生命早期抗生素使用与儿童哮喘:因果关系还是混杂效应?

摘要

儿童哮喘的发病率逐年上升.基于卫生假说,抗生素使用可能减少了微生物暴露,从而增加了过敏性疾病发生的风险.近十年来,就早期抗生素暴露与儿童哮喘的关系进行的大量的流行病学调查的结果并不一致.大多数回顾性研究发现正相关联系,但前瞻性研究未发现联系或联系强度较弱.逆向因果和指示混淆可部分解释两者的关系,但也难以否定因果关系的存在.%The prevalence of childhood asthma has been increased yearly.Based on the hygiene hypothesis,the antibiotic use may increase the risk of the allergic disease by reducing microbial exposure.In the last decade,a number of epidemiological studies have been conducted on the association between early exposure of antibiotic and childhood asthma,and the results are not consistent.The majority retrospective studies have found a positive association but the prospective studies have showed a null or weak association.Reverse causation and confounding-by-indication may partly explain the relation.But it is difficult to deny a causal link between antibiotic use and asthma.