目的 探讨高原地区0~14岁儿童哮喘的危险因素,为疾病的预防提供临床指导。方法 选取2020年1月1日—2020年12月31日于甘肃省妇幼保健院就诊的33例哮喘儿童为病例组,同期在本院就诊的44例非哮喘儿童为对照组,采用自制哮喘问卷调查分析高原地区儿童哮喘发生的影响因素。结果 高原地区哮喘儿童发病季节不定(12例,36.4%)或9~11月高发(11例,33%),容易在午夜(12例,36.4%)发病,发病诱因主要是呼吸道感染(13例,39.4%)和接触冷空气(7例,21.2%)所致,哮喘限制了儿童的体育活动(26例,78.8%),且增加家庭的经济负担。Logistic多因素回归分析显示,既往诊断为哮喘(OR=3.660,95%CI:1.498～6.549)、呼吸道感染史(OR=2.660,95%CI:1.409~7.291)、早产儿(OR=2.413,95%CI:1.380~4.356)、有家庭成员吸烟(OR=2.834,95%CI:1.501~5.487)和早期应用过抗生素治疗(OR=4.328,95%CI:3.384~8.645)是儿童哮喘的危险因素(P＜0.05)。而生后6个月纯母乳喂养(OR=0.057,95%CI:0.008~0.411)为儿童哮喘的保护因素(P＜0.05)。结论 在氧气稀薄的高原地区,家长应积极避免儿童哮喘的危险因素,婴儿期尽量使用纯母乳喂养,对预防和控制高原地区儿童哮喘具有重要意义。

Objective To investigate the risk factors of asthma in children aged 0 to 14 years from the plateau area, in order to provide clinical guidance for asthma prevention. Methods From January 1st to December 31st, 2020, 33 asthmatic children in Gansu Provincial Maternal and Child Health Hospital were selected into the case group, and 44 non-asthmatic children with matched gender and age were selected into the control group. A self-designed asthma questionnaire was used to analyze the influencing factors of asthma in children from the plateau area. Results The onset season of asthma in children from the plateau area was variable(12 cases, 36.4%) or the incidence was high(11 cases, 33%) from September to November, and the onset was easy at midnight(12 cases, 36.4%). The main causes were respiratory tract infection(13 cases, 39.4%) and exposure to cold air(7 cases, 21.2%). Asthma restricted children's physical activity(26 cases, 78.8%) and increased family financial burden. Logistic multivariate regression analysis showed that previous diagnosis of asthma(OR=3.660, 95%CI:1.498 - 6.549), respiratory tract infection history(OR=2.660, 95%CI:1.409 - 7.291), premature infants(OR=2.413, 95%CI:1.380 - 4.356), family members smoking(OR=2.834, 95%CI:1.501 - 5.487) and early use of antibiotics(OR=4.328, 95%CI:3.384 - 8.645) were risk factors for childhood asthma(P<0.05), while exclusive breastfeeding for 6 months after birth(OR=0.057, 95%CI:0.008 - 0.411) was a protective factor for childhood asthma(P<0.05). Conclusion In plateau area where oxygen is scarce, parents should actively avoid risk factors for childhood asthma and choose exclusive breastfeeding as much as possible during infancy, which is of great significance for the prevention and control of childhood asthma in plateau area.