氣喘病是兒童最常見的慢性疾病。影響氣喘發作的因素極為複雜，氣候及空氣污染緘被認為是重要的影響因素。我們發現雖然空污指數逐年下降，但氣喘盛行率卻仍逐年上升；許多研究也發現氣溫可能影響氣喘病人的肺功能，儘管其機制仍不甚清楚。

　　為了進一步了解空污及日溫差變化是否影響氣喘病之發作，我們在台灣進行本研究；以民國90年全年度台灣健保住院資料，篩檢18歲以下(含)氣喘病青少年及兒童共7,623人次為對象，進行其住院期間和非住院期間的日溫差和空污暴露資料比對。統計方法採用2 sample t test及多變項回歸分析方法進行分析，以了解空污、日溫差、和氣喘發作住院間的關係。另以partial correlation coefficient analysis探討空污、日溫差之間是否有交互作用存在。

　　結果發現，不同季節的日溫差效應並不相同，在春、夏、秋三季雖有一致性效應，冬季出現相反溫差效應；此種溫差效應變化，則與該區域的地形有關。至於空污指標效應之研究，受限於測站2km內涵蓋醫院資料不足，僅彰化測站呈現住院前第三日(住院組)的PSI值61.81高於非住院組的56.75(P=0.03)；另外，中山站住院前第五天的PSI平均指標60.21，也高於組外的PSI均值52.03 (P=0.00)；除此之外，其他4處測站皆未呈現統計差異性。以partial correlation coefficient analysis分析結果，未見空污、日溫差之間有明顯交互作用存在。

　　總之，日溫差的絕對值大小不是造成氣喘發病之因素，氣喘發作取決於不同季節、不同地形區域的日溫差是否發變化而定；因此，居住非高山區域且臨海縣市的氣喘病童，應避免在夏天頻繁進出使用空調場所或使用溫度設定過低之空調。

　　Asthma is the most common chronic disease in children. Factors associated with asthma were complicated. Climate and air pollution have been proposed as important factors of asthma, but the prevalence of asthma has been increasing in spite of reduce of pollution. Many studies found that temperature might affect the pulmonary function in asthma patients, but its effect on symptoms of asthma is still unclear.

　　To evaluate whether the air quality and diurnal temperature changes have influences on symptoms of asthma, we conducted a study in Taiwan. Children less than 18 years of age who were admitted to hospitals for the exacerbation of asthma between January 1 and December 31, 2001 were recruited. A total of 7,623 asthmatic children were included. The air quality and the diurnal temperature changes on the days with admission for asthma were compared with those on the days without admission. Two-sample t test was used to evaluate the differences in diurnal temperature changes or PSI exposure between the two groups--days with admission for exacerbation of asthma and days without. Multiple linear regressions were used to assess the relative strength of effects of the two different factors on the attack of asthma. Furthermore, possible interactions between the diurnal change of temperature and the PSI were assessed by analyses of partial correlation coefficient.

　　The effects of diurnal changes of temperature were found to vary in different seasons and geographic settings. Only two monitor regions showed significant difference of higher PSI on days with admission than without admission (61.81 v.s. 56.75, 60.21 v.s. 52.03; P<0.05), and the lack of hospital data was a limitation.

　　In conclusion, the unusually diurnal changes of temperature, not the absolute value of diurnal changes, may affect the exacerbation of asthma in different geographic areas and different seasons. We suggest that asthmatic children living in the regions of lower altitude avoid going into or out of rooms with the air conditioners frequently on the summer, especially when the air conditioners are set on a relatively low temperature. Further control and close monitor of the air pollution are still important measures to prevent the increasing prevelance of bronchial asthma in children.

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