Y Hoc TP. Ho Chi Minh * Tap 16 * So I * 2012 N g h i e n ciiu Y oc
Sir LIEN QUAN GIlTA NHIEM GIUN SAN VA BENH HEN 6 TRE EM TAI HUYEN CU CHI
MaiNguyltThuHdng;PhanHmNguyetDii:n",NguyenAnh Tuin", TrktAnh Tmrn'", Trdn niKim Dung'; Trdn ThlHSng", Trhi Khiem Hung', To Thj Tuyit Mai"", Hodng TrfltgKim"
Bat van de: hen la benh duimg ho Mp rat thiecmg gap i tre em. Tan suit benh ngiy cang tang Benh keo^
dai va dnh huong nghiem trong den sirc khoe eita tre. Mot so nghien dm gan day vemien didi hoc dm thay tri emnh&nmol so loai giun sdn co the dmc hao ve it bi hen hoac neu co bi hot thi trieu chimg benh cung nhe Imn o tre khong nhiSm giun son. Muc Heu: xac djnh anh huing eita nhiem giun sdn len benh hen a be em 7-15 turn tai huyen Cit Chi.
Phumig phdp nghiin ahi so sdnh ty le nhilm giun san tren 33 tre mdc benh hen vd 125 tri kliong mic benh hen tai Cii Chi. Chan doan benh hen theo Ueu chuan GINA 2008. Chan dodn nhilm giun sdn: xet nghiem ttm trimg giun sdn truing tiianh, huyet thanh chan doan nhilm giun san. Phan tich mm lien quan giiia nhiem giun sdn vd Slf xuai hien benh hai (STATA 10).
Kei qud -Ban luin: tyle mac benh hen i tre bi nhilm giun la 8.6%. Ti/ le mdc benh hen a tre kSmng nhiem giun Id 28% Ty suai chenh OR la 0.24, p=O.O0t, 95% CI: 0.08-0,69. KM cjiid cho thay co mm Urn quan giiia nhiem giun sdn vd mic benh hen, tre nhihn giun sdn CO ty le mdc benh hen thap hem i,16 lan (1/0.24) so vdi tre khong nhiem giun sdn. Kit qud ndy phit hap vii nhiHt nghien a'nt khdc.
Kei luan: nhiem giun sdn segidm duac nguy ca benh hen trong quan tht Tit khoa: hen, nliiem giun sdn, tuang tdc mtin dich
ABSIRACT
RELATIONSHIP BETWEEN HELMINTH INFECTION AND ASTHMA IN CU CHl REGION Mai Nguyet Thu Hong, Phan Huu Nguyet Diem, Nguyen Anh Tuan, Tran Anh Tuan, Tnm Thi Kim IDung, Tran Thi Hong, Tran Kliiem Hung, To Thi Tuyet Mai, Hoang Trong Kim
* Y hoc TP. Ho Chi Minh * Vol. 16 - No.l - 2012: 46 - 52 Introduction: asthnia is a very common respiratory disease in children. The incidence of asthma is increasing. This chronic disease has a lifelong effect on children's health. Some recent immunological studies slioited that helminth infection can reduce tlie incidence of asthma or lessen the severity of this disease.
Objective: to observe the effed of helminth infection on asthnia in children 7-5 years dd in Cu Chi region.
Method: ratio comparision af helminth infection in 33 asthma cases and 125 control cases. Asthma diagnosis- GINA criteria (2008). Helminth infection diagnosis: Ova & parasite examination (direct wet mount, concentration), serology diagnostic test. Analyse the relationship between helminth infection and asthma (STATA 10).
Result - Disaission: tlie proportion cf asthma cases in helminth infection children was 8.6% and that df asthnia cases in non helminth inaction children was 28%. OR: 0.24, p-C.004, 95% CL 0.08-0.69. Children affected by Helminth infection are 4 times less likely to conti-act asthma. This finding tallies with others previous
' Dai hoc Y lAoa Ph?m Ngoc Thach, »: Dai hoc Y Duoc TP.Ho Chi Minh
• " Benh vien Nhi dong I, *"• Tmng tam Y tedu phong Huyen Cii Chi, TP.HCM Trie jioJini/acBS Mai Nguyet Thu Hong DT: Email:
Key words: Asthma, helminth infection, immunol
©ATVANBE
Hen la benh ly dudng ho ha'p, thudng gap d tre em dudi 10 tudi, ddi khi d tudi ldn hon.
Benh keo dai va anh hudng nghiem trpng de'n sue khde ciia tr^^'.
Hang nam, tren 300 trieu ngudi mac bfnh hen, &8% ngudi Idn, 10-12% tre dudi 15 hidi, 15 trifu ngudi tir vong'^'". Tai Viet Nam, nghien cuu cua Bach Van Cam cho thay 17% - 29.1% tre mac benh hen*"^*. Theo Nguyen Nang An ti If bfnh hen tgi Viet Nam la 5%, benh hen lua tudi hpe dudng 11-12%<'*>. Nghien cuu ciia Bp mdn Nhi, Dai Hoc Y Dupc TP. HCM nam 2007 cho tha'y ti le tre khd khe dgng hen la 3% tgi Can Tho va 19-20% tai TP. Ho Chi Mmh.
Hen phe'quan la nguyen nhan nhgp vifn hang dau ciia benh man tinh d tre em dudi 15 tudi. Mpt so nghien cuu gan day ve mien dich hpe va bfnh nhiem ky sinh trimg nhan tha'y tre em nhiem mdt so' loai giun san cd the dupc bao vf it bi bfnh hen hoac ne'u cd mae benh thi trieu chung benh ciing khdng nang nhu d tre khdng nhiem giun san<^""'.
Rieng tai Viet Nam, vdi ti le benh hen kha cao, 11% tren liia tudi hoc dudng, 20% d ^ n g dd till va tinh hinh nhiem giun san tgi mdt sd' viing ndng thdn Vift Nam. la kha cao nen vifc tim hieu anh huong cua nhiem giun san tren bfnh hen la ra't can thie't''^'.
Muc tieu: xac dinh su lien quan giiia nhilm giun san va bfnh hen d tre em 7-15 tudi tai huyen Cu Chi, TP. HCM.
Phticmg phap nghien cixu Thie't ke'nghien cihx
Phan tich md ta theo kieu benh ehiing, 1 benh/ 4 chiing, vdi 30 benh, 120 chiing.
interaction Thu thap mau
Nhom benh: tre dupc xac dinh mac benh hen theo tieu chuan GINA.
Nhom chting: tre binh thudng, khdng mic benh hen, khong mac bfnh man tinh va benh ve mau, dupc chpn ngau nhien tu 21 xa cua huyfn Cu Chi.
Xdc dinh tre mdc benh hett: tieu chuan chan doan GINA^-18).
Kfidm ldm sdng benh hen'^ '*'• con hen phe' quan dgc hieu
Can Idmsdng'^-'^'
• Xet nghiem chan dodn tdc nghen: do chiic nang ho hap. He so Tiffeneau: FEVil VC <
75% thi cd tac nghen phe'quan
• Xet nghiem hd trg chan dodn: huyei do, bgch cdu di toan, bgch cau da nhan trung tinh Chan dodn xdc dinh
• Ldm sdng: ho, khd khe, khd thd
• Tieh can: ho, khd khe, tai phat, co dia di ling
• Can Idm sang: do chiic nang hd ha'p Chan dodn phdn biet
Viem tieu phe'quan, viem phe'quan phdi cd hdi chiing tac nghen, di vat phe' quan bd quen, lao ndi mac phe'quan
logi bac hen ^- '• ^*: mdt trong cae bieu hifn cua bac hen tuong ung theo GINA 2008.
Xdc dfnh tre nhiem giun sdn
Phitang phdp tim trirng giun sdn trong phdn'^" ^'^'
• Xet nghiem phdn: quan sat true tie'p mau phan
• Ky thugt tap trung ky sinh triing: Willis, Kato - Katz
Huyei thanh chan dodn ky sinh tritng'^''-^^>
48
Y Hoc TP. Ho Chi Minh * T a p 16 * So I * 2012
Ung dung ky thuat ELISA de xac dinh hifu gia khang the khang giun san.
Xet nghiem cong thiic mau Thu thap solieu
Ke' hogch nghien cuu dupc thdng qua Uy Ban Nhan Dan huyfn, xa - Hdi Phu ni>, td dan phd' va trgm y te. Tre phai cd ban thda thuan nghien cuu trudc khi chinh thiic tham gia vao nghien ciiu.
Khdm ldm sdng vd do chiic ndng ho hap Phan mdn Hd ha'p, Bp mdn Nhi, Dgi Hpe Y Dupe TP. HCM va Khoa hd ha'p benh vifn Nhi Dong I.
Xet nghiem cong thiic mdu
Bfnh vifn Nhi Dong 1 - Phdng Kham Nhi Khoa.
Nhdp - phdn tich, xu ly so'lieu Tmdng Dgi Hpe Y Dupc TP. HCM Phan tich thong ke
Su dung phan mem STATA 10.0 de phan tich so' lifu
KETQUA Dac diem dich te hpe Tong soman
Tdng sd tre 158, 62,66% (99/158) nam, 37,34% (59/158) nii.
Lira tuoi: 7-15.
Phdn bo tre theo xa: 21 xa tai huyen Cii Chi deu cd tre tham gia nghien cuu, xa it nha't la 2 tre (2,53%), xa nhieu nhat la 13 tie (8,23%).
Tmh hinh benh hen Tong 50^ tre
33 tre mSc benh hen, 125 tre khdng mSc bfnh hen.
Ltia tuoi mdc benh hen
Phdn boty le ca benh vd ca chung: ty Ie ca ehiing cao gap 4 ca benh
Phdn bo benh hen theo tittig nhom tuoi
Nghien CU" Y h o c
Trong 33 tre bi hen nhom tuaicWemJy^?
hen tren 20% la h^ 1 " - J . ^ ^ j 13 luSi.
CO ty le hen dudi 20% la tre 7 ' _..
Chua phat hien tre bi hen a nhom tuoi . Phdn bo tre mdc benh hen theo xa
Xa CO ty le tre bi hen cao nhat l i Tan Thanh Dong - 3,16% (5/158). Xa chua phat hien tre bi hen la An Nhon Tay, Phuoc VTnh An, Thi Tran Cii Chi va Trung Lap Thuong.
Phdn ho benh hen theo giai ttnh Khong khac biet ve gicM tinh (p>0,05).
Phdn loai bac hen
Phan loai bac hen tren 33 tre bi hen nhu sau: hen bdc 1: 14 tre - 42,42% 04/33), Hen bac 2. 0 tre - 0,00%, Hen bac 3: 14 tre - 42,42%
a4/33J, Hen bac 4: 5 tre -15,15% f5/33;
t i n h hinh nhilm giun Ty le nhiim giun
So' tre n h i l m giun la 36,71% (58/158).
Liia tuoi
Lira tuoi nhiem giun cao la 7-11 tuoi ehiein ty le tir 5,06%-9,49%, tir 12- 15 tuoi, ty le nhiem giun tha'p tir 0,63-1,27%.
Phdn bo mice do nhiem giun theo xa Cac xa CO ty le nhiem giun cao la Tnmg Lap Thucmg chiem ty le 4,43%, An Phii 3,80%.
Phdn bo tif le nhiem cdc lodi giun Ty le nhiem Ankylostoma duodenale va Toxocara sp. cao 11,39%, Cystycercus cellulosae 6,96%, Strongyloides stercoralis 5,06%, Paragonimus sp. 3,16%, Fasciola sp., Gnathostoma sp. 2,53%, Trichuris trichiura 1,90% va Enterobius vermicularis 0,63%
Phdn boty le dong nhiem cdc lodi giun Ty le nhiem 1 loai giun la 29,75%, 2 loai giun la 6,33% va 3 loai giun la 1,90%.
Benh hen va n h i e m giun san
Moi lien quan giiea benh hen vd nhiem giun sdn tren qudn the
cuu, phan bd' benh hen va nhiem giun san nhu sau:
- 72 tre khdng mac benh hen va khdng nhiem giun san.
- 53 tre khdng m^c bfnh hen va cd nhiem giun san.
- 28 tre mac benh hen va khdng nhiem giun san,
- 5 tre mac benh hen va cd nhiem giun san.
Ty If tre mac benh hen va ed nhiem giun la 8,6%. Ty le tre mac benh hen va khdng nhiem giun la 28%. Ty sua't chenh OR la 0,24, p=0,004, 95% CI: 0,08-0,69. Ket qua eho tha'y co mo'i lien quan giiia nhiem giun san va mac bfnh hen, tre nhiem giun san cd ty Ie mae benh hen tha'p hon 4,16 lan (1/0,24) so vdi tre khdng nhiem giun san.
Bdng 1. Phan tich mdi lien quan gitea benh hen vd nhiem giun sdn
Nfiifim giun sdn , Ctt Khfing ntiiem
giun san Ting cpng 158 58 100
Hen N
5 28
%
8,6%
2 8 % P value
0,004 OR
0,24 1
9S%
Cl
0,08- 0.69 Cdc Iodi giun sdn gdy nhiem tren nhom tre
mdc benh hen
Trong 5 tre mac bfnh hen va nhiem giun san, loai giun san gay nhiem nhu sau:
• 4 tre chi nhiem mpt logi giun san trong eac loai giun san sau:
• Giun duimg ruot: Trichuris trichiura
• Giun trong mo:
Strongyloides stercoralis: 2 tre vdi hifu gia khang thela 1,15 va 1,169
Paragonimus sp,: 1 tre nhiem vdi hifu gia khang thela 1,18
• 1 tre ddng nhiem 3 loai giun Strongyloides stercoralis, Paragonimus sp., va
Phan bo nhiem giun san tren bac h e n
• Hen bdc 1:14 tre hen bac 1, trong dd ed 2 tre nhiem giun
• Hen bdc 2: khdng cd tre mac benh hen
• Hen bdc 3: 14 tre hen bge 3, trong dd cd 3 tre nhiem giun san
• Hen bdc 4: 5 tre hen bac 4. BChdng cd tre nhiem giun san.
O bac hen nang nha't - hen bge 4 ehua phat hifn tre nhiem giun san
Vi cd mau cdn it, nen ehua the nhgn xet ve mdi lien quan giua nhiem giun san va bae hen. Can thuc hifn d quan the cd ty If mac benh hen cao hon.
BAN LUAN
Liia tudi tham gia nghien ciju la tre tu 7-15 tudi, phu hpp vdi nghien cuu eiia Nguyen Nang An<"> tai Viet Nam, ty Ie hen tren liia tudi hpe dudng la 11-12%; nghien euu eiia Internationale Study of Asthma and Allergies in Chilhood (ISAAC) tai TP. HCM nam 2005 cd ty te tre 13-14 tud'i da timg khd khe, cd eon hen 12 thang trude do la 16,2%i'5i.
Ve dia ban nghien ciiu, 21 xa ciia huyfn Cu Chi deu cd tre tham gia nghien ciiu.
Tinh hinh benh hen
Phdn boty le ca benh vd ca chieng tinh theo lida tuoi
Ty le ca chiing cao ga'p 4 ca benh, phu hpp vdi tieu ehuan 1 ca bfnh tuong ung vdi 4 ca chiing.
Phdn bo tre mac benh hen theo xd Tre bi hen phan bd' tren 17 xa vimg ndng thon, 4 xa cdn Iai chua phat hien tre ed bfnh hen.
Phdn ho benh hen theo giai tinh Ti If hen d nam va nii khdng khac biet
50
Y Hoc TP. Ho Chi M i n h * Tap 16 * So J * 2012
Phdn loai bac hen
Nghien ciiu cua chiing tdi va nghien cihi cua bfnh vien Xhi Dong 1 deu phat hifn hen bac 4 d miic dp tha'p (nghien cieu ciia chung toi la 15,15% vd nghien ciru cua benh vien Nhi Dong 1 la 17%('S'
N g h i e n ctf" Y h o c
Tinh hinh n h i l m giun Ty le nhiem giun
Nhiem giun trong quan the nghien eiiu la 36,71%. Ty If nay kha cao, nhung vi Cu Chi la viing dich te ciia nhiem giun san nen phu hpp vdi tinh hinh nhiem giun san tgi Vift Nam:
nhiem giun dudng rudt - 35,6-95%,. giun dua - 0,2-75,6%, giun tdc - 1,7-87,5%, giun mdc - 7,7-45,5%, san la gan nhd 0,53-49,09%, san day
<13%. Ti If ddng nhiem giun 60-80% va tai nhiem giun cd the len de'n 68% (khao sat tren 8.562.348 hpe sinh tieu hpc)"*'^'«>.
Phdn bo'ty Ie nhiem cdc lodi giun Ty Ie nhiem Aukylosloma duodenale va Toxocara sp. 11,39%, Cystycercus cellulosae 6,96%, Strongyloides stercoralis 5,06%, Paragonimus sp. 3,16%, Fasciola sp., Gnathostoma sp. 2,53%, Trichuris trichiura 1,90% va Enterobius vermicularis 0,63%
Ke't qua ciia chiing tdi phii hap vdi ke't qua tir cac nghien cuu khac: nhiem giun diia: 0,2- 75,6%, giun tdc 1,7-87,5%, giun mdc 7,7-45,5%, san la gan nhd 0,53-49,09%, san la gan ldn
<0,2%, san la rupt nhd <15,3%, san la rupt Idn
<3%, san day <13,6%, san la phdi 0,5% (khao sat tren 8.562.348 hpe sinh tieu hpe) ^; nhiem san la phdi la 6,8% (khao sat tren 1.019 ngudi)<"'-i8i.
Benh hen va nhiem giun san
Phdn tich md'i lien quan giUa benh hen vd nhiem giun sdn:
Tre nhiem giun san cd ty le mSc benh hen tha'p hon 4,16 Ian (1/0,24) so vdi tre khdng nhiem giun san.
Ket qua nay phii hpp vdi cac nghien euu
- ' • icAAC i'-^Ulniernational - Nghien cuu cua ISAAC ' ,. , Study of Asthma and Allergies in Childhood) c^o thay ti le benh hen o nude c6 neh edng nghiep phat trien cao hon nhieu so vdi nirac nong nghiep va nhdm tae gia cung nhgn thay a .omg nhiet ddi, benh di ting d thanh thi cao han rat nhieu so vdi vimg ndng thon.
- Carstefi Flohr (^ quan sat tren 1.601 ti^
em Viet Nam nlian tiiay nguy eo nhay cam vdi ve mat giam khi n h i l m Ankylostonm duodenale ngng - OR: 0,61; 95% CI: 0,39-0,96 giua 350 tning so vdi khdng cd tning, khi nhilm Ascaris lumbricoides (giun dUa) la OR, 0,28; 0,10-0,78. Tac gia ke't luan rang nhiem giun san lim hanh, dieu kien vf sinh, ngudn nude sgeh anh hudng de'n nguy co di ung d tre em Vift Nam. Benh di iing dupc bao ve bdi nhilm giun san luu hanh hoac cac nhiem triing tieu hda khac.
- Lync/if"' nhan thay nguy co di iing se giam d vimg nhiem nang ky sinh trimg. Ne'u xd giun nhieu lan co the gay ra phan ung di ling da hoae lam gia tang ti If phan ling nay d tre nhiem giun trong vimg luu hanh giun
- Cazzolett '^' nhgn tha'y co su tuong quan nghich giiia trifu chung khd khe vdi hien tupng nhiem nang Ankylostoma duodenale, Ascaris lumbricoides^*''. Phoi nhiem ky sinh triing luu hanh da tae dpng de'n bieu hifn sdm cua benh di iing va ngan ngira su xua't hien viem da di iing d tre nhii nhi, giam di nguy co benh hen nang, benh viem miii di iing hoge trieu chiing bfnh hen luc ve gia''^'^^*.
- Cooper*^'nhan tha'y tan sua't bfnh di ung tang d cac nude eong nghifp phat trien trong 30-40 nam gan day va su thay dd'i di truyen eiing anh hudng de'n su phai nhiem vdi mdi trudng sdng. Qua nhieu nghien ciiu, Philip Cooper nhan tha'y tre sd'ng trong gia dinh
Nghien cmi Y hoc Y Hoc TP. Ho Chi Minh * Tap 16 * So I * 2012
nhieu the he, tre dupe giri nha tre hogc tre sd'ng trong vimg dan cu ddng diic, chat chdi it cd nguy co mae bfnh di ling hon vi su tie'p xiic thudng xuyen vdi virus va vi khuan Iiic nhd cd the bao ve khdng phat bfnh benh di ling khi ldn hon -gia thuye't ve sinh''*'.
- Mohamed Elfatih H. Bashi^> nhan tha'y hien tupng dieu hoa nguoc IgE dae hieu lien quan deh hifn tupng giam tiet IL-13 cua te' bao T dae hieu va lam giam phan iing di iing d chupt da nhiem giun san.
Kunihiko Kitagaki^^> nhan tha'y d cac nude cham phat trien chinh dieu kien ve sinh kem da giiip cdng ddng bao ve dupe bfnh hen. Tac gia cho rang tie'p xiic nhieu vdi tac nhan gay bfnh se lam giam phan iing viem qua trung gian te'bao Th2. Chuot nhiem giun san ciing dupe bao vf de chd'ng lai hien tupng viem theo kieu eosinophile do truyen thu dong te' bao CD4 dupc kich thieh bdi OVA.
Kunihiko Kitagaki nhan thay su hifn difn ciia giun san da chd'ng lai bfnh hen va cac rd'i loan do CO dia, va cytokine IL-10 cd viii trd quan trpng trong eo che' dieu hda phdn umg viem di ieng phu thuoc nhiem giun sdn.
Vifn Qudc Gia siic khoe Hoa Ky eho bie't khoang 40-50 trieu ngudi My m i c bfnh di ling, va cd rJiihig bao cao cho tha'y tai \'img xich dao, noi nhiem nang giun san thi ty If bfnh hen va bfnh di iing ra't tha'p. Ngudi ta nhan tha'y vai trd ciia cac cytokine 17, cytokine 25 trong co che' logi trir mien dich nay"'"^'.
Cdc Iodi giun sdn gdy nhihn tren nhom tre mdc henh hen
Ke't qua khao sat nhiem giun san tren 33 tre mSc bfnh hen cho thay:
Chi nhihn mot logi giun san.
Giun san dudng rudt: Yi ic>h} i> mchiura
<-;iiin foci
Giun san trong md: Strongyloides stercoralis, Paragonimus sp.,
Ddng nhiem giun: Strongyloides stercoralis, Paragonimus sp., Toxocara canis. Nghien cuu tir cac tac gia khac cung cho ke't qua vdi eac loai giun san tuong tu:
Philip Cooper: nghien ciiu tren Ascaris lumbricoides (giun diia), Trichuris tiichiura (giun tdc), Ankylostoma duodenale (giun mde), Enterobius vermicularis (giun kim) (^'
Jo Leonard i-Bee: nghien ciiu tren Ankylostoma duodenale (giun mdc), Ascaris lumbricoides (giun diia), Trichuris trichiura (giun tdc), Enterobius vermicularis (giun kim)<2'.
Carsten Flohr: nghien cuu tren Ankylostoma duodenale (giun mdc), Ascaris lumbricoides (giun dua), Trichuris trichiura (giun tdc)Pi.
Mai Nguyet Thu Hong, Tran Thi Kim Dung va cs."^* (2010): Strongyloides stercoralis (giun luon) Ankylostoma duodenale (giun mde), Toxocara canis (giun diia chd, meo).
N h u vay, phan bd' loai giun san ma chiing tdi quan sat dupc d tre mac benh hen ciing phu hpp vdi eac nghien ctiu khac.
KETLUAN
Khao sat "Sif Uen quan giua nhidm giun sdn vd benh hen a tre em tgi huyen Cii Chi" da thu dupe cac ke't qua nhu sau:
Quan the nghien euu ed 158 tre 7-15 tudi, 62,66% tre nam va 37,34% tre nii. 21 xa ciia huyfn Cu Chi deu co tre tham gia nghien ciiu.
Neu len dupc su lien quan giiia nhiem giun san va mac benh hen. Ty le mac benh hen d tre cd nhiem giun san la 8,6%. Ty le mac benh hen d tre khdng nhiem giun la 28%. Ty
Y Hoc TP. Ho Chi Minh * Tap 16 * So I * 2012
sua't ehenh OR la 0,24, p=0,004, 95% CI: 0,08- 0,69. Ke't qua eho tha'y cd su lien quan giiia nhiem giun san va mic bfnh hen. Tre nhiem giun san ed t\' le mac benh hen tha'p hon 4,16 Ian (1/0,24) so vdi tre khdng nhiem giun san.
Cac loai giun san gay nhiem tren nhdm tre mac benh hen: Trichuris trichuria, Strongyloides stercoralis, Paragonimus sp. vd Toxocara canis.
Ke't qua cua nghien ciiu nay da neu len dupe 1 nhgn xet la nhiem giun san cd giam nguy CO bfnh hen trong quan the. Tre nhiem giun san co ty If mic bfnh hen tha'p han 4,16 lan (l/0,.24) so vdi tre khdng nhiem giun san.
Day la tien de cho 1 so' nghien ciiu khac nhu nhiem giun san va dp ngng cua benh hen, xd giun va benh hen, tuong tac mien dich giiia nhiem giun va bfnh hen... de tim hieu sau hon ve ca che'mien dich trong nhiem giun san va su ddng tie'n hoa ciia vi sinh vgt va con ngudi.
TAI UEU THAM KHAO
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An Enlenc Helminth Infection Protects Against an Allergic R e ^ n s e to Dietaiy Antigen, n w Journal of I m m u n o l o ^ , 169:
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Z Bee LJ, Pntchard D, Bntton J et al (2006). Asthma and Current Intestinal Parasite Infection Systematic Review and Meta- Analyas American. Journal of Respratory and aitical care medicme. 174:514-523.
3 Cazzolem 1, Marcon A, Janson C, Corsico A, Jarvis D, Pin I, et a]
(2007). Asthma control in Europe: a real -world evaluation based
<m an international population-based study. J. Allergy Qin.
Immunol 120 (6): 1360-1367.
4 Oaik TJH, Bateman ED, Bousquet J, Busse WW, Grouse L, Holgate ST, Lenfant C Byrne P, Ohta K, Pedersen SE, Singh RB, Tan W C Bames PJ, Beasley R, Bi^aard H, Boushey HA, Custovic A, FitzGerald .IM, Neville R. Silvennan M, Sterk P, Schayck OCP, Vignola AM <2004). Global Initiative for Asthma.
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