哮喘联盟

   摘要
   目的：对于描述了所有环境暴露与儿童（平均年龄≤9岁）哮喘症状和急性发作相关性的文献作一系统综述。
   研究设计：系统综述。
   机构：在电子数据库中(MEDLINE, EMBASE, CINAHL, Cochrane Controls Trials Register)搜索直到2013年11月发表的所有文章，确定的研究和综述纳入参考文献列表中。
   受试者：受试者为所入选的评估环境因素暴露与哮喘症状和急性发作相关性研究中的儿童，平均年龄≤9岁。
   主要和次要结果评估：哮喘症状、哮喘控制和急性发作的指标
   结果：共纳入27项研究，其中包括8项吸入过敏原研究和4项兴趣暴露的环境性吸烟(ETS)研究。有证据表明过敏源、ETS、空气质量差以及无烟囱取暖的暴露具有较小的影响轻度(ORs 在2–3之间)。也有证据观察到暴露因素间如过敏源和ETS之间的相互作用。
   结论：吸入过敏源、ETS、无烟囱取暖器以及不良空气质量的暴露对哮喘幼儿急性发作具有重要的影响，应该被减至最小限度或避免（理想情况）。更好的认识潮湿住房、空调以及饮食因素暴露的影响加上环境暴露因素间的相互作用与急性发作间的关系是必要的。
 

（林江涛 审校）
BMJ Open. 2014 Feb 12;4(2):e003827. doi: 10.1136/bmjopen-2013-003827.


 

Associations between environmental exposures and asthma control and exacerbations in young children: a systematic review.
 

Dick S, Doust E, Cowie H, Ayres JG, Turner S.

Abstract
OBJECTIVE: To complete a systematic review of the literature describing associations between all environmental exposures and asthma symptoms and exacerbations in children up to mean age of 9 years.
DESIGN: Systematic review.
SETTING: Reference lists of identified studies and reviews were searched for all articles published until November 2013 in electronic databases (MEDLINE, EMBASE, CINAHL, Cochrane Controls Trials Register).
PARTICIPANTS: Studies were selected which examined a link between exposure to environmental factors and asthma symptoms and exacerbations where the study participants were children with a mean age of ≤9 years.
PRIMARY AND SECONDARY OUTCOME MEASURES: Indices of asthma symptoms, control and exacerbations.
RESULTS: A total of 27 studies were identified including eight where inhaled allergens and four where environmental tobacco smoke (ETS) were the exposures of interest. There was evidence that exposure to allergen, ETS, poor air quality and unflued heaters had a modest magnitude of effect (ORs between 2 and 3). There was also evidence of interactions observed between exposures such as allergen and ETS.
CONCLUSIONS: Exposure to inhaled allergens, ETS, unflued heaters and poor air quality has an important effect on exacerbations in young children with asthma and should be minimised or, ideally, avoided. Better understanding of the effect of exposure to damp housing, air conditioning and dietary factors plus interactions between environmental exposures associated with exacerbations is required.
 

BMJ Open. 2014 Feb 12;4(2):e003827. doi: 10.1136/bmjopen-2013-003827.