与重度哮喘相关的因素。

Factors associated with severe asthma.

作者信息

Ratageri V H, Kabra S K, Dwivedi S N, Seth V

机构信息

Department of Pediatrics, All India Institute of Medical Sciences, New Delhi 110 029, India.

出版信息

Indian Pediatr. 2000 Oct;37(10):1072-82.

PMID:11042705

Abstract

OBJECTIVE

To study the role of various factors associated with development and severity of bronchial asthma in children between 5-15 years of age.

SETTING

Tertiary Care Medical College Hospital.

METHODS

A case control study was carried out during May 96 to April 98. Sixty children each suffering from mild (chronic) and severe asthma (chronic) and 60 controls were enrolled to study the association of various risk factors with development of asthma and for severe disease.

RESULTS

On univariate analysis factors associated with significant risk for development of asthma included family history of asthma (p = 0.003), lack of exclusive breastfeeding (p = 0.05), past history of bronchiolitis (p = 0.02), associated allergic rhinitis (p = 0.04) and atopic dermatitis (p = 0.01). For development of severe asthma, associated factors were early onset of symptoms (p = 0.01), family history of asthma in grandparents (p = 0.04) and more than 10 cigarettes per day smoked by any family member. No significant effect of air pollution, overcrowding, pets and passive smoking were found on either development of asthma or it's severity. On multivariate analysis only age of onset below 48 months was associated with severe asthma (OR 2.13, 95% CI 1.00-4.54). Exclusive breastfeeding for more than 4 months was the most protective factor for development of asthma (OR 0.25, 95% CI 0.08-0.70). A strong association between development of asthma and past history of bronchiolitis or tuberculosis (OR 5.26, 95% CI 1.7-16.20) and presence of associated atopic dermatitis or rhinitis (OR 7.5, 95% CI 1.64-34.48) was observed.

CONCLUSION

History of associated allergic diseases and past history of bronchiolitis were significantly associated with development of asthma. Exclusive breastfeeding for first 4 months of life was protective. The most significant factor associated with severe asthma was onset of illness before 48 months of age. There was no significant effect of air pollution, over crowding, pets at home or passive smoking on severity of asthma

摘要

目的

研究5至15岁儿童中与支气管哮喘发生及严重程度相关的各种因素的作用。

地点

三级医疗医学院附属医院。

方法

于1996年5月至1998年4月进行了一项病例对照研究。招募了60名患有轻度（慢性）和重度哮喘（慢性）的儿童以及60名对照，以研究各种危险因素与哮喘发生及严重疾病的关联。

结果

单因素分析显示，与哮喘发生显著风险相关的因素包括哮喘家族史（p = 0.003）、非纯母乳喂养（p = 0.05）、既往细支气管炎病史（p = 0.02）、伴发过敏性鼻炎（p = 0.04）和特应性皮炎（p = 0.01）。对于重度哮喘的发生，相关因素有症状早发（p = 0.01）、祖父母有哮喘家族史（p = 0.04）以及任何家庭成员每天吸烟超过10支。未发现空气污染、居住拥挤、宠物和被动吸烟对哮喘发生或严重程度有显著影响。多因素分析显示，仅发病年龄低于48个月与重度哮喘相关（OR 2.13，95% CI 1.00 - 4.54）。纯母乳喂养超过4个月是哮喘发生的最具保护作用的因素（OR 0.25，95% CI 0.08 - 0.70）。观察到哮喘发生与既往细支气管炎或结核病病史（OR 5.26，95% CI 1.7 - 16.20）以及伴发特应性皮炎或鼻炎（OR 7.5，95% CI 1.64 - 34.48）之间存在强关联。