Leung Ting-fan, Lam Christopher W K, Chan Iris H S, Li Albert M, Ha Gladys, Tang Nelson L S, Fok Tai-fai
Department of Paediatrics, The Chinese University of Hong Kong, Prince of Wales Hospital, Hong Kong SAR.
J Asthma. 2002 Jun;39(4):323-30. doi: 10.1081/jas-120002289.
Sensitization to aeroallergens has been found to be a dominant risk factor for asthma in population-based studies. Similar results in asthmatic children being managed in hospital-affiliated outpatient clinic have not been established. We therefore conducted a case-control study on asthmatic children attending a university hospital-based outpatient clinic to investigate the pattern of aeroallergen sensitization and to assess the correlation between asthma control and the presence of allergen-specific IgE-s. Asthmatic patients underwent a questionnaire assessment of their asthma control, skin prick tests (SPT) for allergen sensitization, and spirometric evaluation. Peripheral blood was collected from all subjects for in vitro serum specific IgE assay (RAST) to common aeroallergens. One hundred and seventy asthmatics (aged 9.8 +/- 3.7 years) and 57 age-matched control subjects were enrolled. Our patients had a median of two asthmatic attacks within 6 months prior to evaluation, and their median Disease Severity Score was 13. The median FEV1 in our asthmatic children was 98%, whereas serum logarithmic total IgE concentrations in patients and controls were 2.57 and 2.09, respectively (p < 0.0001). More than 85% of our asthmatic children were sensitized to house-dust mite (HDM), and sensitization to HDM and cat, as well as elevated serum total IgE concentration, was a significant risk factor for the development of asthma in this cohort. Several objective measures of asthma severity, as well as FEV1, correlated significantly with sensitization to HDM, pets, and cockroaches. In conclusion, indoor aeroallergens are one of the risk factors for the development and severity of mild-to-moderate asthma in Chinese children in Hong Kong.
在基于人群的研究中，已发现对空气过敏原致敏是哮喘的主要危险因素。在医院附属门诊治疗的哮喘儿童中，尚未证实有类似结果。因此，我们对在大学医院门诊就诊的哮喘儿童进行了一项病例对照研究，以调查空气过敏原致敏模式，并评估哮喘控制与过敏原特异性IgE存在之间的相关性。哮喘患者接受了哮喘控制的问卷调查评估、过敏原致敏的皮肤点刺试验（SPT）和肺功能评估。采集所有受试者的外周血用于体外检测对常见空气过敏原的血清特异性IgE（RAST）。招募了170名哮喘患者（年龄9.8±3.7岁）和57名年龄匹配的对照受试者。我们的患者在评估前6个月内哮喘发作的中位数为两次，其疾病严重程度评分中位数为13。我们哮喘儿童的FEV1中位数为98%，而患者和对照的血清对数总IgE浓度分别为2.57和2.09（p<0.0001）。超过85%的哮喘儿童对屋尘螨（HDM）致敏，对HDM和猫致敏以及血清总IgE浓度升高是该队列中哮喘发生的重要危险因素。哮喘严重程度的几项客观指标以及FEV1与对HDM、宠物和蟑螂的致敏显著相关。总之，室内空气过敏原是香港中国儿童轻度至中度哮喘发生和严重程度的危险因素之一。
