Alm Bernt, Goksör Emma, Pettersson Rolf, Möllborg Per, Erdes Laslo, Loid Petra, Aberg Nils, Wennergren Göran
Department of Paediatrics, University of Gothenburg, Gothenburg, Sweden.
Pediatr Allergy Immunol. 2014 Aug;25(5):468-72. doi: 10.1111/pai.12244. Epub 2014 Jun 9.
Heredity as well as external factors influences the development of allergic rhinitis. The aim of this study was to analyse early risk factors and protective factors for allergic rhinitis at school age.
This is a prospective, longitudinal study of children born in western Sweden in 2003 where 50% of the birth cohort was randomly selected. The parents answered questionnaires at 6 months, 12 months, 4.5 yr and 8 yr. At 8 yr, 5044 questionnaires were distributed. Of these, 4051 responded, that is, 80.3%. Current allergic rhinitis was defined as symptoms and use of medication during the past 12 months.
Current allergic rhinitis at 8 yr was reported by 10.9%. Mean onset age was 5.7 yr, and 61.9% were boys. In a multivariate analysis, antibiotics in the first week of life increased the risk of allergic rhinitis (adjusted odds ratio 1.75, 95% confidence interval (1.03, 2.97)). Increased risk was also seen with parental allergic rhinitis (aOR 2.73 (2.12, 3.52)), food allergy first year (aOR 2.45 (1.61, 3.73)), eczema first year (aOR 1.97 (1.50, 2.59)) and male gender (aOR 1.35 (1.05, 1.74)). Living on a farm at 4.5 yr reduced the risk (aOR 0.31 (0.13, 0.78)).
Antibiotics in the first week of life increased the risk of allergic rhinitis at school age, while living on a farm at preschool age reduced the risk. Both findings are compatible with the hygiene hypothesis.
遗传因素以及外部因素均会影响过敏性鼻炎的发展。本研究旨在分析学龄期过敏性鼻炎的早期危险因素和保护因素。
这是一项对2003年出生于瑞典西部儿童的前瞻性纵向研究，随机选取了出生队列的50%。父母在孩子6个月、12个月、4.5岁和8岁时回答问卷。在8岁时，发放了5044份问卷。其中，4051份做出回应，即回应率为80.3%。当前过敏性鼻炎定义为过去12个月内出现症状并使用药物治疗。
8岁儿童中报告当前患有过敏性鼻炎的比例为10.9%。平均发病年龄为5.7岁，男孩占61.9%。在多变量分析中，出生后第一周使用抗生素会增加患过敏性鼻炎的风险（调整后的优势比为1.75，95%置信区间为(1.03, 2.97)）。父母患有过敏性鼻炎（调整后的优势比为2.73(2.12, 3.52)）、第一年出现食物过敏（调整后的优势比为2.45(1.61, 3.73)）、第一年出现湿疹（调整后的优势比为1.97(1.50, 2.59)）以及男性（调整后的优势比为1.35(1.05, 1.74)）也会增加风险。4.五岁时生活在农场会降低风险（调整后的优势比为0.31(0.13, 0.78)）。
出生后第一周使用抗生素会增加学龄期患过敏性鼻炎的风险，而学龄前生活在农场则会降低风险。这两项发现均与卫生假说相符。
