Jaén A, Sunyer J, Basagaña X, Chinn S, Zock J P, Antó J M, Burney P
Respiratory and Environmental Health Research Unit, Institut Municipal d'Investigació Mèdica (IMIM), Barcelona, Spain.
Clin Exp Allergy. 2002 Dec;32(12):1713-9. doi: 10.1046/j.1365-2222.2002.01539.x.
The role of atopy in the evolution to chronic obstructive disease remains controversial.
We aimed to assess the association between individual sensitization to common allergens and lung function.
We analysed data from 12,687 subjects aged 20 to 44 years, from 34 centres in 15 countries participating in the European Community Respiratory Health Survey (ECRHS). Participants performed a blood test, lung function test, methacholine challenge, and answered an administered questionnaire. The relationships between specific IgE, FEV1 and FEV1/FVC ratio were assessed for each study centre stratified by sex, followed by random effects meta-analysis.
Asthmatics sensitized to house dust mite had a lower FEV1 (-119 mL in women and -112 mL in men) and FEV1/FVC ratio (-1.95%, and -2.48%) than asthmatics without sensitization. Asthmatics sensitized to cat had a lower FEV1 (statistically significant for women only) and a lower FEV1/FVC ratio. Asthmatic women sensitized to grass had a lower FEV1 and a lower ratio, and those sensitized to Cladosporium had a lower FEV1. A weak association was found with sensitization to cat and to Cladosporium among non-asthmatic women, which disappeared after adjusting for BHR.
We conclude that atopy was related to a lower lung function, which was only apparent among asthmatics. This relationship was explained by specific sensitization to cat and to house dust mite, the latter being homogeneous across areas.
特应性在慢性阻塞性疾病发展过程中的作用仍存在争议。
我们旨在评估个体对常见变应原的致敏作用与肺功能之间的关联。
我们分析了来自15个国家34个中心的12687名年龄在20至44岁之间的受试者的数据,这些受试者参与了欧洲共同体呼吸健康调查(ECRHS)。参与者进行了血液检测、肺功能检测、乙酰甲胆碱激发试验,并回答了一份调查问卷。按性别对每个研究中心进行分层,评估特异性IgE、第一秒用力呼气容积(FEV1)和FEV1/用力肺活量(FVC)比值之间的关系,随后进行随机效应荟萃分析。
对屋尘螨致敏的哮喘患者的FEV1(女性降低119 mL,男性降低112 mL)和FEV1/FVC比值(分别降低1.95%和2.48%)低于未致敏的哮喘患者。对猫致敏的哮喘患者的FEV1较低(仅对女性有统计学意义)且FEV1/FVC比值较低。对草致敏的哮喘女性的FEV1和比值较低,对枝孢菌致敏的哮喘女性的FEV1较低。在非哮喘女性中发现对猫和枝孢菌致敏存在弱关联,在调整气道高反应性(BHR)后这种关联消失。
我们得出结论,特应性与较低的肺功能有关,这仅在哮喘患者中明显。这种关系可由对猫和屋尘螨的特异性致敏来解释,屋尘螨致敏在各地区具有同质性。