摘要

背景:本研究旨在解决儿童哮喘和过敏性疾病增加的原因。根据观察到的家庭规模与过敏性疾病或特异反应之间的反比关系，有人提出，常见儿童感染的下降可能是哮喘发病率上升的原因。本研究旨在调查家庭规模与报告的过敏性疾病之间的关系，并验证这两者之间的负相关关系是儿童感染的结果这一假设。方法:数据来自1964年对阿伯丁10岁至14岁学童的随机抽样横断面调查。2111名受试者在调查时是否有哮喘、湿疹或花粉热的记录，以及三岁前后的麻疹、百日咳、水痘、风疹和腮腺炎史。结果:花粉热(优势比0.2,95% CI 0.1至0.8)和湿疹(OR 0.3, CI 0.1至0.7)的风险与有三个或三个以上的哥哥姐姐呈负相关，而哮喘的风险(OR 0.4, CI 0.1至0.9)与有三个或三个以上的弟弟妹妹呈负相关。兄弟姐妹总数的增加显示出对湿疹和花粉热的保护的显著趋势。3岁后的麻疹对哮喘的保护作用较弱(OR 0.5, CI 0.3至0.9)，湿疹风险的轻微增加与风疹或百日咳有关，哮喘风险的轻微增加与水痘有关。3岁前的感染数量与哮喘风险增加的比值比有显著趋势相关(p = 0.025)。风疹、腮腺炎和水痘暴露增加，湿疹和花粉热风险增加的比值比有显著趋势。 These relations between infection and atopic diseases were independent of the potential confounding factors age, sex, father's social class, and total number of siblings. CONCLUSIONS: These data add to the accumulating evidence that membership of a large sibship confers some protection against atopic disease. This does not appear to be explained by the common childhood infections which show conflicting relationships with atopic disease, in that measles may have some protective effect against asthma but the more infections a child has had, the more likely he or she is to have atopic disease. The explanation of the sibship effect is likely to lie elsewhere and the fall in common childhood infections is unlikely to explain the rise in atopic disease.