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早发型早缓解特应性皮炎不会增加 3 岁时发生过敏性疾病的风险。

Early-onset-early-resolving atopic dermatitis does not increase the risk of development of allergic diseases at 3 Years old.

机构信息

Department of Pediatrics, National Taiwan University Hospital, Taipei, Taiwan.

Department of Medical Research, National Taiwan University Hospital, Taipei, Taiwan.

出版信息

J Formos Med Assoc. 2020 Dec;119(12):1854-1861. doi: 10.1016/j.jfma.2020.02.014. Epub 2020 Mar 13.

DOI:10.1016/j.jfma.2020.02.014
PMID:32178903
Abstract

BACKGROUND

Epidemiological findings showed the increased risk of allergic rhinitis (AR) and asthma in the children with preceding atopic dermatitis (AD). In this study, we aimed to observe the development of allergic diseases in infantile AD patients.

METHODS

We followed up the prospective observational cohort enrolling two-to four-month-old exclusively breastfed infants. The presence of physician-diagnosed asthma, AR and AD at age 3 was recorded with the laboratory tests for atopic sensitization.

RESULTS

Fifty infantile AD patients and 48 healthy controls were enrolled. The sex, age and parental atopy history were not significantly different between the two groups. At age 3, 21 (42%) patients had persistent AD in the infantile AD group while only 2 (4.2%) patients had newly diagnosed AD in the control group (p < 0.001). The early-onset-early-resolving AD (subsides before age 2) did not increase the risk of AR and asthma development, and the sensitization to allergens. However, the early-onset-persistent AD (persists after age 2) increased the risk of AR development and sensitization to inhalant allergens (adjusted odds ratio 2.83, 7.07, respectively). The parental atopy status was associated with any allergic disease at age 3 (p = 0.020). The maternal atopy history was the significant factor associated with AD, AR and eosinophilia at age 3 (p = 0.004, 0.014, 0.031, respectively).

CONCLUSION

The early-onset-early-resolving AD was not associated with allergic diseases development at age 3. The parental atopy history and early-onset-persistent AD might be the risk factors for development of allergic diseases at age 3.

摘要

背景

流行病学研究结果表明,特应性皮炎(AD)患儿发生过敏性鼻炎(AR)和哮喘的风险增加。本研究旨在观察婴儿期 AD 患者过敏性疾病的发展情况。

方法

我们对前瞻性观察队列进行了随访,纳入了 2-4 个月龄的纯母乳喂养婴儿。通过实验室特应性检测,记录 3 岁时医生诊断的哮喘、AR 和 AD 的发生情况。

结果

共纳入 50 例婴儿 AD 患者和 48 例健康对照者。两组的性别、年龄和父母特应性史无显著差异。在 3 岁时,婴儿 AD 组中 21 例(42%)患者仍患有持续性 AD,而对照组中仅 2 例(4.2%)患者新诊断为 AD(p<0.001)。早发早缓解 AD(2 岁前消退)不会增加 AR 和哮喘发展及变应原致敏的风险。然而,早发持续 AD(2 岁后持续存在)增加了 AR 发展和吸入性变应原致敏的风险(调整后的比值比分别为 2.83、7.07)。父母特应性状态与 3 岁时任何过敏性疾病相关(p=0.020)。母亲特应性史是与 3 岁时 AD、AR 和嗜酸性粒细胞增多相关的显著因素(p=0.004、0.014、0.031)。

结论

早发早缓解 AD 与 3 岁时过敏性疾病的发展无关。父母特应性史和早发持续 AD 可能是 3 岁时发生过敏性疾病的危险因素。

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