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3岁时的肺功能:宠物饲养及接触室内过敏原的影响

Lung function at age 3 years: effect of pet ownership and exposure to indoor allergens.

作者信息

Lowe Lesley A, Woodcock Ashley, Murray Clare S, Morris Julie, Simpson Angela, Custovic Adnan

机构信息

North West Lung Centre, Wythenshawe Hospital, Southmoor Road, Manchester M23 9LT, UK.

出版信息

Arch Pediatr Adolesc Med. 2004 Oct;158(10):996-1001. doi: 10.1001/archpedi.158.10.996.

Abstract

OBJECTIVE

To investigate the effect of pet ownership and exposure to indoor allergens on lung function in 3-year-old children.

DESIGN

Birth cohort study.

SETTING

Community.

PARTICIPANTS

Children recruited prenatally and followed prospectively to age 3 years.

MAIN OUTCOME MEASURES

Specific airway resistance (sRaw) (measured with body plethysmograph) at age 3 years; skin-prick tests; data on cat and dog ownership collected prospectively; allergen levels measured in dust collected from homes (high exposure defined as mite allergens >2 microg/g in mattress, and dog >10 microg/g and cat >8 microg/g allergens on the living room floor).

RESULTS

There was no effect of cat or dog ownership at birth or age 3 years on lung function, and no association between lung function and mite, dog, or cat allergen exposure. Sensitized children exposed to high levels of sensitizing allergen had significantly poorer lung function (n = 49, sRaw kiloPascal per second [kPa/s]; geometric mean [GM], 1.20; 95% confidence interval [CI], 1.13-1.28) than children who were not sensitized and not exposed (n = 114; GM, 1.08; 95% CI, 1.04-1.12); not sensitized, but exposed (n = 282; GM, 1.07; 95% CI, 1.05-1.10); or sensitized and not exposed (n = 53; GM, 1.12; 95% CI, 1.06-1.18; P = .005). In a multivariate model, independent significant associates of lung function were maternal and paternal asthma, and the combination of sensitization and exposure to sensitizing allergen, with significant interaction between them. Lung function was substantially worse in sensitized and highly exposed children with both asthmatic parents (GM, 2.23; 95% CI, 1.68-2.97), compared with those with neither (GM, 1.09; 95% CI, 1.04-1.16) or just 1 of these features.

CONCLUSIONS

Pet ownership, sensitization without exposure, or exposure in nonsensitized individuals have no effect on lung function. However, the combination of specific sensitization and exposure to sensitizing allergen is associated with significantly poorer lung function in early life.

摘要

目的

研究养宠物及接触室内过敏原对3岁儿童肺功能的影响。

设计

出生队列研究。

地点

社区。

参与者

产前招募的儿童,并前瞻性随访至3岁。

主要观察指标

3岁时的特异性气道阻力(sRaw)(用体描仪测量);皮肤点刺试验;前瞻性收集的养猫和养狗情况数据;从家中收集的灰尘中测量的过敏原水平(高暴露定义为床垫中螨过敏原>2微克/克,客厅地板上狗过敏原>10微克/克,猫过敏原>8微克/克)。

结果

出生时或3岁时养猫或养狗对肺功能无影响,肺功能与螨、狗或猫过敏原暴露之间无关联。暴露于高水平致敏过敏原的致敏儿童的肺功能(n = 49,sRaw千帕斯卡每秒[kPa/s];几何平均数[GM],1.20;95%置信区间[CI],1.13 - 1.28)明显比未致敏且未暴露的儿童(n = 114;GM,1.08;95%CI,1.04 - 1.12)、未致敏但暴露的儿童(n = 282;GM,1.07;95%CI,1.05 - 1.10)或致敏但未暴露的儿童(n = 53;GM,1.12;95%CI,1.06 - 1.18;P = 0.005)差。在多变量模型中,肺功能的独立显著相关因素是母亲和父亲的哮喘,以及致敏和暴露于致敏过敏原的联合作用,且它们之间存在显著交互作用。与父母双方均无哮喘的儿童(GM,1.09;95%CI,1.04 - 1.16)或仅具有其中一个特征的儿童相比,父母双方均患有哮喘的致敏且高暴露儿童的肺功能明显更差(GM,2.23;95%CI,1.68 - 2.97)。

结论

养宠物、未暴露的致敏或未致敏个体的暴露对肺功能无影响。然而,特异性致敏和暴露于致敏过敏原的联合作用与早期生活中明显较差的肺功能相关。

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