JAMA Pediatr:学龄前黑人儿童是美国儿童哮喘高风险人群

2021-05-18 MedSci原创 MedSci原创

哮喘家族史、种族以及性别因素均影响儿童哮喘发病率,总体上学龄前黑人儿童的哮喘风险较高,有必要制定相应的早期干预措施

2018年的统计数据中,美国18岁以下儿童哮喘患病率为7.5%,其中5-14岁儿童(8.6%)、男孩(8.3%)、非西班牙裔黑人儿童(14.3%)、波多黎各裔儿童(17.0%)、东北部地区儿童(8.9%)以及低收入家庭儿童(10.2%)的哮喘患病率高于平均水平。在流行病学中,实现初级预防的第一步是发病率研究,目前大多数关于儿童哮喘的流行病学数据都集中于患病率或发病率上。近日研究人员根据核心人口群体和父母哮喘史评估全国儿童哮喘发病率。

ECHO研究为环境对儿童健康结果影响研究,数据采集工作从1980年5月1日开始,直至2018年3月31日,包含31个儿童队列,年龄范围在孕34周至18岁。研究人员对ECHO研究数据进行二次分析,提取哮喘诊断数据。研究的主要终点为每个年龄段的哮喘特异性发病率,通过分析父母家族哮喘史(FH)、性别和种族进行计算。

研究包含11404名儿童数据,平均年龄10.0岁,5836名男童(51%),5909名白人儿童(53%),2494名(23%)非西班牙裔黑人儿童。7326名儿童(64%)无哮喘家族史,4078名儿童(36%)有哮喘家族史,有家族哮喘史儿童在4岁前的哮喘发病风险是无哮喘家族史的近2倍(IRR=1.94),但随后风险差异趋于一致。若不考虑家族哮喘史,学龄前非西班牙裔黑人儿童的哮喘发病率明显高于非西班牙裔白人儿童(IRR:1.58),9-10岁后无哮喘家族史的非西班牙裔黑人儿童的哮喘发病率低于白人儿童(IRR:0.67)。男孩哮喘发病率随着年龄的增长而下降,而女孩的哮喘发病率在各个年龄段都相对稳定,尤其是在无哮喘家族史的人群。

家族哮喘史、性别及种族对儿童哮喘风险的影响

哮喘家族史、种族以及性别因素均影响儿童哮喘发病率,总体上学龄前黑人儿童的哮喘风险较高,有必要制定相应的早期干预措施

原始出处:

Christine Cole Johnson et al. US Childhood Asthma Incidence Rate Patterns From the ECHO Consortium to Identify High-Risk Groups for Primary Prevention. JAMA Pediatr. May 17, 2021.

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    2021-05-19 12346c4dm64暂无昵称

    低收入家庭

    0

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    2021-05-18 旺医

    顶刊就是顶刊,谢谢梅斯带来这么高水平的研究报道,我们科里同事经常看梅斯,分享梅斯上的信息

    0

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    2021-05-18 ltxdsr810920

    学习

    0

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    2021-05-18 1209e435m98(暂无昵称)

    学习了,谢谢分享

    0

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Eur Respir J:生命早期暴露于空气污染与儿童哮喘、过敏性鼻炎和湿疹的发生率

由此可见,暴露于氧化性空气污染物(O3和NO2)而不是PM2.5与儿童患哮喘和湿疹的风险增加相关。这表明改善空气质量可能有助于预防儿童期和青春期的哮喘和其他过敏性疾病。

Eur Respir J:妊娠期镇痛药暴露与儿童哮喘风险

由此可见,研究人员建议在妊娠期间使用镇痛剂不会引起儿童哮喘/喘息,并且这种关联会被母亲固有的未测量因素所混淆,例如慢性疼痛或焦虑。

四百万儿童哮喘与交通污染有关

一份新的报告显示,全球有400万儿童哮喘与交通引起的N02空气污染有关。

BMJ:与儿童哮喘相关的空气及家庭因素研究

PM2.5是诱发儿童哮喘和持续性喘息的重要风险因素,其他相关的危险因素包括父母哮喘、父母社会经济地位和孕期吸烟

Nat Commun:FUT2-ABO上位效应提高了早期儿童哮喘和肺炎链球菌感染的呼吸系统疾病的发病风险

重度哮喘病是幼儿住院的最常见原因,其对于生活质量和医疗保健费用有着严重的影响。急性哮喘发作通常是由呼吸道感染引起的,但是导致某些儿童反复感染和急性发作的宿主因素仍未完全清楚。由于当前的治疗选择和预防措