Weiss S T, Horner A, Shapiro G, Sternberg A L
Brigham and Women's Hospital, Channing Laboratory, Boston, MA, USA.
J Allergy Clin Immunol. 2001 Apr;107(4):634-40. doi: 10.1067/mai.2001.113869.
The Childhood Asthma Management Program, a 5-year randomized clinical trial of treatments for childhood asthma, has enrolled and characterized a cohort of 1041 children with mild-to-moderate asthma.
We sought to describe self-reported sensitivities and environmental exposures and investigate the relationships between self-report of these exposures as asthma triggers and their prevalence in the home.
Self-reports of sensitivities and home exposures were obtained by interview with the child or parent. Sensitivities were further assessed by using allergy skin testing (prick or puncture) against a core battery of allergens. Home exposures were further assessed by using analysis of a home dust sample.
Environmental exposures were surprisingly common despite self-reported sensitivities to environmental factors. Of patients reporting that cigarette smoking frequently causes asthma symptoms, 26% reported having at least one parent who smokes cigarettes. Thirty-nine percent of patients reporting that exposure to animals frequently causes asthma symptoms live with a furry pet in their home. We found a smaller proportion of homes with a high level of cat allergen (P <.001) among the children who reported that animals frequently or always trigger asthma symptoms compared with those who reported that animals never or occasionally trigger asthma symptoms, suggesting modification of the home environment. No such results were seen for dog exposure. However, clinical symptoms did not reduce exposure to parental cigarette smoking (P =.15), house dust (P =.31), or damp and musty areas (P =.51).
These data suggest that children with mild-to-moderate asthma are frequently symptomatic and exposed to a wide variety of environmental exposures that are perceived to trigger symptoms by means of self-report. Although environmental modification of asthmatic homes may occur, many children remain exposed to agents that are known to trigger their asthma.
儿童哮喘管理项目是一项针对儿童哮喘治疗的为期5年的随机临床试验，已招募并描述了1041名轻至中度哮喘儿童的队列特征。
我们试图描述自我报告的敏感性和环境暴露情况，并调查这些暴露作为哮喘触发因素的自我报告与它们在家庭中的患病率之间的关系。
通过与儿童或家长访谈获取敏感性和家庭暴露的自我报告。通过对一组核心过敏原进行过敏皮肤试验（点刺或皮内注射）进一步评估敏感性。通过对家庭灰尘样本进行分析进一步评估家庭暴露情况。
尽管自我报告对环境因素敏感，但环境暴露却出奇地普遍。在报告吸烟经常导致哮喘症状的患者中，26%报告至少有一位家长吸烟。在报告接触动物经常导致哮喘症状的患者中，39%家中养有带毛宠物。我们发现，与报告动物从不或偶尔触发哮喘症状的儿童相比，报告动物经常或总是触发哮喘症状的儿童家中猫过敏原水平高的比例较小（P<.001），这表明家庭环境需要改善。对于接触狗的情况，未发现此类结果。然而，临床症状并未减少对父母吸烟（P =.15）、房屋灰尘（P =.31）或潮湿发霉区域（P =.51）的暴露。
这些数据表明，轻至中度哮喘儿童经常出现症状，并暴露于多种通过自我报告被认为会触发症状的环境暴露中。尽管哮喘家庭可能会进行环境改善，但许多儿童仍然暴露于已知会触发其哮喘的因素中。
