目的 分析142例学龄前儿童支气管哮喘发病特点及其危险因素,以期为哮喘的预防提供参考。方法 选择2018年1月-2019年12月在川北医学院第二临床医学院南充市中心医院接受住院治疗的学龄前儿童支气管哮喘患者142例为病例组,选取与病例组性别、年龄匹配的非哮喘住院患儿142例为对照组。以问卷调查的方式获取调查对象基本情况,采用Logistic回归分析明确儿童支气管哮喘的危险因素。结果 本次纳入调查的病例组患儿男83例,女59例;129例患儿是因呼吸道感染而引起,感染病原体包括:支原体46例,呼吸道合胞病毒37例,流感病毒33例,腺病毒14例,副流感病毒5例。多因素分析显示出生孕周≥37周(OR=0.792,95%CI:0.357~0.948)、出生后6个月纯母乳喂养(OR=0.320,95%CI:0.107~0.479)为学龄前儿童支气管哮喘发病的保护因素,有家族过敏史(OR=1.513,95%CI:1.206~1.742)、有变应性鼻炎史(OR=1.304,95%CI:1.182~1.549)、有食物过敏史(OR=1.815,95%CI:1.492~2.203)、家庭1年内装修(OR=1.328,95%CI:1.102~1.591)、家庭成员吸烟(OR=2.115,95%CI:1.628~2.499)、长期接触毛绒或泡沫制品(OR=1.480,95%CI:1.173~1.772)、学校或家庭邻近大马路(OR=1.815,95%CI:1.692~2.203)是危险因素(P<0.05)。结论 学龄前儿童支气管哮喘多由呼吸道感染所引起,主要受出生孕周、家族过敏史等因素的影响,临床上可针对上述因素进行干预,以降低学龄前儿童支气管哮喘的发病率。
Abstract
Objective To analyze the characteristics and risk factors of bronchial asthma in 142 preschool children, in order to provide reference for preventing asthma. Methods A total of 142 preschool children with bronchial asthma hospitalized in Nanchong Central Hospital from January 2018 to December 2019 were selected as case group.Meanwhile, 142 non-asthmatic hospitalized children in the respiratory department, who were matched by gender and sex, were selected as control group.The basic information of the surveyed objects was obtained by questionnaire survey.And the risk factors for bronchial asthma were analyzed by Logistic regression analysis. Results There were 83 males and 59 females in the case group, of whom 129 were caused by respiratory tract infection, including 46 cases of mycoplasma, 37 cases of respiratory syncytial virus, 33 cases of influenza virus, 14 cases of adenovirus and 5 cases of parainfluenza virus.Univariate analysis showed that gestational age ≥37 weeks (OR=0.792, 95%CI:0.357-0.948), exclusive breastfeeding within 6 months old (OR=0.320, 95% CI:0.107-0.479) were the protective factors for the onset of bronchial asthma in preschool children, while the risk factors included family history of allergic disease (OR=1.513, 95% CI:1.206-1.742) and allergic rhinitis (OR=1.304, 95% CI:1.182-1.549), history of food allergy (OR=1.815, 95% CI:1.492-2.203), family decoration within one year (OR=1.328, 95% CI:1.102-1.591), family members smoking (OR=2.115, 95% CI:1.628-2.499), long-term contact with fluffy or foam products (OR=1.480, 95% CI:1.173-1.772), school or family near the main road (OR=1.815, 95% CI:1.692-2.203) were the risk factors (P<0.05). Conclusion Bronchial asthma in preschool children is mostly caused by respiratory tract infections and is mainly influenced by factors such as gestational age at birth and family history of allergies, which can be intervened targetedly to reduce the incidence of bronchial asthma in preschool children.
关键词
学龄前儿童 /
支气管哮喘 /
发病特点 /
呼吸道感染
Key words
preschool children /
bronchial asthma /
incidence characteristics /
respiratory track infections
{{custom_sec.title}}
{{custom_sec.title}}
{{custom_sec.content}}
参考文献
[1] 徐晓华, 赵彤, 辛然.儿童支气管哮喘160例临床分析[J].中国实验诊断学, 2018, 22(6):1091-1092.
[2] 马香萍, 乔丽潘, 多力坤,等.乌鲁木齐市0～14岁儿童支气管哮喘流行病学调查分析及危险因素分析[J].中华实用儿科临床杂志, 2015, 30(4):261-263.
[3] Mejias SG, Ramphul K.Prevalence and associated risk factors of bronchial asthma in children in Santo Domingo, Dominican Republic[J].Cureus,2018,10(2):2211-2214.
[4] Singh S, Jindal S,Goyal JP.Risk factors for bronchial asthma in school going children[J].Indian J Pediatr,2017,84(11):873-874.
[5] 中华医学会儿科学分会呼吸学组, 《中华儿科杂志》编辑委员会.儿童支气管哮喘诊断与防治指南(2016年版)[J].中华儿科杂志, 2016, 54(3):167-181. [6] Valle SOR,Kuschnir FC, Solé Dirceu, et al.Validity and reproducibility of the asthma core International Study of Asthma and Allergies in Childhood (ISAAC) written questionnaire obtained by telephone survey[J].J Asthma, 2012, 49(4):390-394.
[7] Qurieshi UA, Bilquees S, Haq I, et al.Epidemiology of bronchial asthma in school children (10-16 years) in Srinagar[J].Lung India, 2016, 33(2):167-173.
[8] 沙莉, 邵明军, 刘传合,等.2010年与2000年中国城市儿童支气管哮喘患病率比较[J].中华结核和呼吸杂志, 2015, 38(9):664-668.
[9] Wu P, Feldman AS, Rosas-Salazar C, et al.Relative importance and additive effects of maternal and infant risk factors on childhood asthma[J].PLoS One, 2016, 11(3):151705-151709.
[10] 郭彩云,张金凤,魏楚洪, 等.5岁以下喘息性支气管炎的临床特征及发展为支气管哮喘的相关因素分析[J].数理医药学杂志,2019,32(7):1020-1022.
[11] 肖小兵, 邓建荣, 聂煜哲,等.5岁以下儿童支气管哮喘发病与其母亲孕期及新生儿时期的相关因素分析[J].临床肺科杂志, 2019, 24(4):705-708.
[12] Vollmer RL,Adamsons K, Foster JS, et al.How are fathers' demographic characteristics related to preschool-age children's weight and obesity risk factors?[J].Ecol Food Nutr, 2017, 56(5):381-392.
[13] 王玲, 郭蓉, 杨欢, 等.重庆地区室内环境与儿童支气管哮喘的相关性研究[J].中国全科医学, 2019, 22(12):1405-1412.
[14] Yong MP,Lee SY, Woo KK,et al.Risk factors of atopic dermatitis in Korean schoolchildren:2010 international study of asthma and allergies in childhood.[J].Asian Pac J Allergy Immunol, 2016, 34(1):65-72.
[15] Chikara O, Englund JA, Bradford MC, et al.Characteristics and outcomes of coronavirus infection in children:the role of viral factors and an immunocompromised State[J].J Pediatric Infect Dis Soc, 2019,28, 8(1):21-28.
[16] Zaroudi M, Charati JY, Mehrabi S, et al.Dietary patterns are associated with risk of diabetes type 2:a population-based case-control study[J].Arch Iran Med,2016,19(3):166-172.
PDF(526 KB)
