Division of Allergology, Skin and Allergy Hospital, Department of Medicine, Helsinki University Central Hospital, Helsinki, Finland.
Respir Med. 2011 Oct;105(10):1449-56. doi: 10.1016/j.rmed.2011.04.013. Epub 2011 May 20.
To examine the incidence of allergic rhinoconjunctivitis and asthma, and to assess allergic rhinoconjunctivitis as a risk factor for incident asthma, we performed a 11-year follow-up postal survey.
The original study population was a random population sample of 8000 inhabitants of Helsinki aged 20-69 years in 1996. Participants in the first postal questionnaire survey, 6062 subjects, were invited to this follow-up study, and provided 4302 (78%) answers out of 5484 traced subjects in 2007.
Cumulative incidence of asthma from 1996 to 2007 was 4.0% corresponding to an annual incidence rate of 3.7/1000/year. After exclusion of those with asthma medication or physician-diagnosed chronic bronchitis or COPD at baseline in 1996, the cumulative incidence decreased to 3.5% (incidence rate 3.2/1000/year), and further to 2.7% (2.5/1000/year) when also those reporting recurrent wheeze or shortness of breath during the last year in 1996 were omitted from the population at risk. Remission of asthma occurred in 43 subjects and was 16.9% over 11 years. Cumulative 11-year incidence of allergic rhinoconjunctivitis was 16.9% corresponding to 16.8/1000/year, and cumulative remission was 18.1%. Incidence of allergic rhinoconjunctivitis was significantly lower among those who had lived in the countryside or on a farm during the first 5 years of life, but this was not true for asthma. In multivariate analysis, farm living during the first 5 years of life was protective for the development of allergic rhinoconjunctivitis, OR 0.75 (95%CI 0.57-0.99). Allergic rhinoconjunctivitis was a significant independent risk factor for incident asthma, OR 2.15 (95%CI 1.54-3.02). In the cohort, the prevalence of rhinoconjunctivitis increased from 38.0% in 1996 to 40.9% in 2007, physician-diagnosed asthma from 6.8% to 9.4%, while current smoking decreased from 31.3% to 23.3%.
Incidence of allergic rhinoconjunctivitis was higher than in earlier studies, while asthma incidence remained on similar level, both being significantly higher in women. Allergic rhinoconjunctivitis doubled the risk for incident asthma.
为了研究过敏性鼻结膜炎和哮喘的发病率，并评估过敏性鼻结膜炎是否为哮喘发病的危险因素，我们进行了为期 11 年的随访邮寄调查。
原始研究人群为 1996 年赫尔辛基 8000 名 20-69 岁居民的随机人群样本。首次邮寄问卷调查的 6062 名参与者被邀请参加此项随访研究，并在 2007 年追踪到的 5484 名受试者中提供了 4302 名（78%）的回答。
1996 年至 2007 年期间哮喘的累积发病率为 4.0%，相当于每年 3.7/1000/年的发病率。排除 1996 年基线时有哮喘药物治疗或经医生诊断的慢性支气管炎或 COPD 的人群后，累积发病率下降至 3.5%（发病率为 3.2/1000/年），当排除 1996 年报告在过去一年中反复喘息或呼吸急促的人群后，进一步下降至 2.7%（2.5/1000/年）。43 名哮喘患者缓解，缓解率为 11 年 16.9%。16.9%的人群在 11 年内累积出现过敏性鼻结膜炎，相当于每年 16.8/1000/年的发病率，而累积缓解率为 18.1%。过敏性鼻结膜炎在生命的前 5 年生活在农村或农场的人群中发病率较低，但哮喘则不然。多变量分析显示，生命的前 5 年生活在农村或农场对过敏性鼻结膜炎的发展具有保护作用，OR 0.75（95%CI 0.57-0.99）。过敏性鼻结膜炎是哮喘发病的一个显著独立危险因素，OR 2.15（95%CI 1.54-3.02）。在该队列中，1996 年时，鼻结膜炎的患病率从 38.0%上升至 40.9%，经医生诊断的哮喘从 6.8%上升至 9.4%，而当前吸烟率则从 31.3%下降至 23.3%。
过敏性鼻结膜炎的发病率高于早期研究，而哮喘的发病率保持在类似水平，两者在女性中均显著更高。过敏性鼻结膜炎使哮喘发病的风险增加了一倍。
