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首页> 外文期刊>Clinical and experimental allergy : >Establishing the sequential progression of multiple allergic diagnoses in a UK birth cohort using the General Practice Research Database.
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Establishing the sequential progression of multiple allergic diagnoses in a UK birth cohort using the General Practice Research Database.

机译：使用通用实践研究数据库确定英国出生队列中多种过敏性诊断的顺序进展。

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BACKGROUND: There is considerable international interest in understanding the sequential progression of multiple allergic conditions (also sometimes known as 'the allergic march'). OBJECTIVES: To study the sequential progression of multiple allergic conditions in a national birth cohort throughout childhood. METHODS: We constructed a birth cohort of 43,477 children born in 1990 and registered in UK general practices within a year of birth, using the national General Practice Research Database. Of these, 24,112 with complete follow-up until the age of 18 years were studied in order to understand disease progression and to estimate the absolute and relative risks of developing second and third allergic diagnoses following an index allergic condition. RESULTS: 52.1% of children were diagnosed with at least one condition at some point in childhood. We were able to describe 15 different disease trajectories. Eczema was the most likely index condition with 60.7% [95% confidence interval (CI): 59.8-61.6] of allergy sufferers being diagnosed with this condition first. For those with a diagnosis of eczema, the relative risks of being diagnosed with asthma followed by rhinitis and rhinitis followed by asthma were 1.59 (95% CI: 1.32-1.91; P<0.0001) and 0.54 (95% CI: 0.43-0.68; P<0.0001), respectively. For those diagnosed with asthma first, the relative risks of being diagnosed with eczema followed by rhinitis and rhinitis followed by eczema were 1.27 (95% CI: 0.96-1.68; P=0.095) and 0.27 (95% CI: 0.20-0.36; P<0.0001), respectively. For those diagnosed with rhinitis first, the relative risks of being diagnosed with eczema followed by asthma and asthma followed by eczema were 0.64 (95% CI: 0.42-0.95; P=0.025) and 0.47 (95% CI: 0.32-0.67; P<0.0001), respectively. CONCLUSIONS: Among children diagnosed with multiple allergic diseases there is likely to be a number of variants of 'the allergic march'. Of these, the diagnosis of eczema followed by asthma, which is in turn followed by rhinitis, is the most common trajectory. Surprisingly, some diagnoses indicate a possible strong protective effect of manifesting further likely allergic diagnoses.
机译：背景：国际上对了解多种过敏性疾病（有时也称为“过敏行军”）的连续进展感兴趣。目的：研究整个儿童全国出生队列中多种过敏性疾病的连续进展。方法：我们建立了一个出生队列，该队列中有1990年出生的43477名儿童，并使用国家通用实践研究数据库在出生的一年之内在英国通用实践中注册。在这些患者中，对24,112例至18岁的患者进行了完整的随访研究，以了解其疾病进展，并估计在出现指数性过敏性疾病后进行第二和第三次过敏性诊断的绝对和相对风险。结果：52.1％的儿童在童年某个时候被诊断出患有至少一种疾病。我们能够描述15种不同的疾病轨迹。湿疹是最有可能的指标疾病，首先被诊断出这种疾病的过敏患者占60.7％[95％置信区间（CI）：59.8-61.6]。对于那些被诊断为湿疹的人，被诊断出患有哮喘并发鼻炎和鼻炎并发哮喘的相对风险分别为1.59（95％CI：1.32-1.91; P <0.0001）和0.54（95％CI：0.43-0.68; P <0.0001）。对于首先被诊断为哮喘的患者，被诊断为湿疹继之以鼻炎和鼻炎继之以湿疹的相对风险为1.27（95％CI：0.96-1.68; P = 0.095）和0.27（95％CI：0.20-0.36; P <0.0001）。对于那些首先被诊断为鼻炎的人，被诊断为湿疹继之以哮喘和哮喘继之以湿疹的相对风险分别为0.64（95％CI：0.42-0.95; P = 0.025）和0.47（95％CI：0.32-0.67; P <0.0001）。结论：在被诊断患有多种过敏性疾病的儿童中，“过敏行军”可能有多种变体。其中，最常见的轨迹是诊断为湿疹继之以哮喘，再继之以鼻炎。出乎意料的是，一些诊断表明进一步可能的变态反应诊断可能具有强大的保护作用。

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