安庆市0-14岁儿童哮喘流行病学调查及危险因素研究

发布时间：2018-03-19 02:35

本文选题：儿童　切入点：哮喘　出处：《安徽医科大学》2012年硕士论文　论文类型：学位论文

【摘要】：目的支气管哮喘（简称哮喘）是小儿时期最常见的呼吸道过敏性疾病，，严重影响儿童身心健康，近年来，世界各国儿童哮喘患病率都呈上升趋势。我国儿童哮喘发病率亦有上升趋势，安庆市城区儿童哮喘发病情况及其与其他城市是否有差别，以往少见报道。按照全国儿童哮喘流调协作组及国家疾病预防控制中心（Centers for Disease Control，CDC）的要求，我们于2010年10月1日至2011年9月30日对安庆市城区10000名0～14岁儿童进行了哮喘流行病学调查，旨在了解本地区小儿哮喘发病情况及相关因素，为更好地防治儿童哮喘提供科学依据。方法采用整群随机抽样和电话家访相结合的方式，对安庆市迎江、大观（含石化辖区）10000例0～14岁儿童进行哮喘流行病学调查。调查对象为所在调查地区的幼儿园、中小学和散居儿童。自1996年7月1日零点～2010年6月30日11时59分之间出生的儿童。采用全国哮喘防治协作组制定的统一方案、步骤和问卷，由本科室经过正规培训的儿科医师协助组成调查小组，首先使用儿童哮喘初筛调查表对上述对象进行调查，筛选出可疑哮喘，再对可疑患儿进行详细询问病史和必要的体格检查，为避免家长记忆错误，凡有病历的均核对门诊病历和住院病历，符合诊断标准的儿童填写正式调查表。结果（1）从9173（发出10000张表收回9173张，容许流失率10%）名儿童中筛查出哮喘患儿338例，安庆市0～14岁儿童哮喘累计患病率是3.68%，其中儿童哮喘297例（87.87%）、婴幼儿哮喘41例（12.13%）。男女之比是1.77:1，男性累计患病率(4.49%)高于女性(2.80%)，差异有显著性(χ2=18.33，P0.05)。现患患病率为2.74%。发病率最高的年龄阶段是1～8岁。首次发病年龄3岁以前者占89.94%。（2）哮喘发作的诱因以上呼吸道感染为主，占73.96%，其次是天气变化或接触冷空气，占70.12%。哮喘发病季节以换季和冬季为主，好发时辰相当一部分无规律性，其次以午夜和清晨为主。使用过抗生素治疗者占71.30%，而接受吸入激素者占45.23%。（3）哮喘儿童中一、二级亲属有哮喘史分别占10.65%和10.95%，个人过敏史占32.54%，湿疹占30.18%，过敏性鼻炎占47.93%，荨麻疹占21.89%。结论本次调查发现男性患病率高于女性，89.94%的患儿3岁以前发病，1～8岁是哮喘发病的高峰年龄段。发病诱因以呼吸道感染最常见，其次是天气变化或接触冷空气，此外运动、被动吸烟等与哮喘发病有关。在哮喘治疗过程中大多数患儿使用过抗生素，而接受吸入激素治疗者比例较低。
[Abstract]:Objective bronchial asthma (Asthma) is the most common respiratory allergic disease in childhood, which seriously affects the physical and mental health of children. The prevalence of asthma in children all over the world is on the rise. The incidence of asthma in children in China is also on the rise. The incidence of asthma in urban areas of Anqing City is different from that in other cities. Rarely reported in the past. According to the request of the National Children's Asthma flow Coordination Group and the National Centers for Disease Control and Prevention, From October 1st 2010 to September 30th 2011, we conducted an epidemiological survey on asthma among 10000 children aged 14 years old in Anqing City, in order to understand the incidence of asthma and its related factors. To provide scientific basis for better prevention and treatment of childhood asthma. Methods A cluster random sampling combined with telephone home visits was used to investigate the epidemiology of asthma among 10 000 children aged 0 to 14 years old in Yingjiang and Daguan areas of Anqing city. Children born between 00:00 and 11:59 on July 1st 1996 and June 30th 2010, children born in primary and secondary schools and in the diaspora, using a unified programme, steps and questionnaires developed by the National Asthma Prevention and Control Cooperation Group, With the help of a regular trained pediatrician in our department, a survey team was formed. First, the above subjects were investigated by using the child asthma screening questionnaire, and suspected asthma was screened out. In order to avoid the parents' memory errors, all the medical records of outpatients and inpatients were checked, and the children who met the diagnostic criteria filled out a formal questionnaire. Results 1) 338 children with asthma were screened out of 9173 children (9173 sheets were issued and the allowable wastage rate was 10). The cumulative prevalence of asthma was 3.68 in 14 year old children in Anqing city, including 297 cases of asthma in children (87.87%) and 41 cases of asthma in infants (12.13131.The ratio of male to female was 1.77: 1, the cumulative prevalence rate of male was 4.49%), and the difference was significant (蠂 218.33 P 0.055.The prevalence rate was 2.74%). The first onset age was 3 years (89.94%). The main cause of asthma attack was upper respiratory tract infection. Accounting for 73.96, followed by weather changes or exposure to cold air, accounting for 70.12.The incidence of asthma is mainly seasonal and winter, and a considerable part of the predilection time is irregular. The second was midnight and early morning. Those who had been treated with antibiotics accounted for 71.30, while those who received inhaled hormones accounted for 45.23.03) of the children with asthma, 10.65% and 10.95 had a history of asthma in the second degree relatives, 32.54 had a history of personal allergies, 30.18 in eczema, 47.93 in allergic rhinitis and 21.8900m in urticaria. Conclusion the prevalence rate of male children is 89.94% higher than that of females. The peak age of asthma onset is before 3 years of age. Respiratory tract infection is the most common cause, followed by weather changes or exposure to cold air, in addition to exercise. Passive smoking was associated with asthma. Most of the children had used antibiotics in the course of asthma treatment, but the proportion of those who received inhaled hormone therapy was lower.
【学位授予单位】：安徽医科大学
【学位级别】：硕士
【学位授予年份】：2012
【分类号】：R725.6

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