险：女性（OR：1.97;95%（CI）：1.38，2.31），支气管高反应性（3.25；2.19，4.83），特应性（1.55；1.08，2.11），FEV1<100%预计值（1.87；1.34,2.62），气道高反应性（1.98；1.39,2.84）和遗传性哮喘（1.91,；1.13,3.21）。尽管具体作用仍有待确认，但肥胖症，早年的呼吸道感染和高危职业这些因素增加了新患哮喘的风险。在异位体质反应中，猫的总的IgE和致敏性与新增哮喘的风险是独立相关的。因特应性导致哮喘的比例在12%～21%。
总结：未曾罹患哮喘的成年人处于在包括肺功能在内的众多独立危险因素影响下的新患哮喘的巨大危险中。特应性只能解释新患哮喘原因中的一小部分。
(谢萌 首都儿科研究所 100020 摘译)
（Allergy. 2010 Feb 4）
（原文出自《Allergy》第65期，《Risk factors of new-onset asthma in adults:a population-based international cohort study》）
Risk factors of new-onset asthma in adults: a population-based international cohort study.
Allergy. 2010 Feb 4;
Authors: Antó JM, Sunyer J, Basagaña X, Garcia-Esteban R, Cerveri I, de Marco
R,Heinrich J, Janson C, Jarvis D, Kogevinas M, Kuenzli N, Leynaert B, Svanes C, Wjst
M, Gislason T, Burney P
To cite this article: Antó JM, Sunyer J, Basagaña X, Garcia-Esteban R, Cerveri I,
de Marco R, Heinrich J, Janson C, Jarvis D, Kogevinas M, Kuenzli N, Leynaert B, Svanes
C, Wjst M, Gislason T, Burney P. Risk factors of new-onset asthma in adults: a
population-based international cohort study. Allergy 2010; DOI:
10.1111/j.1398-9995.2009.02301.x
Abstract
Background: The occurrence of new-onset asthma during adulthood is common, but there
is insufficient understanding of its determinants including the role of atopy.
Objective: To assess the risk factors for the development of new-onset asthma in middle-aged adults and to compare them according to atopy.
Methods: A longitudinal analysis of 9175 young adults who participated in two surveys of the European Community Respiratory Health Survey (ECRHS) conducted 9 years apart.
Findings: We observed 179 cases of new-onset asthma among 4588 participants who were free of asthma and reported at the beginning of the follow-up that they had never had asthma (4.5 per 1000 person-years). In a logistic regression, the following risk factors were found to increase the risk of new-onset asthma: female gender (OR: 1.97; 95% confidence interval (CI): 1.38,2.81), bronchial hyperresponsiveness (3.25; 2.19,4.83), atopy (1.55;1.08,2.21), FEV(1) < 100 % predicted (1.87;1.34,2.62), nasal allergy (1.98;1.39,2.84) and maternal asthma (1.91;1.13;3.21). Obesity, respiratory infections in early life and high-risk occupations increased the risk of new-onset asthma although we had limited power to confirm their role. Among the atopics, total IgE and sensitization to cat were independently related to the risk of new-onset asthma. The proportion of new-onset asthma attributable to atopy varied from 12% to 21%.
Conclusion: Adults reporting that they had never had asthma were at a substantial
risk of new-onset asthma as a result of multiple independent risk factors including
lung function. Atopy explains a small proportion of new-onset adult asthma.
PMID: 20132157 [PubMed - as supplied by publisher]
Keywords:asthma;atopy;bronchialhyperresponsiveness;ERCHS;environment;lung fuction;respiratory symptoms
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经医生诊断的变应性鼻炎是否是哮喘发展中的危险因素？
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