[波兰学龄儿童特应性与支气管高反应性之间的关系]
[Relationships between atopy and bronchial hyper-reactivity in Polish school age children].
作者信息
Lis Grzegorz, Cichocka-Jarosz Ewa, Gazurek Dorota, Szczerbiński Tomasz, Głodzik Izabela, Sawiec Piotr, Białoruska Beata
机构信息
Oddział Pulmonologii i Alergologii, Klinika Chorób Dzieci Katedry Pediatrii Polsko-Amerykański Instytut Pediatrii Collegium Medicum Uniwersytetu Jagiellońskiego w Krakowie.
出版信息
Przegl Lek. 2002;59(10):780-4.
OBJECTIVE
To determine the prevalence of atopy and bronchial hyper-reactivity (BHR) and their relationship with wheezing and diagnosed asthma reported in schoolchildren.
MATERIAL AND METHODS
In Cracow, 1347 schoolchildren (9.7 +/- 0.7 yrs of age) were surveyed with ISAAC questionnaire. Skin prick tests with 7 aeroallergens and the exercise challenge test for BHR evaluation were carried out. Atopy was established when a positive skin reaction with at least one allergen occurred. The BHR was confirmed in presence of at least 15% decrease of the relative post-exercise peak expiratory flow (D% PEF) or wheezing during or immediately after exercise.
RESULTS
Atopy was found in 26.2% of schoolchildren, with a two-fold higher risk in boys/odds ratio (OR) = 2.14; 95% confidence interval (CI) (1.59-2.86)/. In the group of atopic children, wheeze in the last year and diagnosis of asthma occurred significantly more often. The risk of wheeze in last year related to the type of sensitizing allergen and was highest for Der. f./OR = 6.1; 95% CI (3.78-10.16)/, medium for allergens of trees, dog's fur, Der. p., cat's fur and grasses/OR = 5.17; 95% CI (2.27-11.76), OR = 4.36; 95% CI (2.35-8.13), OR = 4.00; 95% CI (3.12-8.01), OR = 3.86; 95% CI (2.18-6.82), OR = 2.58; 95% CI (1.50-4.45), respectively/. In case of Alternaria allergens no correlation with wheeze was observed/OR = 2.71; 95% CI (0.88-8.31)/. BHR was identified in 12.4% of schoolchildren and demonstrated a significant correlation with that reported in the questionnaire: wheeze in the last year/OR = 2.28; 95% CI (1.25-4.14)/, diagnosis of asthma/OR = 2.96; 95% CI (1.38-6.34)/and post-exercise wheeze/OR = 3.17; 95% CI (1.60-6.27)/. Moreover, a significant correlation was demonstrated between atopy and BHR/OR = 1.85; 95% CI (1.22-2.79)/. In the group of children without wheeze in the past and without diagnosis of asthma, BHR was significantly higher in atopic children (positive skin test to in-door allergens) comparing to non-atopic ones, mean D% PEF values were 3.95%, -0.39%, respectively (p. = 0.0014).
CONCLUSIONS
In children, there is a significant correlation between atopy and BHR, modified by individual history of wheeze or asthma, sex and allergen type.
目的
确定学龄儿童中特应性疾病和支气管高反应性（BHR）的患病率及其与喘息和确诊哮喘的关系。
材料与方法
在克拉科夫，对1347名学龄儿童（9.7±0.7岁）进行了国际儿童哮喘及变应性疾病研究（ISAAC）问卷调查。进行了针对7种气传变应原的皮肤点刺试验和用于评估BHR的运动激发试验。当出现至少一种变应原的阳性皮肤反应时，确定为特应性。当运动后呼气峰值流速相对下降至少15%（D%PEF）或运动期间或运动后立即出现喘息时，确认存在BHR。
结果
26.2%的学龄儿童患有特应性疾病，男孩的患病风险高出两倍/优势比（OR）=2.14；95%置信区间（CI）（1.59 - 2.86）/。在特应性儿童组中，去年喘息和哮喘诊断的发生率明显更高。去年喘息的风险与致敏变应原的类型有关，对于粉尘螨/OR = 6.1；95%CI（3.78 - 10.16）/最高，对于树木、狗毛、屋尘螨、猫毛和草类变应原中等/OR = 5.17；95%CI（2.27 - 11.76），OR = 4.36；95%CI（2.35 - 8.13），OR = 4.00；95%CI（3.12 - 8.01），OR = 3.86；95%CI（2.18 - 6.82），OR = 2.58；95%CI（1.50 - 4.45），分别/。对于链格孢属变应原，未观察到与喘息的相关性/OR = 2.71；95%CI（0.88 - 8.31）/。12.4%的学龄儿童被确定存在BHR，并且与问卷中报告的情况存在显著相关性：去年喘息/OR = 2.28；95%CI（1.25 - 4.14）/、哮喘诊断/OR = 2.96；95%CI（1.38 - 6.34）/和运动后喘息/OR = 3.17；95%CI（1.60 - 6.27）/。此外，特应性与BHR之间存在显著相关性/OR = 1.85；95%CI（1.22 - 2.79）/。在过去无喘息且无哮喘诊断的儿童组中，特应性儿童（对室内变应原皮肤试验阳性）的BHR明显高于非特应性儿童，平均D%PEF值分别为3.95%、 - 0.39%（p = 0.0014）。
结论
在儿童中，特应性与BHR之间存在显著相关性，喘息或哮喘个人史、性别和变应原类型会对其产生影响。
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