School of Social and Community Medicine, University of Bristol, UK.
Paediatr Respir Rev. 2013 Mar;14(1):9-15; quiz 16. doi: 10.1016/j.prrv.2012.04.004. Epub 2012 May 11.
Acetaminophen is a widely used medication for the treatment of pain and fever in children and pregnant women. There is substantial epidemiological evidence in adults and children that acetaminophen use is associated with asthma symptoms. There is also a considerable body of evidence that supports a modest but consistent association of acetaminophen use in pregnancy and early infancy with asthma in later childhood. This relationship is robust to adjustment for a large range of potential confounding factors and, in some studies, shows clear evidence of a dose-dependent association but the possibility of confounding by indication has remained a concern. However, the epidemiological evidence is now compelling and there is a clear need to establish causation so that appropriate advice and interventions can be developed for children at risk of asthma. This requires randomised trials of analgesics and antipyretics, including acetaminophen, in a variety of clinical settings.
对乙酰氨基酚是一种广泛应用于治疗儿童和孕妇疼痛和发热的药物。大量的成人和儿童流行病学证据表明，对乙酰氨基酚的使用与哮喘症状有关。还有相当多的证据支持，在怀孕期间和婴儿早期使用对乙酰氨基酚与儿童后期哮喘之间存在适度但一致的关联。这种关系在调整了一系列潜在混杂因素后仍然很稳健，在一些研究中，显示出对乙酰氨基酚剂量依赖性关联的明确证据，但仍存在由指示性混杂的可能性。然而，目前的流行病学证据非常有说服力，因此迫切需要确定因果关系，以便为有哮喘风险的儿童制定适当的建议和干预措施。这需要在各种临床环境中对包括对乙酰氨基酚在内的镇痛药和退烧药进行随机试验。
