童年农场生活为青春期后期哮喘的保护性因素，能降低哮喘发病率
2011/01/27
摘要
儿童期哮喘的发病率和危险因素已经得到广泛的研究，但有关青春期后期的相关证据较为缺乏。本试验旨在儿童期向成人期过渡的青春期后期哮喘人群中，研究哮喘的发病率及其危险因素。此外，分析哮喘发病率是否下降。针对哮喘和呼吸道症状及其哮喘可能危险因素的详细问卷调查表，通过邮寄的方式对瑞典哥德堡及其周围西部地区的30000名随机选择的16～75岁研究对象进行大规模调查。本研究收集来自1261名16～20岁人群（560名男性，701名女性）的数据。医生诊断的哮喘患病率为9.5％，而9.6％的患者主诉采用哮喘药物治疗。多变量分析显示，医生诊断的哮喘及其他哮喘变量最强的危险因素是哮喘的遗传性和过敏症的遗传性，特别是两者同时存在时。在农场长大的人群中，由医生诊断的哮喘患病率和使用哮喘药物治疗的概率显著降低（OR 0.1；95% CI 0.02-0.95）。吸烟能增加喘息复发、长期咳嗽和咳痰等风险。总之，16～20岁的年轻人，在20世纪50年代至90年代间，由医生诊断的哮喘患病率和哮喘药物使用显著增加，但本研究显示，上述指标的增加目前得到一定缓解。与卫生学假设相一致的是，在农场生长的人群，其哮喘患病可能性显著降低。此外，我们同样在年轻人群中观察到了吸烟对哮喘的不良影响。
（陈欣 审校）
Pediatr Allergy Immunol. 2010 Aug;21(5):806-13. Epub 2010 Apr 8
Asthma in late adolescence--farm childhood is protective and the prevalence increase has levelled off.
Wennergren G, Ekerljung L, Alm B, Eriksson J, Lötvall J, Lundbäck B.
Krefting Research Centre, Department of Medicine, Sahlgrenska Academy at University of Gothenburg, Gothenburg, Sweden. goran.wennergren@pediat.gu.se
Abstract
While the prevalence of and risk factors for asthma in childhood have been studied extensively, the data for late adolescence are more sparse. The aim of this study was to provide up-to-date information on the prevalence of and risk factors for asthma in the transitional period between childhood and adulthood. A secondary aim was to analyze whether the increase in asthma prevalence has levelled off. A large-scale, detailed postal questionnaire focusing on asthma and respiratory symptoms, as well as possible risk factors, was mailed to 30 000 randomly selected subjects aged 16-75 in Gothenburg and the surrounding western Sweden region. The present analyses are based on the responses from 1261 subjects aged 16-20 (560 men and 701 women). The prevalence of physician-diagnosed asthma was 9.5%, while 9.6% reported the use of asthma medicine. In the multivariate analysis, the strongest risk factors for physician-diagnosed asthma and other asthma variables were heredity for asthma and heredity for allergy, particularly if they occurred together. Growing up on a farm significantly reduced the prevalence of physician-diagnosed asthma and the likelihood of using asthma medication, OR 0.1 (95% CI 0.02-0.95). Smoking increased the risk of recurrent wheeze, long-standing cough, and sputum production. In conclusion, the prevalence of physician-diagnosed asthma and the use of asthma medication in the 16- to 20-yr age group support the notion that the increase in asthma prevalence seen between the 1950s and the 1990s has now levelled off. In line with the hygiene hypothesis, a farm childhood significantly reduced the likelihood of asthma. The adverse effects of smoking could already be seen at this young age.
上一篇：
儿童哮喘自然病程的长期研究
下一篇：
哮喘青少年的饮食摄入：有待改善
