哮喘联盟

   摘要
   背景：哮喘患病率在几个而非所有区域持续大量增加。尽管已经确定了个体危险因素，但观察到患病率趋势的原因在很大程度上是未知的。
   目的：本研究旨在显示什么危险因素伴随哮喘患病率的趋势
   方法：对来自相同的瑞典研究区域7～8岁儿童进行基于两个人群的队列研究，通过展开ISAAC问卷调查，比较10年的差距。1996年和2006年分别完成了3430（97％的参与）和2585（96％参与）份问卷调查。1996年有2148（88％参与），2006年有1700（90％参与）的儿童完成了皮肤点刺试验。采用患病率和每个危险因素的多变量优势比来计算校正人群归因分数（aPAF）。
   结果：1996年和2006年哮喘和喘息的患病率是相似的，而变应性致敏却从21％增加到30％。父母哮喘的患病率从17％增加到24％，而呼吸道感染率（60％降至29％）和母亲吸烟率（32％降至16％）逐渐下降。1996年-2006年哮喘非环境危险因素的aPAFs增加：变应性致敏从35％增加到41％，父母哮喘从27％增加到45％，男性从20％增加到25％。相反的，环境危险因素的aPAFs下降：呼吸道感染从36％降至32％，潮湿的家和母亲吸烟分别从14％和19％降至2006年接近于零。
   结论和临床意义：从1996年到2006年，非环境危险因素如父母哮喘，变应性致敏和男性对7～8岁儿童哮喘有增加或不变的重要性。暴露于潮湿室内环境、呼吸道感染和母亲吸烟的重要性下降。这种危险因素的平衡可以解释哮喘的患病率水平。这篇文章受版权保护。
 

（林江涛 审校）
Clin Exp Allergy. 2014 Oct 16. doi: 10.1111/cea.12439. [Epub ahead of print]


 

Decreased importance of environmental risk factors for childhood asthma from 1996 to 2006.
 

Bjerg A1, Hedman L, Perzanowski M, Wennergren G, Lundbäck B, Rönmark E.
 

ABSTRACT
BACKGROUND: The large increase in asthma prevalence continues in several, but not all areas. Despite the individual risk factors that have been identified, the reasons for the observed trends in prevalence are largely unknown.
OBJECTIVE: This study sought to characterize what trends in risk factors accompanied trends in asthma prevalence.
METHODS: Two population-based cohorts of 7-8-year-old children from the same Swedish study areas examined by expanded ISAAC questionnaires were compared 10 years apart. In 1996 3,430 (97% participation) and in 2006 2,585 (96% participation) questionnaires were completed. A subset was skin-prick tested: in 1996, 2,148 (88% participation) and in 2006, 1,700 (90% participation) children. The adjusted population attributable fraction (aPAF) was calculated using the prevalence and multivariate odds ratio of each risk factor.
RESULTS: The prevalence of current asthma and wheeze were similar in 1996 and 2006. Allergic sensitisation however increased from 21% to 30%. The prevalence of parental asthma increased from 17% to 24% while respiratory infections and maternal smoking decreased (60% to 29% and 32% to 16%, respectively). The aPAFs of non-environmental risk factors for current asthma increased 1996-2006: Allergic sensitization from 35% to 41%, parental asthma from 27% to 45% and male sex from 20% to 25%. Conversely, the aPAFs of environmental risk factors decreased: Respiratory infections from 36% to 32% and damp home and maternal smoking from 14% and 19% respectively to near zero in 2006.
CONCLUSIONS AND CLINICAL RELEVANCE: From 1996 to 2006 the non-environmental risk factors parental asthma, allergic sensitisation and male sex had an increasing or constant importance for current asthma in 7-8-year-old children. The importance of the environmental exposures damp home, respiratory infections and maternal smoking decreased. This counter-balancing in risk factors may explain the level prevalence of current asthma. This article is protected by copyright.
 

Clin Exp Allergy. 2014 Oct 16. doi: 10.1111/cea.12439. [Epub ahead of print]