Paracetamol Use in Infancy and Risk of Asthma in Children Aged 6 to 7 Years: Presented at ERS
By Chris Berrie
婴幼儿使用对乙酰氨基酚与6-7岁儿童期哮喘危险：欧洲呼吸年会上报告
BERLIN -- October 8, 2008 -- The reported use of paracetamol (acetaminophen) in the first year of life is associated with increases in reported symptoms of asthma and risk of severe asthma symptoms in children aged 6 to 7 years, according to analysis of data from the multicentre, multicountry, cross-sectional International Study of Asthma and Allergies in Children (ISAAC).
柏林—2008年10月8日—通过对多中心、多国度、交叉的儿童中哮喘与过敏问题国际研究(ISAAC)分析显示，6-7岁儿童哮喘的症状与严重程度跟其在一岁内使用对乙酰氨基酚有关。
The study also found an association between use of paracetamol in childhood and an increased risk of symptoms of rhinoconjunctivitis and eczema in childhood, said principal investigator Richard Beasley, MD, Medical Research Institute of New Zealand, Wellington, New Zealand.
据此项调查负责人--新西兰惠灵顿新西兰医学研究所医学博士Richard Beasley说，研究还发现，儿童期鼻结膜炎与湿疹的症状发生与儿童期使用对乙酰氨基酚也有关系。
The increased international use of paracetamol over the last 40 years occurred contemporaneously with an increased prevalence of asthma, Dr. Beasley said during a presentation on October 7 at the European Respiratory Society (ERS) 18th Annual Congress.
过去四十年对乙酰氨基酚使用的增加，导致了哮喘发病率上升，Dr. Beasley在10月7日欧洲第十八届呼吸年会上发表了这个报告。
"[This study] was based on a hypothesis that was raised 10 years ago, where it was proposed that the switch from aspirin to paracetamol in childhood may have contributed to the increase in asthma prevalence that was noted in many countries in the 1980s," he said.
他说：“这个研究基于10年前一个假设，它推测在20世纪80年代，儿童期用对乙酰氨基酚替代阿斯匹林，导致了许多国家哮喘发病率增加。”
Therefore, Dr. Beasley and colleagues conducted a study to investigate the association between paracetamol use in infancy and self-reported symptoms of asthma in children aged 6 to 7 years participating in the ISAAC program, which was formed in 1991 to facilitate research into asthma, allergic rhinitis, and eczema.
所以，Dr. Beasley与同事们就ISAAC项目下样本进行研究，观察婴儿期对乙酰氨基酚使用与6-7岁儿童期的自述症状之间关系，ISAAC项目成立于1991年，致力于哮喘、过敏性鼻炎、湿疹研究。
Data were obtained from 2 groups (children aged 6 to 7 and 13 to 14) from random samples of schools in defined geographical areas worldwide. Samples were collected using 2 simple standardised questionnaires that were completed by the children's parents or guardians.
数据来源于随机全球特定区域的学校样本两组人群（6-7岁组与13-14岁组），样本资料通过两个标准化问卷来收集，问卷由儿童的家长或监护人来填写。
The prevalence questionnaire obtained data regarding symptoms of asthma, rhinoconjunctivitis, and eczema in these children, while the environmental questionnaire obtained data on a wide range of putative protective and risk factors for asthma and allergic disorders, including paracetamol use for fever in the first year of life.
发病率的问卷采集这些儿童有关哮喘、鼻结膜炎、湿疹症状，而环境问卷则采集哮喘与过敏疾病中相关的被认为是保护与危险的因素，包括生后第一年内使用对乙酰氨基酚来退烧情况。
A total of 194,555 children from 69 centres in 29 countries were included in the analysis, with the multivariate analysis based on 105,041 of these children with complete covariance data.
总共29个国家69个中心194555儿童参加了此次研究，多变量分析依据于有完整统计资料105,041例。
This multivariate analysis of the associations with paracetamol use showed significant odds ratios (ORs) as follows: asthma, 1.46 (95% confidence interval [CI], 1.36-1.56); rhinoconjunctivitis, 1.48 (95% CI, 1.38-1.60); and eczema, 1.35 (95% CI, 1.26-1.45).
与对乙酰氨基酚使用相关性的多变量分析提示有下列显著性相对危险(ORs)：哮喘1.46 (95% confidence interval [CI], 1.36-1.56)，鼻结膜炎1.48 (95% CI, 1.38-1.60)，与湿疹 1.35 (95% CI, 1.26-1.45)。
When severe asthma symptoms were defined as wheezing causing sleep disturbance or limiting speech, or 4 or more attacks of wheezing in the past 12 months, a similar significant association was seen at the multivariate level for the use of paracetamol (OR, 1.43; 95% CI, 1.30-1.58).
如果将喘息引起睡眠障碍或讲话受限、过去12个月中有4或以上喘息发作定义为严重的哮喘症状，则在多变量分析中仍显示跟对乙酰氨基酚使用有以上相似的显著性，(OR, 1.43; 95% CI, 1.30-1.58)。
Dr. Beasley noted, "While paracetamol has been shown to be safer than the alternatives and is the recommended treatment ... what we found in this study was that there was a very widespread use of paracetamol beyond its indication for relief of high fever."
Dr. Beasley 说明，“当对乙酰氨基酚显示出比其它药更安全时，它就会推荐用于治疗…我们研究发现，除了用于退烧的适应症外，它还有广泛的应用。”
Indeed, as he stressed, "What we need now is randomised controlled trials to really sort this out properly, and from these trials, there will be the basis for making firm guidelines in terms of management."
其实，他强调说，“我们现在需要的是随机对照的临床实验来厘清这个结论，这是疾病控制方面制定切实指南的基础”
The study was published in The Lancet in September 2008 (Beasley R et al. 2008;372:1039-1048).
此研究刊登于2008年九月柳叶刀杂志上(Beasley R et al. 2008;372:1039-1048)。 |
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