Vogel Nicola M, Katz Hary T, Lopez Rocio, Lang David M
The Children's Hospital, The Cleveland Clinic Foundation, Center for Pediatric Allergy and Immunology, Cleveland, Ohio 44195, USA.
J Asthma. 2008 Dec;45(10):862-6. doi: 10.1080/02770900802444195.
Risk factors for potentially fatal childhood asthma are incompletely understood.
To determine whether self-reported food allergy is significantly associated with potentially fatal childhood asthma.
Medical records from 72 patients admitted to a pediatric intensive care unit (PICU) for asthmatic exacerbation were reviewed and compared in a case-control design with 2 randomly selected groups of 108 patients admitted to a regular nursing floor for asthma and 108 ambulatory patients with asthma. Factors evaluated included self-reported food allergy, gender, age, poverty area residence, race/ethnicity, inhaled steroid exposure, tobacco exposure, length of hospital stay, psychologic comorbidity, and season of admission.
At least one food allergy was documented for 13% (38/288) of the patients. Egg, peanut, fish/shellfish, milk, and tree nut accounted for 78.6% of all food allergies. Children admitted to the PICU were significantly more likely to report food allergy (p = 0.004) and 3.3 times more likely to report at least one food allergy compared with children admitted to a regular nursing floor, and significantly more likely to report food allergy (p < 0.001) and 7.4 times more likely to report at least one food allergy compared with children seen in the ambulatory setting. Children admitted to either the PICU or the regular nursing floor were significantly more likely be African-American (p < 0.001) and to be younger (p < 0.01) compared with children seen in the ambulatory setting.
Self-reported food allergy is an independent risk factor for potentially fatal childhood asthma. Asthmatic children or adolescents with food allergy are a target population for more aggressive asthma management.
儿童潜在致命性哮喘的危险因素尚未完全明确。
确定自我报告的食物过敏是否与儿童潜在致命性哮喘显著相关。
回顾了72名因哮喘急性加重入住儿科重症监护病房（PICU）的患者的病历，并采用病例对照设计，与随机选择的两组患者进行比较，一组是108名入住普通护理病房的哮喘患者，另一组是108名门诊哮喘患者。评估的因素包括自我报告的食物过敏、性别、年龄、贫困地区居住情况、种族/民族、吸入性类固醇暴露、烟草暴露、住院时间、心理合并症和入院季节。
13%（38/288）的患者记录有至少一种食物过敏。鸡蛋、花生、鱼/贝类、牛奶和坚果占所有食物过敏的78.6%。与入住普通护理病房的儿童相比，入住PICU的儿童报告食物过敏的可能性显著更高（p = 0.004），报告至少一种食物过敏的可能性是其3.3倍；与门诊儿童相比，入住PICU的儿童报告食物过敏的可能性显著更高（p < 0.001），报告至少一种食物过敏的可能性是其7.4倍。与门诊儿童相比，入住PICU或普通护理病房的儿童更有可能是非裔美国人（p < 0.001）且年龄更小（p < 0.01）。
自我报告的食物过敏是儿童潜在致命性哮喘的独立危险因素。有食物过敏的哮喘儿童或青少年是更积极哮喘管理的目标人群。
