Department of General Practice, Erasmus MC, University Medical Center, Rotterdam, The Netherlands.
NIVEL, Netherlands Institute for Health Services Research, Utrecht, The Netherlands.
BMJ Open. 2017 Nov 12;7(11):e018091. doi: 10.1136/bmjopen-2017-018091.
This study aimed to investigate both atopic and non-atopic comorbid symptoms and diseases in children with physician-diagnosed atopic disorders (atopic eczema, asthma and allergic rhinitis).
All children aged 0-18 years listed in a nationwide primary care database (the Netherlands Institute for Health Services Research-Primary Care Database) with routinely collected healthcare data in 2014 were selected. Children with atopic disorders were matched on age and gender with non-atopic controls within the same general practice. A total of 404 International Classification of Primary Care codes were examined. Logistic regression analyses were performed to examine the associations between the presence of atopic disorders and (non-)atopic symptoms and diseases by calculating ORs.
Having one of the atopic disorders significantly increased the risk of having other atopic-related symptoms, even if the child was not registered as having the related atopic disorder. Regarding non-atopic comorbidity, children with atopic eczema (n=15 530) were at significantly increased risk for (infectious) skin diseases (OR: 1.2-3.4). Airway symptoms or (infectious) diseases (OR: 2.1-10.3) were observed significantly more frequently in children with asthma (n=7887). Children with allergic rhinitis (n=6835) had a significantly distinctive risk of ear-nose-throat-related symptoms and diseases (OR: 1.5-3.9). Neither age nor gender explained these increased risks.
General practitioners are not always fully aware of relevant atopic and non-atopic comorbidity. In children known to have at least one atopic disorder, specific attention is required to avoid possible insufficient treatment and unnecessary loss of quality of life.
本研究旨在调查患有医生诊断的特应性疾病（特应性皮炎、哮喘和过敏性鼻炎）的儿童的特应性和非特应性共病症状和疾病。
从全国初级保健数据库（荷兰卫生服务研究-初级保健数据库）中选择 2014 年有常规收集的医疗保健数据的 0-18 岁所有儿童。在同一普通诊所中，根据年龄和性别对特应性疾病儿童与非特应性对照进行匹配。共检查了 404 个国际初级保健分类代码。通过计算比值比（OR），进行逻辑回归分析，以研究特应性疾病的存在与（非）特应性症状和疾病之间的关联。
患有特应性疾病之一会显著增加出现其他特应性相关症状的风险，即使儿童未被登记为患有相关特应性疾病。关于非特应性合并症，患有特应性皮炎（n=15530）的儿童患（感染性）皮肤病的风险显著增加（OR：1.2-3.4）。患有哮喘（n=7887）的儿童气道症状或（感染性）疾病更为常见（OR：2.1-10.3）。患有过敏性鼻炎（n=6835）的儿童患耳鼻喉相关症状和疾病的风险显著不同（OR：1.5-3.9）。年龄和性别均不能解释这些增加的风险。
全科医生并不总是完全了解相关的特应性和非特应性合并症。对于已知至少患有一种特应性疾病的儿童，需要特别注意避免可能的治疗不足和不必要的生活质量下降。
