目的 探索郊区和城区空气污染物浓度差异及空气污染指数与儿童哮喘患病情况的关系,为哮喘防治提供理论依据。方法 本次研究对象为2017年1月—2019年12月期间中国医科大学附属盛京医院收治的211例哮喘患儿,均进行肺功能、哮喘评分评估,同时选取辽宁省沈阳市城区面积23.71 km²,郊区面积22.86 km²进行空气污染物浓度检测,并分析城区、郊区空气污染物、儿童哮喘患病情况之间的关系。结果 城区空气污染物中总计PM₁₀浓度[(0.139±0.032)mg/m³]、API浓度(65.455±8.741)、PM_2.5[(0.061±0.010)mg/m³]高于郊区空气中总计PM₁₀浓度[(0.048±0.012)mg/m³]、API浓度(56.955±8.774)、PM_2.5[(0.061±0.010)mg/m³](t=24.256、6.827、17.575,P＜0.001)。从哮喘发生情况分析,城区总计哮喘发生率高于郊区(χ²=26.626,P＜0.001),组间对比FEV₁、PEF差异无统计学意义(P>0.05),但哮喘评分差异有统计学意义(t=18.863,P＜0.001)。经Pearson法分析,城区、郊区患者哮喘评分与NO₂、SO₂、PM₁₀、PM_2.5、API呈正相关性(r_城区=0.197、0.318、0.252、0.451、0.167,P＜0.05;r_郊区=0.281、0.241、0.428、0.395、0.487,P＜0.05);经Spearman法分析,城区、郊区哮喘病情严重程度与NO₂、SO₂、PM₁₀、API、哮喘评分、PM_2.5、FEV₁、PEF呈正相关性(r_城区=0.458、0.398、0.478、0.498、0.356、0.524、0.511、0.528,P＜0.05;r_郊区=0.457、0.419、0.589、0.524、0.398、0.425、0.424、0.407,P＜0.05)。结论 城区和郊区的空气污染物浓度存在差异,与哮喘儿童病情严重程度呈正相关性。污染越严重,儿童患病程度越严重。

Objective To explore the difference in air pollutant concentration between suburbs and urban areas and its correlation with the severity of asthma in children, in order to provide theoretical reference for the prevention and treatment of asthma. Methods A total of 211 children with asthma treated from January 2017 to December 2019 were enrolled in this study, and were evaluated for pulmonary function and asthma score. Meanwhile, 23.71 km² urban area of Shenyang, Liaoning Province and 22.86 km² suburban areas were selected to detect the concentration of air pollutants. The correlation of the air pollutants concentration in suburbs and urban area with the prevalence of asthma was analyzed. Results The total concentration of PM₁₀ [(0.139±0.032)mg/m³ vs. (0.048±0.012)mg/m³], API (65.455±8.741 vs. 56.955±8.774) and PM₂ [(0.036±0.010)mg/m³ vs. (0.036±0.010)mg/m³] in urban air pollutants was significantly higher than those in suburban air pollutants (t=24.256, 6.827, 17.575, P＜0.001). The incidence of asthma in urban area was higher than that in suburban area (χ²=26.626,P＜0.001). There was no statistical difference in FEV1 and PEF between children in suburbs and urban area(P>0.05), but significant difference was found in asthma score (t=18.863,P＜0.001). Pearson correlation analysis showed that the asthma scores of urban and suburban patients were significantly correlated with the concentration of NO₂, SO₂, PM₁₀, PM_2.5 and API (r_{urban area}=0.197, 0.318, 0.252, 0.451, 0.167, P<0.05; r_{suburban area}=0.281, 0.241, 0.428, 0.395, 0.487, P<0.05). Spearman correlation analysis showed that the severity of asthma in suburbs and urban area was positively related to NO₂, SO₂, PM₁₀, PM₂₅, API, asthma score, PM2.5, FEV1 and PEF (r_{urban area} =0.458, 0.398, 0.478, 0.498, 0.356, 0.524, 0.511, 0.528, P<0.05; r_{suburban area}=0.457, 0.419, 0.589, 0.524, 0.398, 0.425, 0.424, 0.407, P<0.05). Conclusion There are differences in air pollutants concentration between suburbs and urban area, which is positively correlated with the severity of asthma children. The more polluted the area, the more severe the asthma in children.