[北京城乡儿童卡介苗疤痕直径与哮喘、特应性的关系]

Ma Yu, Li Xiu-fang, Zhao Jing, Wong G W K, Zhou Chang-shan, Chen Yu-zhi

Asthma Clinic and Education Center, Capital Institute of Pediatrics, Beijing 100020, China.

Zhonghua Jie He He Hu Xi Za Zhi. 2003 Sep;26(9):526-30.

OBJECTIVE

To compare the diameters of Bacille Calmette-Guerin (BCG) scars between asthmatic (allergic) students and normal students, and to compare the diameters of BCG scars in children in rural Beijing area with those in urban Beijing area, and to compare the prevalence of asthmatic (allergic) symptoms and atopy between rural and urban Beijing students.

METHODS

Sampled by cluster-random Method, 819 urban school children and 1 044 rural school children aged 13 - 14 years were recruited for the Beijing arm of the phase III international study of asthma and allergies in childhood. The children answered the core questionnaires, and underwent skin prick test for 13 allergens, and were checked for BCG scars on their arms.

RESULTS

(1) In both rural and urban Beijing students, the mean diameters of BCG scars in those with asthma (allergy) (asthma ever, wheeze ever, current wheeze within 12 months, hay fever ever, repeated rash ever, eczema ever, allergic rhinitis, atopy, high-sensitivity or were diagnosed asthma) were (7.0 +/- 2.1) mm-(8.8 +/- 2.8) mm, which were not significantly different from those of (7.2 +/- 2.7) mm-(8.2 +/- 2.2) mm in normal students (P > 0.05). (2) Compared to the urban students, the mean diameter of BCG scars in the rural students was (8.2 +/- 2.3) mm, significantly larger than that of (7.3 +/- 2.9) mm in the urban students (P < 0.01). The prevalence of asthma (allergy) (asthma ever, wheeze ever, current wheeze within 12 months, hay fever ever, repeated rash ever, eczema ever, allergic rhinitis, atopy, high-sensitivity or diagnosed asthma) were 0.6% - 11.4% in the rural Beijing students, significantly lower than that of 3.1% - 35.7% in urban Beijing schoolchildren (P < 0.01).

CONCLUSIONS

The diameters of BCG scars were not significantly different between asthmatic (allergic) students and normal students. The diameters of BCG scars in the rural students were significantly larger than those in the urban students. The prevalence of asthma and allergy in the rural children were significantly lower than that in the urban students. The results suggest that there is difference in immunity between rural and urban children from early life, which may be caused by the different living environments.

目的

比较哮喘（过敏）学生与正常学生之间卡介苗（BCG）瘢痕直径，比较北京农村地区儿童与北京城区儿童的卡介苗瘢痕直径，并比较北京农村与城区学生哮喘（过敏）症状及特应性疾病的患病率。

方法

采用整群随机抽样方法，选取819名13 - 14岁的城区在校儿童和1044名13 - 14岁的农村在校儿童，参与儿童哮喘与过敏国际研究第三阶段北京地区的研究。儿童回答核心问卷，接受13种变应原的皮肤点刺试验，并检查其手臂上的卡介苗瘢痕。

结果

（1）在北京农村和城区学生中，患有哮喘（过敏）（曾患哮喘、曾喘息、12个月内有当前喘息、曾患花粉症、曾反复出现皮疹、曾患湿疹、过敏性鼻炎、特应性、高敏或被诊断为哮喘）的学生卡介苗瘢痕平均直径为（7.0±2.1）mm - （8.8±2.8）mm，与正常学生（7.2±2.7）mm - （8.2±2.2）mm相比，差异无统计学意义（P>0.05）。（2）与城区学生相比，农村学生卡介苗瘢痕平均直径为（8.2±2.3）mm，显著大于城区学生的（7.3±2.9）mm（P<0.01）。北京农村学生哮喘（过敏）（曾患哮喘、曾喘息、12个月内有当前喘息、曾患花粉症、曾反复出现皮疹、曾患湿疹、过敏性鼻炎、特应性、高敏或被诊断为哮喘）的患病率为0.6% - 11.4%，显著低于北京城区在校儿童的3.1% - 35.7%（P<0.01）。