Meijer G G, Postma D S, van der Heide S, de Reus D M, Koëter G H, Roorda R J, van Aalderen W M
Department of Pediatric Pulmonology, Beatrix Children's Hospital, Groningen, the Netherlands.
Am J Respir Crit Care Med. 1996 Oct;154(4 Pt 1):881-4. doi: 10.1164/ajrccm.154.4.8887579.
The aim of the study was to investigate whether seasonal differences in house dust mite (HDM) allergen exposure influence the circadian peak expiratory flow (PEF) amplitude in asthmatic children. Asthmatic children (n = 25) with a solitary allergy to HDM were studied in spring and in autumn. All used inhaled corticosteroids (ICS) regularly. Six days after withdrawal of ICS, PEF amplitude (every 4 h during 24 h, highest-lowest/percentage of mean value) was assessed. HDM allergen (HDMA) in living rooms, bedrooms, and mattresses was collected. HDMA levels were not always highest in autumn. PEF amplitudes in spring and autumn did not correlate with HDMA levels in the same season. However, the seasonal difference in PEF amplitude (autumn value - spring value) correlated positively and significantly with the seasonal difference in HDMA exposure levels from the mattresses (rho = 0.34, p < 0.05). Multivariate analysis showed that the seasonal difference in HDMA exposure in the mattress was the single parameter explaining seasonal difference in PEF amplitudes by 21.0% (p = 0.02). Our cross-sectional study showed a higher PEF amplitude not to be significantly associated with higher HDMA exposure in mattresses in a group of HDM-allergic asthmatic children. However, the change in HDMA exposure over seasons contributed significantly to the change in PEF amplitude after withdrawal of ICS in HDM-allergic asthmatic children.
本研究的目的是调查屋尘螨（HDM）变应原暴露的季节性差异是否会影响哮喘儿童的昼夜呼气峰值流速（PEF）幅度。对25名仅对HDM过敏的哮喘儿童在春季和秋季进行了研究。所有儿童均定期使用吸入性糖皮质激素（ICS）。在停用ICS 6天后，评估PEF幅度（24小时内每4小时一次，最高值-最低值/平均值的百分比）。收集客厅、卧室和床垫中的HDM变应原（HDMA）。HDMA水平并非总是在秋季最高。春季和秋季的PEF幅度与同一季节的HDMA水平无相关性。然而，PEF幅度的季节差异（秋季值-春季值）与床垫中HDMA暴露水平的季节差异呈显著正相关（rho = 0.34，p < 0.05）。多变量分析显示，床垫中HDMA暴露的季节差异是解释PEF幅度季节差异的唯一参数，解释率为21.0%（p = 0.02）。我们的横断面研究表明，在一组HDM过敏的哮喘儿童中，较高的PEF幅度与床垫中较高的HDMA暴露无显著相关性。然而，HDM过敏的哮喘儿童在停用ICS后，HDMA暴露随季节的变化对PEF幅度的变化有显著贡献。
