致编辑:
We read with interest the paper by Larsson等。1in which they reported in a large population-based sample of nonsmokers that respiratory symptoms were related to environmental tobacco smoke (ETS). They gave special consideration to respiratory symptoms triggered by a variety of lower airway irritants and they showed for these symptoms that the relation was stronger in females than in males. Although, such symptoms are particularly frequent among asthmatics2,,,,they did not perform an analysis according to asthma.
正如关于哮喘(EGEA)遗传学和环境的流行病学研究包括大量的成人哮喘患者以及对照3,,,,we analysed whether sex differences were observed for symptoms triggered by various stimuli in 366 population-based (mainly electoral roll) controls and in 213 asthmatics cases. Triggers were exposure to hay/flowers, pets, dust, cold air, exercise and ETS. Symptoms were as in the study by Larson等。1respiratory symptoms (fits of coughing, shortness of breath and/or wheezing), but also nasal symptoms (runny nose and/or sneezes) and ocular symptoms (runny/itchy eyes)4,,,,5。如预期的那样,哮喘患者触发的症状的报道明显高于对照组(例如,ETS和宠物触发的呼吸道症状分别为57%和26%的哮喘患者,对照组分别为19%和2%。)。就像在拉尔森等。1研究,女性报告的症状比男性基于人群的对照(不包括哮喘患者)的症状更多。此外,考虑到哮喘病例,观察到类似的模式,女性在一般情况下报告的症状比男性更多。对于呼吸道症状,女性的患病率通常高于男性(图1⇓)。Age-adjusted odds ratios (ORs) were statistically significant for symptoms triggered by ETS and by exercise (age-adjusted OR (95% confidence interval (CI)) 2.4 (1.3–4.4) and 2.7 (1.3–5.6) respectively). The prevalence of nasal symptoms triggered by stimuli varied between 7% for exercise to 54% for dust in asthmatics. Females also reported more nasal symptoms than males for all triggers except hay/flowers, with age-adjusted ORs for ETS, exercise, pets and hay/flowers of 1.9 (0.9–4.0), 1.9 (0.6–5.8), 1.7 (0.9–3.4) and 1.0 (0.5–1.7) respectively.
![图。1。-](http://www.qdcxjkg.com/content/erj/22/4/716/F1.medium.gif)
Sex differences in trigger-induced respiratory symptoms. ETS: environments tobacco smoke. ┘: females; □: males.
The analysis by Larson等。1was restricted to nonsmokers due to the focus on ETS. Considering sex differences in ETS‐triggered respiratory symptoms according to active smoking is also of interest, as active smoking is related to the number of asthma attacks, an aspect of the severity of asthma3。实际上,主动吸烟改变了性别与ETS触发症状的关联。在非吸烟者和Exsmokers中,女性报告了更多症状(调整年龄或(95%CI)2.5(1.0-5.8)和2.6(0.8-8.1)),而吸烟者中没有观察到性别差异(0.9(0.2-5.4))。
Our results confirm and extend the results of Larson等。1。各种刺激引起的症状的感知被认为是生活质量的重要方面,但通常对这些症状的性别差异几乎没有关注2或生活质量量表。疾病的临床模式可能因性别而异,部分原因是关于感知或报告症状的性别差异6目前的结果表明,前往n of symptoms in relation to specific triggers should be considered in clinical settings. Our observation as well as those of Larson等。1进一步表明,应根据性别进行流行病学研究的分析,并应进行更多的研究以了解观察到的差异的原因。
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