不同遗传背景婴儿湿疹发病的环境影响因素分析

Investigation of environmental risk factors of eczema in different genetic background infants

目的比较过敏性疾病家族史阳性与阴性婴儿湿疹发病率，探讨环境因素对不同遗传背景婴儿湿疹发生的影响。方法随访270名正常足月儿，记录其过敏性疾病家族史、围生期及生后6月内环境因素、湿疹发生情况至12月龄。采用SPSS21．0统计软件，对影响不同遗传背景婴儿湿疹发生的环境因素进行Logistic回归分析。结果婴儿湿疹发病率约为64．8％（175／270）。过敏性疾病家族史阳性、阴性婴儿湿疹发病率差异无统计学意义（63．9％VS65．5％，P〉0．05）。未发现影响过敏性疾病家族史阳性婴儿发生湿疹的环境危险因素；而对于过敏家族史阴性婴儿，出生于秋冬季是发生湿疹的危险因素，OR值4．921（95％CI：1．102～8．103，P=0．032）；4月龄内纯母乳喂养是发生湿疹的保护因素，OR值0．013（95％CI：0．009～0．518，P=0．020）。结论本调查中婴儿湿疹的发病率较国内外文献报道高；通过询问法获得的过敏性疾病家族史似乎不是影响婴儿湿疹发生的重要因素；对于过敏性疾病家族史阴性婴儿，4月龄内纯母乳喂养可减少湿疹发生；而出生于秋冬季及4月龄内非纯母乳喂养者更易发生湿疹。

Objective To compare the incidence and predisposing environmental factors of eczema in different allergic family history infant. Methods Totally 270 healthy, term newborns enrolled into this study and was followed up to one year old. Informations including allergic family history,delivery mode,environmental smoking exposure and diet during ma- ternal and infancy etc, were recorded during the follow-up period. Multifactors logistic regression was used to analyze the en- vironmental risk factors of eczema in different allergic family history infant. Results The incedence of infantile eczema was 64.8 % （175/270）. There was no significant difference between the prevalence of eczema in infants with or without al- lergic family history（63.9 %vs 65.5 %, P〉0.05）. However, logistic regression analysis showed, although no environmentalrisk factors were found for eczema in infants with allergic family history, for infants without allergic family history, born in autumn and winter were suffering 4. 912 times of infantile eczema risk than that of born in spring and summer,OR4. 921 （95 % CI：I. 102 ~ 8. 103, P ~ 0. 032）, and exclusive breastfeeding within the first 4 months might decrease the risk of infan- tile eczema,ORO. 013（95 ~./0CI：0. 009~0. 518,P=0. 020）. Conclusions The prevalence of infantile eczema in this study is higher than other literatures. Allergic family history seems have no effect on the prevalence of infantile eczema. However, for infants without allergic family history,exclusive breastfeeding during the first 4 months might be benefit to reduce the inci- dence of infantile eczema. Moreover, born in autumn and winter seems to be the risk factors of eczema for infants without al- lergic family history