Punekar Y S, Sheikh A
Schering-Plough Ltd., Welwyn Garden City, Hertfordshire, UK.
Clin Exp Allergy. 2009 Aug;39(8):1209-16. doi: 10.1111/j.1365-2222.2009.03248.x. Epub 2009 Apr 17.
There remains a need to better characterize the epidemiology of allergic disorders, particularly in relation to describing the incidence, natural history and co-morbidity of allergic conditions.
To estimate the incidence and prevalence of clinician-diagnosed eczema, asthma and rhinitis, alone and in combination, in children and adolescents in the United Kingdom.
Using the national General Practice Research Database (GPRD) - one of the largest validated databases of routinely collected healthcare data in the world aggregating 3.6 million individuals - we constructed a retrospective birth cohort of 43,473 children born in the year 1990 and registered with a UK general practice within a year of birth. The cohort was followed until 2008 or the longest available follow-up period to determine the cumulative and age-specific incidence and prevalence rates of clinician-diagnosed eczema, asthma and rhinitis, and an 18-year prevalence of these conditions, alone and in combination.
Eczema had the highest incidence density of 226.9 per 10,000 person-years [95% confidence interval (CI): 225.8-228.0] followed by asthma [136.6;(95% CI: 135.7-137.5)] and rhinitis [61.4;(95% CI: 60.8-62.0)], by the age of 18 years. The incidence densities of suffering from one, two or all three allergic conditions were 323.2 (95% CI: 322.0-324.4), 206.4 (95% CI: 205.7-207.1) and 141.9 (95% CI: 141.4-142.4) per 10,000 person-years, respectively. Among the 24 112 children with a complete 18-year follow-up, eczema had the highest 18-year prevalence of clinician-diagnosed condition at 36.5% (95% CI: 35.9-37.2%) followed by asthma [22.9;(95% CI: 22.3-23.4%)] and rhinitis[11.4;(95% CI: 11.0-11.8%)]. The 18-year prevalence of more than one and all three conditions was 16.1% (95% CI: 15.6-16.6%) and 2.5% (95% CI: 2.4-2.8%), respectively.
This is one of the first studies to provide national estimates on the age-specific incidence and age-specific prevalence of the major allergic disorders showing clinician-diagnosed eczema, asthma and rhinitis to have high incidence rates in early childhood. A significant proportion of children experience and are diagnosed with multiple allergic conditions in early childhood.
仍需要更好地描述过敏性疾病的流行病学特征，特别是在描述过敏性疾病的发病率、自然史和合并症方面。
评估英国儿童和青少年中临床诊断的湿疹、哮喘和鼻炎单独及合并出现的发病率和患病率。
利用国家全科医学研究数据库（GPRD）——全球最大的经过验证的常规收集医疗保健数据的数据库之一，汇集了360万人——我们构建了一个回顾性出生队列，其中包括1990年出生并在出生后一年内注册到英国全科诊所的43473名儿童。对该队列进行随访直至2008年或最长的可用随访期，以确定临床诊断的湿疹、哮喘和鼻炎的累积发病率和年龄特异性发病率及患病率，以及这些疾病单独及合并出现时的18年患病率。
到18岁时，湿疹的发病率密度最高，为每10000人年226.9例[95%置信区间（CI）：225.8 - 228.0]，其次是哮喘[136.6；（95%CI：135.7 - 137.5）]和鼻炎[61.4；（95%CI：60.8 - 62.0）]。患一种、两种或三种过敏性疾病的发病率密度分别为每10000人年323.2例（95%CI：322.0 - 324.4）、206.4例（95%CI：205.7 - 207.1）和141.9例（95%CI：141.4 - 142.4）。在24112名有完整18年随访的儿童中，湿疹的临床诊断疾病18年患病率最高，为36.5%（95%CI：35.9 - 37.2%），其次是哮喘[22.9；（95%CI：22.3 - 23.4%）]和鼻炎[11.4；（95%CI：11.0 - 11.8%）]。一种以上和三种疾病的18年患病率分别为16.1%（95%CI：15.6 - 16.6%）和2.5%（95%CI：2.4 - 2.8%）。
这是首批提供全国范围内主要过敏性疾病年龄特异性发病率和年龄特异性患病率估计值的研究之一，表明临床诊断的湿疹、哮喘和鼻炎在幼儿期发病率很高。相当一部分儿童在幼儿期经历并被诊断患有多种过敏性疾病。
