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儿童热性惊厥与过敏性鼻炎之间的关联增加:一项基于全国人群的回顾性队列研究。

Increased association between febrile convulsion and allergic rhinitis in children: a nationwide population-based retrospective cohort study.

作者信息

Lin Wen-Ya, Muo Chih-Hsin, Ku Yi-Chia, Sung Fung-Chang, Kao Chia-Hung

机构信息

Department of Pediatrics, Taichung Veterans General Hospital, Taichung, Taiwan.

Management Office for Health Data, China Medical University Hospital, Taichung, Taiwan.

出版信息

Pediatr Neurol. 2014 Apr;50(4):329-33. doi: 10.1016/j.pediatrneurol.2013.12.011. Epub 2013 Dec 14.

Abstract

BACKGROUND AND OBJECTIVES

Febrile convulsions and allergic rhinitis are both common childhood disorders and both are considered as generally benign disorders. Yet, especially in the case of allergic rhinitis, adverse effects on school performance and limited socialization are found. The relationship between febrile convulsions and allergic rhinitis has not been previously reported; thus, this article seeks to explore the association between these two disorders by collecting data from the Taiwanese nationwide cohort database.

METHODS

A total of 1304 children with febrile convulsions were identified as the case cohort, and controls were matched based on age, sex, urbanization levels, and parents' occupation on a 1 to 4 ratio. Cox's proportional hazards regression model was used to estimate the hazard ratio and confidence interval of allergic rhinitis disorder among children with febrile convulsions.

RESULTS

During an average 6.7 years follow-up period, the incidence of allergic rhinitis in the febrile convulsions case group was higher (65.16 vs 51.45 per 1000 person-years). After 11 years of follow-up, the allergic rhinitis incidence in the febrile convulsion patients was approximate 4% higher than controls (log-rank test P < 0.0001). Risk of allergic rhinitis in the febrile convulsions group was found to be 1.21 times higher than in the control group (95% confidence interval, 1.08-1.36). This risk of allergic rhinitis development is further increased (0.94 vs 18.9) with frequency of febrile convulsions-related medical visits (one to three visits vs more than three visits, P < 0.0001).

CONCLUSION

Febrile convulsions may be associated with allergic rhinitis occurrence in children. Children with more than three febrile convulsion-related medical visits had a significantly higher cumulative incidence of allergic rhinitis. Both disorders have previously been reported to have similar cytokine profiles and specific viral infection association. More studies are required to explore a possible link between the two disorders.

摘要

背景与目的

热性惊厥和过敏性鼻炎都是常见的儿童疾病,且二者通常都被视为良性疾病。然而,尤其是过敏性鼻炎,会对学业表现产生不良影响,并导致社交受限。热性惊厥与过敏性鼻炎之间的关系此前尚未见报道;因此,本文旨在通过收集台湾全国队列数据库的数据,探讨这两种疾病之间的关联。

方法

共确定1304名热性惊厥儿童作为病例队列,并根据年龄、性别、城市化水平和父母职业以1:4的比例匹配对照组。采用Cox比例风险回归模型估计热性惊厥儿童患过敏性鼻炎的风险比和置信区间。

结果

在平均6.7年的随访期内,热性惊厥病例组过敏性鼻炎的发病率更高(每1000人年65.16例 vs 51.45例)。随访11年后,热性惊厥患者的过敏性鼻炎发病率比对照组高约4%(对数秩检验P<0.0001)。发现热性惊厥组患过敏性鼻炎的风险比对照组高1.21倍(95%置信区间,1.08-1.36)。随着热性惊厥相关就诊次数的增加(1至3次就诊 vs 超过3次就诊,P<0.0001),过敏性鼻炎的发病风险进一步升高(0.94 vs 18.9)。

结论

热性惊厥可能与儿童过敏性鼻炎的发生有关。热性惊厥相关就诊次数超过3次的儿童过敏性鼻炎的累积发病率显著更高。此前已有报道称这两种疾病具有相似的细胞因子谱和特定的病毒感染关联。需要更多研究来探索这两种疾病之间可能的联系。

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