Rönmark E, Jönsson E, Platts-Mills T, Lundbäck B
OLIN Study Group, Department of Medicine, Sunderby Central Hospital of Norrbotten, Luleå, Sweden.
Pediatrics. 2001 Mar;107(3):E37. doi: 10.1542/peds.107.3.e37.
An increasing prevalence of asthma has been reported worldwide as well as in Sweden. In 1996, the prevalence of asthma and type 1 allergy was investigated in a cohort of 3525 children 7 and 8 years old in 3 areas of northern Sweden. The aim of the present study was to estimate the incidence of asthma and to identify risk factors for incident cases over 1 year.
The study started with a parental questionnaire, the International Study of Asthma and Allergies in Childhood questionnaire with additional questions, a skin prick test, and a validation study. The cohort was followed up after 1 year with the same questions. The response rate to the questionnaire was 97% in 1996, and 3339 children (97%) participated both in 1996 and 1997.
The incidence of physician-diagnosed asthma was 0.9/100/year; of wheezing, 3.8/100/year; and of new frequent or daily users of asthma medicines, 1.1/100/year. There was no difference by sex. The risk factor pattern based on incident cases of asthma was different from that based on prevalent cases. Significant risk factors for incident asthma were a positive skin test (odds ratio [OR]: 9.3; 95% confidence interval [CI]: 3.8-22.7); low birth weight (OR: 7.4; 95% CI: 2.2-24.5); and family history of asthma (OR: 2.6; 95% CI: 1.1-6.3). Having or having had pets at home was associated with a decreased risk for asthma and wheezing based on prevalent cases, although it was associated with an increased risk for incidence of wheezing (OR: 2.9; 95% CI: 1.3-6.2). Remission of asthma, which was reported by 10% of the children with current asthma during 1 year, was associated with a negative skin test.
The incidence of asthma at the age of 8 years was high, but remission was also common. Important risk factors for the development of asthma at this age were type 1 allergy, low birth weight, and family history of asthma. Furthermore, the results suggest that in a region where sensitivity to domestic animals is a strong risk factor for asthma, the presence of pets in the home may have different effects in early childhood compared with later in childhood.
据报道，全球以及瑞典哮喘的患病率都在上升。1996年，在瑞典北部3个地区对3525名7至8岁儿童组成的队列进行了哮喘和1型过敏患病率调查。本研究的目的是估计哮喘的发病率，并确定1年内新发病例的危险因素。
研究始于一份家长问卷、儿童哮喘和过敏国际研究问卷（附额外问题）、皮肤点刺试验以及一项验证研究。1年后对该队列进行相同问题的随访。1996年问卷的回复率为97%，3339名儿童（97%）在1996年和1997年都参与了研究。
医生诊断的哮喘发病率为0.9/100/年；喘息发病率为3.8/100/年；新的哮喘药物频繁或每日使用者发病率为1.1/100/年。发病率不存在性别差异。基于哮喘新发病例的危险因素模式与基于现患病例的不同。哮喘新发病例的显著危险因素包括皮肤试验阳性（比值比[OR]：9.3；95%置信区间[CI]：3.8 - 22.7）；低出生体重（OR：7.4；95%CI：2.2 - 24.5）；以及哮喘家族史（OR：2.6；95%CI：1.1 - 6.3）。基于现患病例，家中有或曾有宠物与哮喘和喘息风险降低相关，尽管与喘息发病率增加相关（OR：2.9；95%CI：1.3 - 6.2）。1年内，10%的现患哮喘儿童报告哮喘缓解，这与皮肤试验阴性相关。
8岁儿童哮喘发病率较高，但缓解也很常见。该年龄段哮喘发病的重要危险因素是1型过敏、低出生体重和哮喘家族史。此外，结果表明，在一个对家畜过敏是哮喘重要危险因素的地区，家中饲养宠物在儿童早期与儿童后期可能有不同影响。
