目的 了解贵阳地区哮喘患儿病情控制现状及影响哮喘控制的因素,为进一步加强儿童哮喘防治工作提供依据。方法 选取在贵州医科大学附属医院儿科哮喘门诊就诊的病程超过12个月的1~14岁哮喘患儿400例,采用回顾性调查的方法对其家长就哮喘控制状况及疾病认知情况进行问卷调查,以患儿近12个月有无哮喘发作为标准将其分为控制组和未控制组,对可能影响哮喘控制的相关因素进行多因素分析。结果 在过去12个月内,72.5%的患儿有过哮喘发作,35.5%的患儿有过因哮喘发作的急诊治疗,17.8%的患儿有过因哮喘发作导致的住院治疗。家庭经济收入、家长学历、家长认知水平、坚持规范用药、坚持定期复诊是哮喘患儿控制的保护因素;个人过敏史、哮喘家族史、被动吸烟史是哮喘患儿控制的危险因素。结论 贵阳地区哮喘患儿病情整体控制状况并不理想,与全国城市平均水平相比还存在一定的差距。家长对疾病的认知水平、治疗依从性及不良环境的接触等因素是影响哮喘控制的主要危险因素,认识并改善影响因素,有助于提高哮喘控制水平。
Abstract
Objective To investigate the status of asthma control and the effect factors of asthmatic children in Guiyang,and provide the basis for further strengthening asthma prevention and treatment. Methods A total of 400 asthmatic children who visited the outpatients departments of Affiliated Hospital of Guizhou Medical University were selected,theses asthmatic children aged 1~14 years old and the course was more than 12 months.Retrospective investigation was conducted to the parents on the status of asthma control and their cognitive level about asthma,theses children were separated into the controlled group and uncontrolled group according to asthma conditions in the past 12 months.Multivariate analysis was carried out on the related factors likely to affect the asthma control. Results In the past 12 months,72.5% asthmatic children had asthma attacks,35.5% asthmatic children had visited the emergency room,and 17.8% asthmatic children had been hospitalized.Family economic condition,parents' education,parents' cognitive level,adhere to normalized medication and regular visits were protective factors of asthma control,personal history of allergy,family history of asthma,and history of passive smoking were risk factors of asthma control. Conclusion sChildren's asthma is poorly controlled in Guiyang area,there is a certain gap compared with the national average city.Parents' cognitive level,treatment adherence,contacting with bad environment are the main factors of asthma control.Understanding and improving the influencing factors can help to improve the level of asthma control.
关键词
哮喘 /
控制状况 /
影响因素 /
儿童
Key words
asthma /
control status /
affect factors /
child
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参考文献
[1] Global Initiative for Asthma.Global strategy for asthma management and prevention[EB/OL].Revised,2014.
[2] Wong GWK,Kwon N,Hong JG,et al.Pediatric asthma control in Asia:phase 2 of the asthma insights and reality in Asia-pacific (AIRIAP 2) survey[J].Allergy,2013,68(4):524-530.
[3] 中华医学会儿科学分会呼吸学组.儿童支气管哮喘诊断与防治指南[J].中华儿科杂志,2016,54(3):167-181.
[4] Rade KF,Adachi M,Lai CK,et al.Worldwide severity and control of asthma in children and adults:the global asthma insights and realty surveys[J].J Allergy Clin Immunol,2004,114:40-47.
[5] Demoly P,Annunziata K,Gubba E,et al.Repeated cross-sectional survey of patient-reported asthma control in Europe in the past 5 years[J].European Respiratory Review,2012,21(123):66-74.
[6] 中国哮喘儿童家长知信行调查项目组.中国大陆29个城市哮喘患儿病情控制状况及影响因素[J].中华儿科杂志,2013,51(2):90-95.
[7] 刘传合,沙莉,邵明军,等.北京市城区儿童支气管哮喘诊断与管理状况的调查[J].中华实用儿科临床杂志,2013,28(16).
[8] 黄顺开,陈爱欢,孙丽红,等.广州市支气管哮喘患儿家长知信行问卷调查分析[J].实用儿科临床杂志,2011,26(9):653-655.
[9] 黄洋,黄兆选,杨磊.三甲医院儿童哮喘规范化诊疗现状分析[J].临床肺科杂志,2014,19(1):162-164.
[10] Gold LS,Smith N,Allen-Ramey FC,et al.Associations of patient outcomes with level of asthma control[J].Annals of Allergy,Asthma & Immunology,2012,109(4):260-265.
[11] 徐文林,王爱敏,张楠,等.家庭功能及家庭环境对儿童哮喘控制水平的影响[J].中国儿童保健杂志,2014,22(9):988-990.
[12] Brinke AT,Sterk PJ,Masclee AAM,et al.Risk factors of frequent exacerbations in difficult-to-treat asthma[J].European Respiratory Journal,2005,26(5):812-818.
[13] 王天玥,尚云晓.被动吸烟与儿童哮喘[J].国际儿科学杂志,2011,38(1):1-3.
[14] 陈淑琴.支气管哮喘患者治疗依从性及其与疾病控制的关联性研究[D].苏州:苏州大学,2014.
[15] Yao YY,Lu LH.Investigation on treatment of asthma in children[J].Jilin Medical Journal,2009,30:407-408.
[16] 韩远源.儿童哮喘控制现状及疾病认知程度的调查[J].实用医学杂志,2013,29(11):1858-1860.