Helenius I J, Tikkanen H O, Sarna S, Haahtela T
Department of Allergology, Helsinki University Central Hospital, Finland.
J Allergy Clin Immunol. 1998 May;101(5):646-52. doi: 10.1016/S0091-6749(98)70173-3.
High prevalence of bronchial hyperresponsiveness and asthma has been found in cross-country skiers. There is limited evidence that asthma and bronchial responsiveness would be common also in athletes with summer events.
The objective of this study was to investigate occurrence of and risk factors for increased bronchial responsiveness and asthma in elite athletes with summer events and to compare their results with those of control subjects.
Forty-nine speed and power athletes (mean age 21.1 years, range 16 to 31), 71 long-distance runners (mean age 26.6 years, range 16 to 39), 42 swimmers (mean age 18.6 years, range 14 to 25), and 45 control subjects (mean age 26.7 years, range 21 to 37) were studied. The subjects answered questionnaires and were given a resting spirometric examination, a skin prick test, and a histamine challenge test.
Current asthma (current asthmatic symptoms and increased bronchial responsiveness) was observed in 14% (22 of 162) of the athletes and in 2% (1 of 45) of the control subjects (p = 0.041). Total asthma (current asthmatic symptoms and increased bronchial responsiveness or physician-diagnosed asthma) occurred in 23% (37 of 162) of the athletes and in 4% (2 of 45) of the control subjects (p = 0.0048). Atopy according to skin prick test results was found in 48% (77 of 162) of the athletes and in 36% (16 of 45) of the control subjects (not significant). Clinical pollen allergy (positive skin test reaction to pollen and symptoms of rhinoconjunctivitis) was significantly (p = 0.037) more common in athletes than in control subjects. Atopic athletes showed significantly more often increased bronchial responsiveness, current asthma, and total asthma than nonatopic athletes (p = 0.011, p = 0.0049, and p < 0.0001, respectively), and the odds ratios of increased bronchial responsiveness and asthma increased with the number of positive skin test reactions. After adjustment for confounding factors, the odds ratio for the occurrence of current asthma was 5.49 (95% confidence interval 0.56 to 53.7) in speed and power athletes, 2.88 (0.30 to 27.7) in long-distance runners, and 10.8 (1.10 to 106.0) in swimmers compared with control subjects. The adjusted odds ratios for the occurrence of total asthma were 3.56 (0.62 to 20.5) in speed and power athletes, 6.01 (1.19 to 30.2) in long-distance runners, and 5.89 (1.00 to 34.5) in swimmers.
Asthma is more common in highly trained athletes than in control subjects. Asthma is especially common in elite swimmers, but the risk of asthma is increased also in long-distance runners. Increased bronchial responsiveness and asthma are strongly associated with atopic disposition and its severity in elite athletes.
在越野滑雪运动员中已发现支气管高反应性和哮喘的高患病率。仅有有限的证据表明哮喘和支气管反应性在夏季项目运动员中也很常见。
本研究的目的是调查夏季项目优秀运动员中支气管反应性增加和哮喘的发生率及危险因素，并将他们的结果与对照组受试者的结果进行比较。
对49名速度和力量型运动员（平均年龄21.1岁，范围16至31岁）、71名长跑运动员（平均年龄26.6岁，范围16至39岁）、42名游泳运动员（平均年龄18.6岁，范围14至25岁）和45名对照受试者（平均年龄26.7岁，范围21至37岁）进行了研究。受试者回答问卷，并接受静息肺量计检查、皮肤点刺试验和组胺激发试验。
14%（162名中的22名）的运动员和2%（45名中的1名）的对照受试者出现了现患哮喘（现患哮喘症状和支气管反应性增加）（p = 0.041）。总哮喘（现患哮喘症状和支气管反应性增加或医生诊断的哮喘）在23%（162名中的37名）的运动员和4%（45名中的2名）的对照受试者中出现（p = 0.0048）。根据皮肤点刺试验结果，48%（162名中的77名）的运动员和36%（45名中的16名）的对照受试者存在特应性（无显著性差异）。临床花粉过敏（对花粉的皮肤试验阳性反应和鼻结膜炎症状）在运动员中比在对照受试者中显著更常见（p = 0.037）。与非特应性运动员相比，特应性运动员支气管反应性增加、现患哮喘和总哮喘的发生率显著更高（分别为p = 0.011、p = 0.0049和p < 0.0001），并且支气管反应性增加和哮喘的优势比随皮肤试验阳性反应的数量增加而升高。在对混杂因素进行调整后，与对照受试者相比，速度和力量型运动员现患哮喘发生的优势比为5.49（95%置信区间0.56至53.7），长跑运动员为2.
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