Koster Ellen S, Raaijmakers Jan A M, Vijverberg Susanne J H, van der Ent Cornelis K, Maitland-van der Zee Anke-Hilse
Division of Pharmacoepidemiology & Pharmacotherapy, Faculty of Science, Utrecht Institute for Pharmaceutical Sciences (UIPS), Utrecht University, Utrecht, The Netherlands.
J Asthma. 2011 Sep;48(7):694-700. doi: 10.3109/02770903.2011.601780. Epub 2011 Aug 2.
Seasonal variation in asthma has been widely recognized. The aim of this study was to describe seasonal patterns of asthma symptoms and asthma medication use in a cohort of pediatric asthma medication users and to study determinants of seasonal childhood asthma.
For this study, 602 children participating in the Pharmacogenetics of Asthma medication in Children: Medication with Anti-inflammatory effects) cohort were included. Parents were asked about their child's respiratory symptoms and quick-reliever medication use over the past year. Logistic regression analysis was used to study determinants of seasonality in asthma control (the level of disease control based on symptoms, limitations in activities, and rescue medication use).
There was a decline in asthma symptoms and asthma medication use during the summer period and a peak occurred from autumn to spring. The prevalence of wheeze ranged from 32% in summer to 56% in autumn. The prevalence of respiratory symptoms and medication use was significantly lower during summer (p < .0001). Oral steroids and antibiotics use and strong parental necessity beliefs were associated with uncontrolled asthma, regardless of seasonality. Allergic rhinitis was associated with an increased risk of uncontrolled asthma during spring [odds ratio (OR): 1.9; 95% confidence interval (CI): 1.3-2.8] and summer (OR: 1.9; 95% CI: 1.2-3.0). Eczema was associated with a higher risk of uncontrolled asthma during autumn (OR: 1.5; 95% CI: 1.0-2.2) and winter (OR: 1.3; 95% CI: 1.0-1.9).
We showed seasonal patterns in asthma symptoms and medication use. Associations were shown between allergic rhinitis and asthma control during spring/summer and eczema was associated with uncontrolled asthma during autumn/winter. Seasonality in asthma morbidity and health-care use is most likely associated with atopic constitution and viral infections, which are common during fall, winter, and spring.
哮喘的季节性变化已得到广泛认可。本研究的目的是描述一组儿科哮喘药物使用者的哮喘症状和哮喘药物使用的季节性模式，并研究儿童期季节性哮喘的决定因素。
本研究纳入了602名参与儿童哮喘药物遗传学研究（抗炎药物治疗）队列的儿童。研究人员询问了家长其孩子在过去一年中的呼吸道症状和速效缓解药物的使用情况。采用逻辑回归分析来研究哮喘控制季节性的决定因素（基于症状、活动受限和急救药物使用的疾病控制水平）。
夏季哮喘症状和哮喘药物使用有所下降，秋季至春季出现高峰。喘息的患病率从夏季的32%到秋季的56%不等。夏季呼吸道症状和药物使用的患病率显著较低（p <.0001）。无论季节性如何，口服类固醇和抗生素的使用以及强烈的家长必要性信念都与未控制的哮喘有关。过敏性鼻炎与春季[比值比（OR）：1.9；95%置信区间（CI）：1.3 - 2.8]和夏季（OR：1.9；95%CI：1.2 - 3.0）未控制哮喘的风险增加有关。湿疹与秋季（OR：1.5；95%CI：1.0 - 2.2）和冬季（OR：1.3；95%CI：1.0 - 1.9）未控制哮喘的风险较高有关。
我们展示了哮喘症状和药物使用的季节性模式。研究表明，春季/夏季过敏性鼻炎与哮喘控制之间存在关联，秋季/冬季湿疹与未控制的哮喘有关。哮喘发病率和医疗保健使用的季节性很可能与特应性体质和病毒感染有关，这些在秋季、冬季和春季较为常见。
