变应性鼻炎母代与子代变应性疾病发病的相关性研究

Allergic rhinitis in women and the impact on incidence of allergic diseases in their offspring

目的通过调查分娩后母代变应性鼻炎(allergic rhinitis,AR)的流行病学特征和子代变应性疾病的发病情况,分析母亲患有AR和支气管哮喘与子代变应性疾病发病的相关性。方法收集2007年9月～2008年12月,确诊为AR的592例25～40岁分娩后妇女作为调查对象,根据面访、查体和实验室检查、问卷调查,将分娩妇女分为A组(AR伴哮喘组)和B组(单纯AR组),分析两组患者的AR分型、病情严重程度、分娩年龄及子代变应性疾病发病率,分析上述因素与子代变应性疾病发病率的关系。采用比值比(odds ratio,OR)作为评价危险度的指标。结果①全部病例中,A组患者213例,其中持续性中-重度106例,持续性轻度36例,间歇性中-重度54例,间歇性轻度17例;B组患者379例,其中持续性中-重度178例,持续性轻度81例,间歇性中-重度47例,间歇性轻度72例。②592例患者中384例子代发生变应性疾病,发病率为64.86%,A、B组子代变应性疾病发病率分别为82.63%(176/213)、63.85%(242/379),母代中有AR伴哮喘的子代变应性疾病的发作明显高于母代仅有AR的子代(OR=3.91,OR的95%可信区间为2.33,5.74)。③两组中284例持续性中-重度AR患者中子女变应性疾病发病率为71.48%(203/284),A、B两组子女变应性疾病的发病率分别为85.85%(91/106)、62.92%(112/178),组间差异有统计学意义(P<0.05)。④A组25～30岁年龄段分娩其子代发病率较高(85.42%),各年龄段A、B二组间的差异有统计学意义(P<0.05)。结论①AR伴哮喘的母代其子代变应性疾病的发病率高于单纯AR组。②25～30岁分娩的母亲有持续性中-重度AR伴哮喘为子代变应性疾病高发的危险因素。

Objective To investigate the epidemiological characteristics of allergic rhinitis in women with childbearing history and the incidence of allergic diseases in their offspring. Methods 592 female cases with childbearing history （25-40 years old） suffering from allergic rhinitis （AR） were enrolled and evaluated from September 2007 to December 2008. According to the results of interview,physical examination,laboratory test and questionnaire survey,these patients were divided into AR accompanying with bronchial asthma group （group A） and AR group （group B）.Types and severity degrees of AR,age of childbirth,and their relationship with the incidence of allergic diseases in offspring were analysed. The odds ratio （OR） was regarded as an indicator of risk evaluation. Results ① Of all the 592 cases,213 suffered from AR accompanying with bronchial asthma （35.98%） and 379 suffered from AR only （64.02%）. ② As for the incidence of allergic diseases of offspring,the total incidence was 64.87% （384/592） while those of group A and group B were 82.63% （176/213） and 54.88% （208/379） respectively with a statistically significant difference （OR=3.91,95%,CI 2.33~5.74）. ③ In the offspring of 284 patients with persistent moderrate to severe AR （47.97%）,the incidence of allergic diseases was 71.48%. For the offspring of patients with persistent moderate to severe AR,the incidences of allergic diseases in group A and B were 85.85%,62.92% with statistically significant difference （P0.05）. ④ As for the age of childbirth,the offspring of patients aged from 25 to 30 years old in group A had the highest incidence of allergic diseases （85.42%）.The differences of incidences at any age stage between group A and group B were statistically significant （P0.05）. Conclusion The incidence of allergic diseases in the offspring of women with AR accompanying with asthma is higher than that of women with AR only. For the women with childbirth age of 25~30 years old suffering from persistent moderate to severe AR accompanying with asthma,their offspring are more liable to allergic diseases.