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研究生:章珍珍
研究生(外文):Chen-Chen Chang
論文名稱:台北市學齡前幼童過敏性呼吸道疾病與家庭環境和飲食之相關性研究
論文名稱(外文):Association Between Allergic Airway Diseases with Housing Environment and Diet in Preschool Children in Taipei
指導教授:黃嵩立黃嵩立引用關係
指導教授(外文):Song-Lih Huang
學位類別:碩士
校院名稱:國立陽明大學
系所名稱:環境衛生研究所
學門:醫藥衛生學門
學類:公共衛生學類
論文種類:學術論文
論文出版年:2004
畢業學年度:92
語文別:中文
中文關鍵詞:衛生假說氣喘過敏性鼻炎
外文關鍵詞:hygiene hypothesisasthmaallergic rhinitis
相關次數:
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近十幾年來許多國家氣喘盛行率明顯的上升,幼童氣喘也變成普遍的慢性疾病,成為學齡幼童最重要的健康問題。有許多理論嘗試解釋過敏疾病的增加,其中一個重要的假說是「衛生假說」,認為衛生狀況改善使幼兒時期的感染減少,而促成過敏體質的發展,但是究竟何種感染對於過敏有保護作用,仍待研究。
本研究以幼稚園為單位,建立三歲幼童之研究世代,預計追蹤三年。在追蹤期間,以問卷方式收集幼童氣喘、過敏疾病史、家族疾病史、家庭環境居住特性及飲食狀況等相關資料,並探討氣喘和其他危險因子的相關性,包括家塵細菌內毒素和塵蟎的暴露。
本研究第一次問卷回收率為63.8 %,第二次問卷回收率為80.9 %。追蹤期間,幼童氣喘發生率為3.85 %、過敏性鼻炎發生率為20.83 %及異位性皮膚炎發生率為5.71 %。本研究族群中,男性的氣喘和過敏性鼻炎盛行率均高於女性 (p < 0.01)。父母親有氣喘疾病史的幼童,其氣喘盛行率均顯著高於父母皆無疾病者(p < 0.01,p < 0.01)。父母親有過敏性鼻炎疾病史的幼童,其過敏性鼻炎盛行率均顯著高於父母皆無疾病者(p < 0.01,p < 0.01)。臥室使用冷氣機和空氣清淨機的幼童,其沙發細菌內毒素濃度較低。除此之外,並未觀察到影響細菌內毒素和過敏原濃度之確定環境因子,也未發現內毒素濃度和過敏原濃度與氣喘及過敏性鼻炎之間的關係。在飲食習慣方面,魚以外海鮮之攝食頻率與幼童過敏性鼻炎症狀呈現正相關(OR = 1.43),深海魚的攝食頻率與幼童氣喘症狀呈現正相關(OR = 1.75)。
本研究族群中,觀察到少數家庭環境和食物變項對幼童氣喘發生的影響,主要是男性與父母親有氣喘和過敏性鼻炎疾病史已解釋對幼童過敏性呼吸道疾病和症狀發生的影響,顯示在3~5歲的幼童過敏性呼吸道疾病和症狀仍與父母過敏疾病史,或與其個人過敏體質間有較強的關係。
Asthma prevalence is increasing in many countries, and childhood asthma has also become one of common chronic diseases and the most important health issue in children. Many hypotheses have been raised to explain the phenomena, and “hygiene hypothesis” is one of them. It states that lack of infections in early childhood stimulates the development of atopy, but which infections have protective effect need to be clarified.
A follow-up study based on kindergartens, and the observing period is from age 3 to 6. In follow-up period, we collected data that asthma including medical history of children and their parents, some environmental factors such as housing status, and dietary habits. To investigated the associated between asthma and the concentrations of endotoxin and house dust mite.
In our study, the recover rate of first questionnaire investigate was 63.8 %, secondary was 80.9 %. In follow-up period, incidence of childhood asthma, allergic rhinitis, and atopic dermatitis was 3.85 %, 20.83 %, and 5.71 %, respectively. The prevalence of asthma and allergic rhinitis were male higher than female (p < 0.01).Children that parents with a history of asthma have higher prevalence of asthma than other children (p < 0.01, p < 0.01). Children that parents with a history of allergic rhinitis have higher prevalence of allergic rhinitis than other children(p < 0.01, p < 0.01).Use the airconditioner and an air cleaner in childhood bedroom, the concentrations of endotoxin in sofa is lower. In the dietary habits of child, we observed that the higher frequencies of seafood without fish was positively associated with childhood allergic rhinitis symptom (OR = 1.43), the higher frequencies of deepsea fish was positively associated with childhood asthma symptom (OR = 1.75).
In our study, we observed a few of risk factors that the childhood asthma affected by housing environment and dietary factors. Male gender, mother with a history of asthma, father with a history of asthma were the main risk factor. Results showed asthma in age 3~5 children were more correlated with allergic history of parents and atopy.
第柒章□悁狺暰m
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