Celedón J C, Palmer L J, Weiss S T, Wang B, Fang Z, Xu X
Channing Laboratory, Department of Medicine, Brigham and Women's Hospital, Boston, Massachusetts 02115, USA.
Am J Respir Crit Care Med. 2001 Apr;163(5):1108-12. doi: 10.1164/ajrccm.163.5.2005086.
In industrialized countries with a Western lifestyle, sensitization to perennial aeroallergens is strongly associated with asthma, whereas sensitization to seasonal aeroallergens is closely related to allergic rhinitis. Little is known, however, about the relation between skin test reactivity to aeroallergens and either asthma or rhinitis in mainland China. We studied 10,009 members of 2,544 families in Anqing (China) that were selected on the basis of physician-diagnosed asthma in at least two siblings. Generalized estimating equations were employed to study the association between skin test reactivity to aeroallergens and either asthma or rhinitis. After adjustment for age, sex, intensity of smoking, skin test reactivity to other aeroallergens, and household correlations, sensitization to dust mite was an independent predictor of both asthma (OR = 1.3, 95% CI = 1.1 to 1.5, p = 0.008) and rhinitis (OR = 1.3, 95% CI = 1.0 to 1.8, p = 0.04). Sensitization to mold was significantly associated with asthma (OR = 1.6, 95% CI = 1.1 to 2.3, p = 0.008), and sensitization to silk was an independent predictor of rhinitis (OR = 1.5, 95% CI = 1.1 to 2.2, p = 0.02). Although 46.9% of the study participants were sensitized to at least one allergen, only 3.5% of study subjects reported nasal symptoms consistent with rhinitis. Among asthmatic subjects, 6.2% reported nasal symptoms. Whereas sensitization to perennial aeroallergens was associated with asthma among families of asthmatic subjects in rural China, sensitization to silk was the strongest predictor of rhinitis in this population. Our findings also suggest that allergic rhinitis is far less common among asthmatic subjects in rural China than in asthmatic subjects in industrialized countries with a Western lifestyle.
在具有西方生活方式的工业化国家，对常年性气传变应原致敏与哮喘密切相关，而对季节性气传变应原致敏则与过敏性鼻炎密切相关。然而，关于中国大陆皮肤对气传变应原的试验反应性与哮喘或鼻炎之间的关系，人们了解甚少。我们在中国安庆对2544个家庭的10009名成员进行了研究，这些家庭是基于至少两个兄弟姐妹经医生诊断患有哮喘而挑选出来的。采用广义估计方程来研究皮肤对气传变应原的试验反应性与哮喘或鼻炎之间的关联。在对年龄、性别、吸烟强度、皮肤对其他气传变应原的试验反应性以及家庭相关性进行调整后，对尘螨致敏是哮喘（比值比[OR]=1.3，95%置信区间[CI]=1.1至1.5，p=0.008）和鼻炎（OR=1.3，95%CI=1.0至1.8，p=0.04）的独立预测因素。对霉菌致敏与哮喘显著相关（OR=1.6，95%CI=1.1至2.3，p=0.008），对蚕丝致敏是鼻炎的独立预测因素（OR=1.5，95%CI=1.1至2.2，p=0.02）。尽管46.9%的研究参与者对至少一种变应原致敏，但只有3.5%的研究对象报告有符合鼻炎的鼻部症状。在哮喘患者中，6.2%报告有鼻部症状。在中国农村哮喘患者家庭中，对常年性气传变应原致敏与哮喘相关，而对蚕丝致敏是该人群中鼻炎的最强预测因素。我们的研究结果还表明，中国农村哮喘患者中过敏性鼻炎的发生率远低于具有西方生活方式的工业化国家的哮喘患者。
