Bernstein Jonathan A, Bobbitt R Carter, Levin Linda, Floyd Roger, Crandall Michael S, Shalwitz Robert A, Seth Anand, Glazman Mark
Department of Internal Medicine, Division of Immunology, Allergy Section, Cincinnati, Ohio, USA.
J Asthma. 2006 May;43(4):255-62. doi: 10.1080/02770900600616887.
Centrally installed ultraviolet (UV) irradiation units were investigated to determine the potential health benefits in mold-sensitized asthmatic children.
Nineteen mold-sensitized asthmatic children 5 to 17 years of age with home central ventilation systems were enrolled in a 28-week double-blinded placebo controlled cross-over trial. Clinical outcome measurements included morning and evening peak expiratory flow rates (PEFR), PEFR variability, change in forced expiratory volume in 1 second (FEV1), change in total rhinoconjunctivitis and asthma symptom scores, change in rhinoconjunctivitis and asthma quality-of-life scores, and total (rescue and controller) medication use from baseline and between time periods. Environmental outcomes included changes in temperature, relative humidity, dew point, and indoor airborne mold and bacterial counts from baseline and between time periods. Analysis of variance (ANOVA) and regression analysis and t test were used to evaluate relationships between environmental exposure(s) and clinical outcome measurements during each study period.
Twelve male and seven female children, average age 10.6 years, were enrolled. A statistically significant improvement in PEFR variability in subjects receiving CREON2000 units followed by placebo units was observed (p < 0.05) across both treatment periods. Within group analysis during treatment period 1, a statistically significant improvement in reduction of asthma symptom scores, the number of days with asthma symptoms, total asthma medication use, and PEFR variability were observed in subjects receiving CREON2000 units versus placebo units (p < 0.05). No significant differences were observed between the CREON 2000 and placebo units for other clinical or environmental outcome measurements.
Central UV irradiation was effective at reducing airway hyperresponsiveness manifested as PEFR variability and some clinical symptoms. A larger cohort controlled longitudinal study to validate the clinical health effects of UV irradiation as a primary indoor environmental intervention for allergic asthma is necessary to confirm this finding.
对中央安装的紫外线（UV）照射装置进行研究，以确定其对霉菌致敏哮喘儿童潜在的健康益处。
19名5至17岁、家中装有中央通风系统的霉菌致敏哮喘儿童参与了一项为期28周的双盲安慰剂对照交叉试验。临床结局测量指标包括早晚呼气峰值流速（PEFR）、PEFR变异性、1秒用力呼气容积（FEV1）的变化、鼻结膜炎和哮喘症状总分的变化、鼻结膜炎和哮喘生活质量评分的变化，以及从基线期到各时间段的总（急救和控制）药物使用量。环境结局指标包括从基线期到各时间段温度、相对湿度、露点以及室内空气传播霉菌和细菌数量的变化。在每个研究期间，采用方差分析（ANOVA）、回归分析和t检验来评估环境暴露与临床结局测量指标之间的关系。
共纳入12名男性和7名女性儿童，平均年龄10.6岁。在两个治疗期内，接受CREON2000装置后再接受安慰剂装置的受试者的PEFR变异性有统计学意义的改善（p < 0.05）。在治疗期1的组内分析中，接受CREON2000装置的受试者与接受安慰剂装置的受试者相比，哮喘症状评分降低、哮喘症状天数、哮喘药物总使用量和PEFR变异性有统计学意义的改善（p < 0.05）。在其他临床或环境结局测量指标方面，CREON 2000装置和安慰剂装置之间未观察到显著差异。
中央紫外线照射可有效降低表现为PEFR变异性和一些临床症状的气道高反应性。需要进行一项更大规模的队列对照纵向研究，以验证紫外线照射作为过敏性哮喘主要室内环境干预措施的临床健康效果，从而证实这一发现。
