支气管哮喘与遗传和环境因素的关系

A Case-control Study of the Genetics and Environmental Factors of Asthma

目的 分析遗传、环境因素与支气管哮喘发病的关系为预防和免疫治疗哮喘提供依据。方法 采用病例对照的方法 ,对 3 66例哮喘者进行问卷调查、皮肤试验和血清放免指标测定 ,用Logistic多元回归分析哮喘危险因子。结果 在哮喘患者中具有家族遗传史的占 46 995 % ,是 12 6例正常人群的 5 4倍。 41例哮喘患者血清IgE及IL -4水平与 3 2例比较显著性增高 ,IL -2水平显著性降低 ,IL -4与IgE水平之间存在显著正相关。烟草 (OR =1 83 )、螨(OR =10 44 )、屋尘 (OR =9 45 )、蟑螂 (OR =4 0 4)、豚草花粉 (OR =5 2 6)、皮毛类动物 (OR =5 66)、刺激性气味 (OR =3 40 )、空调房间 (OR =3 3 3 )、呼吸道感染 (OR =2 12 )、霉菌 (OR =3 79)、冷空气刺激 (OR =1 83 )、气候突变 (OR =2 0 5 )与哮喘的关联有显著性。结论 家族遗传史、屋尘螨、花粉、蟑螂、冷空气刺激、气候突变、刺激性气味、空调房间、感染、皮毛类动物、烟草、霉菌等环境因素为哮喘的主要危险因子。

Objective To ivestigate the relationship of the genetics,environmental factors and asthma. Methods Case-control study.We assessed 366 asthma and 126 healthy subjects control group.Questionnaire survey,skin test and blood analysis were carried out,and logistic regression analysis was used to probe the risk factors of asthma. Results The results showed that asthma had obviously genetics factors and were 5.4 times higher than that of control group.The serum total IgE and the level of IL-4 had significantly increased in 41 asthma cases,Comparing with control subjects,the level of IL-2 had singnificantly decreased. The total serum IgE had sinificantly positive relation with the leve of IL-4.Smoking,dust mite,house dust,cockroach,ambrosia pollen,fur of animals,cold,weather change for the worse,pungent niff,air-conditioning equipment in room,infection of respiratory tract and fungi et al had significantly relation with asthma.The odds ratios of these risk factors were 3.4(95%CI:1.39～6.69),10.44(95%CI:5.41～20.13),9.45(95%CI:4.71～18.96),4.04(95%CI:1.59～10.30),5.26(95%CI:2.75～10.05),5.66(95%CI:2.42～13.23),1.83(95%CI:1.16～2.90),2.05(95%CI:1.31～3.20),3.40(95%CI:1.89～6.12),3.33(95%CI:1.80～6.15),2.12(95%CI:1.35～3.33),3.79(95%CI:1.55～9.25).Showed an iverse relationship. Conclusion Family history of allergy,dust mite,house dust,ambrosia pollen,cockroasia,cold,weather change,pungent niff,inflection,air-conditionting equipment in room,fur of animals,smoking and fungi were the main risk factors of asthma.