Lowe A J, Hosking C S, Bennett C M, Carlin J B, Abramson M J, Hill D J, Dharmage S C
Centre for Molecular, Environmental, Genetic and Analytic Epidemiology, Faculty of Medicine, Dentistry & Health Sciences, The University of Melbourne, Melbourne, Australia.
Clin Exp Allergy. 2007 Nov;37(11):1624-31. doi: 10.1111/j.1365-2222.2007.02822.x. Epub 2007 Sep 17.
Assessment of allergic sensitization is not routinely performed in infants and young children with eczema.
To determine whether infants who have atopic eczema (with sensitization) are at a greater risk of developing asthma and allergic rhinitis (AR) than those with non-atopic eczema (without concurrent sensitization).
The presence of eczema was prospectively documented until 2 years of age in a birth cohort of 620 infants with a family history of atopic disease. Sensitization status was determined by skin prick tests (SPTs) at 6, 12, and 24 months using six common allergens. Interviews were conducted at 6 and 7 years to determine the presence of asthma and AR.
Within the first 2 years of life, 28.7% of the 443 children who could be classified had atopic eczema: 20.5% had non-atopic eczema, 19.0% were asymptomatic but sensitized and 31.8% were asymptomatic and not sensitized. When compared with children with non-atopic eczema in the first 2 years of life, children with atopic eczema had a substantially greater risk of asthma [odds ratio (OR)=3.52, 95% confidence interval=1.88-6.59] and AR (OR=2.91, 1.48-5.71). The increased risk of asthma was even greater if the infant had a large SPT (OR=4.61, 2.34-9.09) indicative of food allergy. There was no strong evidence that children with non-atopic eczema had an increased risk of asthma or AR compared with asymptomatic children.
In children with eczema within the first 2 years of life, SPT can provide valuable information on the risk of childhood asthma and AR.
在患有湿疹的婴幼儿中，通常不会对过敏致敏情况进行评估。
确定患有特应性湿疹（伴有致敏）的婴儿患哮喘和变应性鼻炎（AR）的风险是否高于患有非特应性湿疹（无并发致敏）的婴儿。
在一个有特应性疾病家族史的620名婴儿的出生队列中，前瞻性记录湿疹情况直至2岁。在6、12和24个月时使用六种常见变应原通过皮肤点刺试验（SPT）确定致敏状态。在6岁和7岁时进行访谈以确定哮喘和AR的情况。
在生命的前2年内，443名可分类的儿童中，28.7%患有特应性湿疹：20.5%患有非特应性湿疹，19.0%无症状但致敏，31.8%无症状且未致敏。与生命前2年患有非特应性湿疹的儿童相比，患有特应性湿疹的儿童患哮喘的风险显著更高[比值比（OR）=3.52，95%置信区间=1.88 - 6.59]和患AR的风险（OR = 2.91，1.48 - 5.71）。如果婴儿有大的SPT结果（OR = 4.61，2.34 - 9.09）表明存在食物过敏，患哮喘的风险增加更大。没有有力证据表明与无症状儿童相比，患有非特应性湿疹的儿童患哮喘或AR的风险增加。
在生命前2年患有湿疹的儿童中，SPT可以提供有关儿童哮喘和AR风险的有价值信息。
