中国三城市儿童个人过敏原与喘息及气道高反应性的相关性研究  

Individual allergens as risk factors for asthma and bronchial hyperresponsiveness in Chinese children

作　　者：陈育智[1] 马煜[1] 王红玉[2] 王海俊[1] 赵京[1] 曹玲[1] 李硕[1] 黄永坚[3] 钟南山[2] 霍泰辉[3] 赖其伟[3] 

机构地区：[1]首都儿科研究所哮喘中心,北京100020 [2]广州呼吸病研究所 [3]香港中文大学威尔士亲王医院儿科

出　　处：《中华儿科杂志》2003年第7期538-541,共4页Chinese Journal of Pediatrics

摘　　要：目的　了解个人过敏原阳性与喘息及气道高反应性的关系。方法　在北京、广州及香港三城市中采用整群抽样的方法 ,在 9～ 11岁在校学龄儿童中 ,应用国际间儿童哮喘与过敏性疾病研究的第二阶段研究方案进行研究 ,内容包括 (1)家长书面问卷 (共收集问卷 10 90 2份 ) ,(2 )儿童皮肤过敏原点刺试验 (3478例 ) ,(3)乙酰甲胆碱支气管激发试验 (6 0 8例 )。结果　近期喘息 (在 12个月内有发作 )发生率 :北京 3.8%、广州 3.4 %、香港 5 .8%。特应性 (即≥ 1种过敏原阳性 )阳性率北京 2 3.9%、广州 30 .8%、香港 4 1.2 %。乙酰甲胆碱支气管激发试验阳性率 :北京 33.2 %、广州 4 5 .8%、香港 30 .7%。多因素logistic回归分析显示 ,屋尘螨P[相对危险度 (OR) =4 .4 8;95 %可信限 (CI) :3.0 2～ 6 .6 6 ]、猫毛 (OR =2 .5 9 ;95 %CI:1.6 7～ 4 .0 2 )、粉尘螨F(OR =2 .4 1;95 %CI :1.6 5～ 3.5 1)及混合草花粉过敏 (OR =2 .85 ;95 %CI :1.2 4～ 6 .5 0 )是近期喘息显著相关的危险因素 ;特应性 (OR =1.2 9;95 %CI:0 .74～ 2 .2 4 )与近期喘息无显著相关性。特应性 (OR =2 .5 3;95 %CI:1.0 7～ 5 .97)、猫毛 (OR =3.0 1;95 %CI:1.39～ 6 .5 2 )及粉尘螨F(OR =3.6 7;95 %CI:1.93～ 6 .97)是气道高反应性显著相关的危险因?Objective This study aimed to determine the relationship between individual allergens with current wheezing and bronchial hyperresponsiveness(BHR)in schoolchildren from three Chinese cities:Beijing,Guangzhou and Hong Kong.Methods Community_based random samples of 10-yr-old schoolchildren from the 3 cities were recruited for study using the Intemational Study of Asthma and Allergies in Childhood(ISAAC)Phase II protoco1.The subjects were studied by parental questionnaires(n=10 902),skin-prick tests(n=3 478),and methacholine challenge tests(n=608).Results The highest prevalence rates of wheezing in the past 12 months(Beijing,3.8%;Guangzhou,3.4%;Hong Kong,5.8%)and atopy (Beijing,23.9%;Guangzhou,30.8%;Hong Kong,41.2%,defined as having≥1 positive skin-prick tests,)were seen in schoolchildren from Hong Kong.The highest prevalence rates of BHR(Beijing,33.2%;Guangzhou,45.8%;Hang Kong, 30.7%)were seen in schoolchildren from Guangzhou. Multivariate-logistic.regression analyses revealed that sensitization to Dermatophagoides pteronyssinus[odds ratio(OR)=4.48;95%confidence interval(CI);3.02-6.66],cat(OR 2.85;95% CI 1.24—6.50),Dermatophagoides farinae(Df)(OR2.41,95% CI 1.65-3.51)and Mixed grass pollen (OR 2.85,95%CI,1.24-6.50)were significandy associated with current wheezing atopy(OR 1.29,95%CI 0.74-2.24).was not an independent risk factor for current wheezing in children from any of the threecities.Furthermore,atopy(OR=2.53:95%CI1.07-5.97),sensitization to cat(OR 3.01;95%,CI 1.39-6.54)and DF(OR 3.67;95% CI 1.93-6.97) were significantly associated with BHR.Conclusion The authors confirmed that sensitization to house dust mite and cat was significandy associated with currentwheezing and bronchial hyperresponsiveness in Chinese schoolchildren.

关 键 词：中国 儿童 过敏原 喘息 气道高反应性 相关性研究 哮喘 

分 类 号：R725.6[医药卫生—儿科]