Njå F, Nystad W, Hetlevik O, Lødrup Carlsen K C, Carlsen K-H
Geilomo Children's Hospital for Asthma and Allergy, Geilo and Sandvika, Norway.
Arch Dis Child. 2003 Jul;88(7):566-9. doi: 10.1136/adc.88.7.566.
To investigate the association between a history of otitis media and respiratory tract infections in infancy and allergic sensitisation and asthma in school age children of atopic and non-atopic parents.
Based on a survey of 4585 schoolchildren, three groups of children aged 6-16 years were selected, of whom 502 were eligible with complete data: (1) diagnosed asthma (n = 166); (2) wheeze within past 12 months (n = 155); and (3) no asthma/no wheeze (n = 181). This study population was further analyzed by subgroups of children with or without parental atopy. Main outcome measures were allergic sensitisation verified by skin prick test and asthma.
Children of atopic parents had a reduced risk of developing allergic sensitisation in school age if they had a combined history of both otitis media and lower respiratory tract infections during infancy (adjusted odds ratio (aOR) 0.13, 95% CI 0.03 to 0.50) or a history of otitis media (aOR 0.31, 95% CI 0.12 to 0.83). A history of lower respiratory tract infections in infancy increased the risk of asthma in children of non-atopic parents (aOR 4.21, 95% CI 1.68 to 10.57).
In the present study population, a history of otitis media in infancy seems to be negatively associated with allergic sensitisation in school age children of atopic parents, whereas a history of lower respiratory tract infections was positively associated with asthma in children of non-atopic parents.
研究婴儿期中耳炎和呼吸道感染史与特应性和非特应性父母的学龄儿童过敏致敏及哮喘之间的关联。
基于对4585名学童的调查,选取了三组6至16岁的儿童,其中502名儿童数据完整符合条件:(1)确诊哮喘(n = 166);(2)过去12个月内有喘息(n = 155);(3)无哮喘/无喘息(n = 181)。该研究人群进一步按有无父母特应性的儿童亚组进行分析。主要结局指标为经皮肤点刺试验验证的过敏致敏和哮喘。
特应性父母的儿童如果在婴儿期有中耳炎和下呼吸道感染的合并病史(调整优势比(aOR)0.13,95%可信区间0.03至0.50)或中耳炎病史(aOR 0.31,95%可信区间0.12至0.83),则在学龄期发生过敏致敏的风险降低。婴儿期下呼吸道感染史增加了非特应性父母的儿童患哮喘的风险(aOR 4.21,95%可信区间1.68至10.57)。
在本研究人群中,婴儿期中耳炎病史似乎与特应性父母的学龄儿童过敏致敏呈负相关,而下呼吸道感染史与非特应性父母的儿童哮喘呈正相关。