青少年肥胖和母亲孕前超重对青少年支气管哮喘发病的影响

Influence of adolescent obesity and maternal pre-pregnancy overweight on the occurrence of tracheal asthma

目的 明确青少年肥胖及其母亲孕前超重对青少年支气管哮喘发生的影响,并随访研究减轻体重可否协助哮喘的治疗和控制.方法 采用同期对照实验,纳入同一时期就诊的哮喘青少年507例及非哮喘青少年511例,研究其母亲及自身体质超重或肥胖的情况.将体质超重或肥胖的哮喘患儿纳入体重控制研究,在正规治疗哮喘的同时,要求其父母协助患儿正规减重,分析体重减轻对患儿哮喘控制的影响.结果 哮喘青少年组母亲孕前超重比例（115/507）明显高于非哮喘青少年组（90/511）,差异有统计学意义（P〈0.05）;母亲孕前肥胖是青少年发生哮喘的危险因素（OR1.37,95%CI 1.01~1.87,P=0.026）.同样,哮喘青少年组肥胖比例（155/507）也明显高于非哮喘青少年（102/511）,差异有统计学意义（P〈0.05）;青少年超重或肥胖也可能导致其哮喘发生（OR 1.77, 95%CI 1.32~2.35,P〈0.01）.当青少年合理控制体重之后,其哮喘缓解情况明显优于体重对照组,差异有统计学意义（P=0.025）.结论 母亲孕前超重及青少年肥胖均是支气管哮喘发生的危险因素,治疗哮喘的同时减轻体重可有效提高哮喘控制率.

Objective To determine the influence of adolescent obesity and maternal pre-pregnancy over-weight on the occurrence of tracheal asthma among school-age children, and study whether weight loss could assist the treatment and control of asthma. Methods In a concurrent control experiment, 507 cases of asthma adolescent pa-tients （asthma group） and 511 cases of non-asthma adolescent patients （non-asthma group） were included during the same period, with the overweight or obesity of themselves and their mothers studied. And then, asthma patients with overweight or obesity were included into the research of weight-control： parents were asked to help patients to lose weight healthily on the basis of regular treatment of asthma. The effect of weight loss on asthma control of children was analyzed. Results The ratio of maternal pre-pregnancy overweight in asthma group （115/507） was significantly higher than that in non-asthma group （90/511）, P〈0.05. Maternal pre-pregnancy overweight was a risk factor for asth-ma in adolescents （OR 1.37, 95%CI 1.01~1.87, P=0.026）. Meanwhile, rates of adolescent obesity of asthma group （155/507） was significantly higher than that of the non-asthma group （102/511）, which indicates that overweight or obesity of adolescents may also cause the asthma （OR1.77, 95%CI 1.32~2.35, P〈0.01）. Asthma was controlled when the patients lose weight successfully （P=0.025）. Conclusion Overweight or obesity of mother at pre-pregnancy and adolescents themselves are both risk factors of asthma, and weight loss could assist the control of asthma.