儿童哮喘症状的季节性差异
2011/10/13
摘要
前言：哮喘是一种公认的随季节变化的疾病。本研究利用一组用药哮喘患儿，描述哮喘症状和哮喘治疗的季节变化形式，研究儿童期哮喘季节变化的决定因素。
方法：参与儿童哮喘用药遗传药理学和哮喘抗炎治疗队列研究的602名儿童入选本研究。向患儿父母询问患儿过去1年中呼吸道症状和哮喘快速缓解用药情况。Logistic回归分析用于研究哮喘控制季节变化的决定因素（哮喘控制水平通过症状、活动受限和缓解用药来评价）。
结果：哮喘症状和哮喘用药在夏季较少见，峰值出现在秋季至春季。喘息的发病率为32%（夏季）至56%（秋季）。呼吸道症状和用药在夏季显著减少(p < 0.0001)。口服类固醇激素和抗生素以及父母必要的信心与哮喘未控制相关，该相关性与季节无关。过敏性鼻炎与春季（OR：1.9; 95%CI：1.3-2.8）和夏季(OR: 1.9; 95% CI: 1.2-3.0)哮喘未控制风险增加相关。湿疹与秋季(OR: 1.5; 95% CI: 1.0-2.2)和冬季(OR: 1.3; 95% CI: 1.0-1.9)哮喘未控制风险增加相关。
结论：哮喘症状和哮喘药物治疗的季节性变化。春季和夏季过敏性鼻炎与哮喘控制相关，冬季和秋季湿疹与哮喘未控制相关。哮喘发病及治疗的季节性特点与过敏性体质及病毒感染的相关性最为密切，而后两者常见于秋、冬和春三季。
(林江涛 审校)
J Asthma. 2011 Sep;48(7):694-700. Epub 2011 Aug 2.
Asthma Symptoms in Pediatric Patients: Differences throughout the Seasons.
Koster ES, Raaijmakers JA, Vijverberg SJ, van der Ent CK, Maitland-van der Zee AH.
Source
Division of Pharmacoepidemiology & Pharmacotherapy, Faculty of Science, Utrecht Institute for Pharmaceutical Sciences (UIPS), Utrecht University , Utrecht , The Netherlands.
Abstract
INTRODUCTION：Seasonal variation in asthma has been widely recognized. The aim of this study was to describe seasonal patterns of asthma symptoms and asthma medication use in a cohort of pediatric asthma medication users and to study determinants of seasonal childhood asthma.
METHODS：For this study, 602 children participating in the Pharmacogenetics of Asthma medication in Children: Medication with Anti-inflammatory effects) cohort were included. Parents were asked about their child’s respiratory symptoms and quick-reliever medication use over the past year. Logistic regression analysis was used to study determinants of seasonality in asthma control (the level of disease control based on symptoms, limitations in activities, and rescue medication use).
RESULTS：There was a decline in asthma symptoms and asthma medication use during the summer period and a peak occurred from autumn to spring. The prevalence of wheeze ranged from 32% in summer to 56% in autumn. The prevalence of respiratory symptoms and medication use was significantly lower during summer (p < .0001). Oral steroids and antibiotics use and strong parental necessity beliefs were associated with uncontrolled asthma, regardless of seasonality. Allergic rhinitis was associated with an increased risk of uncontrolled asthma during spring [odds ratio (OR): 1.9; 95% confidence interval (CI): 1.3-2.8] and summer (OR: 1.9; 95% CI: 1.2-3.0). Eczema was associated with a higher risk of uncontrolled asthma during autumn (OR: 1.5; 95% CI: 1.0-2.2) and winter (OR: 1.3; 95% CI: 1.0-1.9).
CONCLUSION：We showed seasonal patterns in asthma symptoms and medication use. Associations were shown between allergic rhinitis and asthma control during spring/summer and eczema was associated with uncontrolled asthma during autumn/winter. Seasonality in asthma morbidity and health-care use is most likely associated with atopic constitution and viral infections, which are common during fall, winter, and spring.
J Asthma. 2011 Sep;48(7):694-700. Epub 2011 Aug 2.
前言：哮喘是一种公认的随季节变化的疾病。本研究利用一组用药哮喘患儿，描述哮喘症状和哮喘治疗的季节变化形式，研究儿童期哮喘季节变化的决定因素。
方法：参与儿童哮喘用药遗传药理学和哮喘抗炎治疗队列研究的602名儿童入选本研究。向患儿父母询问患儿过去1年中呼吸道症状和哮喘快速缓解用药情况。Logistic回归分析用于研究哮喘控制季节变化的决定因素（哮喘控制水平通过症状、活动受限和缓解用药来评价）。
结果：哮喘症状和哮喘用药在夏季较少见，峰值出现在秋季至春季。喘息的发病率为32%（夏季）至56%（秋季）。呼吸道症状和用药在夏季显著减少(p < 0.0001)。口服类固醇激素和抗生素以及父母必要的信心与哮喘未控制相关，该相关性与季节无关。过敏性鼻炎与春季（OR：1.9; 95%CI：1.3-2.8）和夏季(OR: 1.9; 95% CI: 1.2-3.0)哮喘未控制风险增加相关。湿疹与秋季(OR: 1.5; 95% CI: 1.0-2.2)和冬季(OR: 1.3; 95% CI: 1.0-1.9)哮喘未控制风险增加相关。
结论：哮喘症状和哮喘药物治疗的季节性变化。春季和夏季过敏性鼻炎与哮喘控制相关，冬季和秋季湿疹与哮喘未控制相关。哮喘发病及治疗的季节性特点与过敏性体质及病毒感染的相关性最为密切，而后两者常见于秋、冬和春三季。
(林江涛 审校)
J Asthma. 2011 Sep;48(7):694-700. Epub 2011 Aug 2.
Asthma Symptoms in Pediatric Patients: Differences throughout the Seasons.
Koster ES, Raaijmakers JA, Vijverberg SJ, van der Ent CK, Maitland-van der Zee AH.
Source
Division of Pharmacoepidemiology & Pharmacotherapy, Faculty of Science, Utrecht Institute for Pharmaceutical Sciences (UIPS), Utrecht University , Utrecht , The Netherlands.
Abstract
INTRODUCTION：Seasonal variation in asthma has been widely recognized. The aim of this study was to describe seasonal patterns of asthma symptoms and asthma medication use in a cohort of pediatric asthma medication users and to study determinants of seasonal childhood asthma.
METHODS：For this study, 602 children participating in the Pharmacogenetics of Asthma medication in Children: Medication with Anti-inflammatory effects) cohort were included. Parents were asked about their child’s respiratory symptoms and quick-reliever medication use over the past year. Logistic regression analysis was used to study determinants of seasonality in asthma control (the level of disease control based on symptoms, limitations in activities, and rescue medication use).
RESULTS：There was a decline in asthma symptoms and asthma medication use during the summer period and a peak occurred from autumn to spring. The prevalence of wheeze ranged from 32% in summer to 56% in autumn. The prevalence of respiratory symptoms and medication use was significantly lower during summer (p < .0001). Oral steroids and antibiotics use and strong parental necessity beliefs were associated with uncontrolled asthma, regardless of seasonality. Allergic rhinitis was associated with an increased risk of uncontrolled asthma during spring [odds ratio (OR): 1.9; 95% confidence interval (CI): 1.3-2.8] and summer (OR: 1.9; 95% CI: 1.2-3.0). Eczema was associated with a higher risk of uncontrolled asthma during autumn (OR: 1.5; 95% CI: 1.0-2.2) and winter (OR: 1.3; 95% CI: 1.0-1.9).
CONCLUSION：We showed seasonal patterns in asthma symptoms and medication use. Associations were shown between allergic rhinitis and asthma control during spring/summer and eczema was associated with uncontrolled asthma during autumn/winter. Seasonality in asthma morbidity and health-care use is most likely associated with atopic constitution and viral infections, which are common during fall, winter, and spring.
J Asthma. 2011 Sep;48(7):694-700. Epub 2011 Aug 2.
上一篇：
父母报告有肺炎病史的哮喘少年儿童是否易发需治疗的呼吸道疾病
下一篇：
学龄前城市儿童哮喘远期发病预测
