5岁以下儿童哮喘危险因素的研究分析
发布时间：2018-08-04 18:36
【摘要】：研究背景：支气管哮喘（哮喘）是由多种炎症细胞，，包括嗜酸性粒细胞、肥大细胞、T淋巴细胞和上皮细胞及其细胞组分参与的气道慢性炎症。临床上表现为反复发作性喘息、呼吸困难、胸闷和咳嗽等症状。哮喘是全球范围内严重威胁公众健康的一种慢性疾病，不论是发达国家还是发展中国家，哮喘已成为严重威胁人类健康的一大疾病。支气管哮喘是儿童时期最常见的慢性呼吸道疾病，患病率亦呈上升趋势，我国儿科哮喘协作组曾对2000年及1990年全国儿童哮喘患病率进行调查，结果显示：我国儿童哮喘患病率从1990年的0.91%上升到2000年的1.5%,上升了64.84%,且2000年调查显示90.33%哮喘儿童首次喘息发生在5岁及以前，69.26%在3岁以下，29.74%在1岁以下。可见，5岁以下儿童哮喘占了儿童哮喘的极高的比例，大多数持续哮喘患者的发病始于学龄前。在5岁以下儿童，除了哮喘症状为非特异性这个普遍特点外，哮喘症状的多变性在这个年龄段更为突出。另外，在这年龄段因不能配合肺功能检查或肺功能检查仅作参考，难以客观评价气流受限和气道炎症，故目前尚无低龄儿童哮喘诊断的金标准。在以往，年幼儿哮喘的定义反复修改数次，但迄今为止仍无适于所有患儿的确切定义，此点也反映出年幼儿哮喘致病因素的复杂性，尽管人们对哮喘的病因进行了大量的研究，但至今仍未能明确阐明。2009年5月全球哮喘防治创议组织（GINA）发布了“5岁及5岁以下儿童哮喘诊断和管理的全球策略”，这是GINA首次针对5岁以下儿童而专有的哮喘管理指南。既往哮喘儿童的危险因素流行病学调查主要针对5岁以上儿童，且国内资料多以单因素分析为主。而对于5岁以下哮喘儿童危险因素的调查资料并不是太完善，大部分仅是调查问卷，如调查对象对过敏原依据的判断仅来源于既往医师的诊断或家人提供的病史而非患儿的实验室检查依据；且低龄儿童发生喘息相对大龄儿童可能更多与病毒感染，过敏原裸露、遗传等有关。因此，从不同角度研究年幼儿哮喘的危险因素，可有针对性地为有效预防与控制哮喘的发生、发展提供理论依据。 目的：通过病例对照研究方法，对5岁以下儿童哮喘危险因素进行单因素、多因素综合分析，以探讨本地区年幼儿哮喘儿童的危险因素所在，为有针对性地为有效预防与控制年幼儿哮喘患儿喘息持续发展提供理论依据，以预防哮喘发展为持续性喘息。 方法：本研究采用病例对照研究方法。研究对象：选择2010年1月至2011年6月在广州医学院第一附属医院儿科住院及门诊诊断哮喘的5岁及以下哮喘患儿共224例为哮喘组，其中男141例，女83例，年龄为2.0±1.46岁。选择同年龄段健康儿童共151例为对照组，其中男71例，女80例，年龄为2.5±0.3岁。通过问卷调查方式对两组进行病例对照研究，调查与年幼儿哮喘有关的因素。年幼儿哮喘诊断标准参照2008年全国儿童哮喘协作组制定的统一标准。并对所有对象抽取静脉血4ml,分离血清，通过酶联免疫分析法检测血清TIgE和常见16种血清过敏原的SIgE。此外抽取静脉血1ml，进行外周血常规检查。所以哮喘组患儿均另抽取静脉血及留取唾液标本进行病毒咽拭子PCR DNA检测、血清9种呼吸道病原学血清抗体检测。将回收的问卷进行核对检查，剔除失访、不配合调查、不合格问卷，哮喘组实际取得完整、合格资料171份问卷，合格率为76.34%，其中男127例，女44例，平均年龄为2.67±1.64岁。健康对照组中剔除不配合调查、不合格问卷共24份，实际取得完整、合格资料共127份问卷，合格率为84.11%，其中男62例，女65例平均年龄为2.94±1.38岁。两组在年龄、体重、身高上无明显差异。将调查结果录入计算机，利用SPSS17.0统计软件建立数据库并进行统计分析。首先将各变量赋值后带入单因Logistic回归分析中，再将单因素分析中有统计学意义的变量引入多因素非条Logistic回归分析中拟合主效应模型，求出最优效应方程估计各种危险因素对儿童哮喘发病的综合相对危险度，进一步考察各因素的作用。 结果：1、单因素分析结果如下所示：①出生史与哮喘的关系：男性（OR＝3.026）；早产或出生体重＜2.53彛∣R＝2.547）；出生时吸氧（OR＝3.603）；新生儿期诉有反复痰鸣（OR＝24.671）是哮喘发病的危险因素（P均＜0.05），阴式分娩是哮喘的保护性因素（OR＝0.363, P＜0.01）。②喂养史与哮喘的关系：母乳喂养持续时间≥6个月（OR＝0.288）；添加益生菌持续时间≥6个月、添加维生素D、钙剂持续时间≥1年是哮喘的保护因素（OR＝0.273和OR＝0.450,P＜0.05）③家居环境及附近外界环境与哮喘关系：生后第1年吸烟暴露（OR＝1.752）；潮湿（OR＝5.573）；花草多（OR＝4.828）；布艺沙发或家居铺地毯多（OR＝3.874）；蟑螂（OR＝6.495）；毛绒玩具多（OR＝10.624）；居住地在城市（OR＝2.642）；附近有工厂（OR＝1.969）；家居靠近马路（OR＝1.901）；家内及周围环境灰尘大（OR＝4.543）是哮喘发病的危险因素（P均＜0.05）。房屋对流通风好（OR＝0.118）；定期清理滤过网（OR＝0.472）；卫生清洁周期≥3次/周（OR＝0.049）是哮喘的保护因素（P均＜0.05）。哮喘组的人居居住面积为23.25±11.24m~2，对照组为33.92±17.86m~2，人均居住面积大是哮喘的保护性因素（OR＝0.250，P＜0.001）。④患儿营养性疾病与哮喘关系：佝偻病、患有其它营养性疾病（包括营养不良、贫血、缺锌等）是哮喘的危险因素（OR＝10.702和12.524，P均＜0.01）；⑤遗传过敏史与哮喘关系：患儿过敏史（OR＝128.348）；父母过敏史(指父母其中一方有过敏史者)（OR＝21.888）；母亲过敏史（OR＝16.109）；父亲过敏史（OR＝7.687）；其他1、2级亲属过敏史（OR＝34.791）是哮喘发病的危险因素（P均＜0.01）。⑥咳嗽症状与哮喘关系：第1次下呼吸道感染年龄＜6月（OR＝2.926）；1年中下呼吸道感染（支气管炎或支气管肺炎）的次数（OR＝6.250）；咳嗽持续时间≥2周（OR＝5.889）；咳嗽发作时间规律性（常在清晨或夜间咳嗽发作）（OR＝8.830）；冬春季节咳嗽多（OR＝2.871）；干咳症状为主（OR＝7.950）；（活动、吃奶、哭闹后）咳嗽气喘加剧（OR＝6.103）；突然出现的剧烈咳嗽（OR＝37.539）；咳嗽常伴随有鼻炎（OR＝5.887）；皮肤痒或眼痒的症状（OR_(伴随皮肤痒)＝38.473，OR_(伴随眼痒)＝17.567）；经常使用抗生素≥1次/月（OR＝9.389）；因呼吸道感染住院次数（OR＝120.780）是哮喘的危险因素（P均＜0.05）。⑦血清过敏原、血嗜酸粒细胞与哮喘关系：哮喘组中TIgE阳性率、SIgE阳性率均较对照组升高，是哮喘的危险因素（OR_(TIgE≥1级阳性率)＝2.888和OR_(SIgE≥1级阳性率)＝4.034， P均＜0.01）。哮喘组吸入性过敏原以螨类、屋尘过敏为主，食物性过敏原以牛奶过敏为主，其次是全蛋过敏。⑧两组其它辅助检查比较分析：哮喘患儿病毒感染阳性率、支原体感染阳性率均较健康儿童高，是哮喘的危险因素（OR＝14.974，和OR＝7.944，P均＜0.01）。 2、多因素分析结果显示：性别（OR＝6.554）、花草多（OR＝6.155）、家内及周围环境灰尘大（OR＝7.389）、父母过敏史（OR＝75.048）、清晨或夜间咳嗽发作（OR＝20.172）、多在冬春季咳嗽（OR＝6.495）、干咳为主（OR＝25.413）、螨类≥1级阳性率（OR＝18.704）、TIgE≥2倍阳性率（OR＝10.201）与对照组相比有统计学意义，是5岁以下儿童哮喘发病的重要危险因素（P均＜0.05）。添加维生素D、钙剂持续时间≥1年、添加益生菌持续时间≥6个月是哮喘的保护性因素（OR＝0.189和OR＝0.192，P均＜0.05）。 结论：通过病例对照分析，可见过敏原、病毒、家居环境、咳嗽症状及规律等因素是年幼儿哮喘的重要危险因素，病毒可能是导致年幼儿哮喘症状反复或加重的危险因素之一。早期预防及诊治年幼儿哮喘对预防哮喘持续发展意义重大。本文通过研究和分析5岁以下哮喘患儿的危险因素，以便明确哮喘的发病机制，并对早期发现哮喘、早期诊治哮喘，避免年幼儿哮喘发展并持续至成人期有一定意义。
[Abstract]:Background: bronchial asthma (asthma) is a chronic airway inflammation involving a variety of inflammatory cells, including eosinophils, mast cells, T lymphocytes and epithelial cells and their cell components. The clinical manifestations are recurrent wheezing, dyspnea, chest tightness, cough and other symptoms. Asthma is a serious threat to the public worldwide. Asthma, a chronic disease in the developed and developing countries, has become a major threat to human health. Bronchial asthma is the most common chronic respiratory disease in childhood, and the prevalence rate is on the rise. The prevalence rate of childhood asthma in 2000 and 1990 in China's pediatric asthma cooperation group has been carried out in China. The results showed that the incidence of asthma in children in China rose from 0.91% in 1990 to 1.5% in 2000, up 64.84%. In 2000, a survey showed that 90.33% asthma children were first wheezing for the first time at 5 years of age, 69.26% under 3 years of age and 29.74% under 1 years of age. The onset of persistent asthma begins before school age. In children under 5 years of age, in addition to the general characteristics of asthma symptoms, the variability of asthma symptoms is more prominent at this age. In addition, it is difficult to objectively evaluate airflow limitation and airway inflammation due to the lack of reference to pulmonary function examination or pulmonary function examination in this age group. So far, there is no gold standard for diagnosis of asthma in young children. In the past, the definition of childhood asthma has been revised several times, but so far there is still no exact definition for all children. This point also reflects the complexity of the pathogenic factors of asthma in young children. Although a lot of studies have been made on the cause of asthma in young children, it is still not clear to date. The global strategy for asthma prevention and management under the age of 5 and 5 years of age was published in May,.2009, the global strategy for asthma diagnosis and management for children under the age of 5 and under the age of 5. This is the first guide to asthma management for children under 5 years of age. The epidemiological investigation of risk factors for children with asthma is mainly aimed at children over 5 years of age, with more domestic data. The data of the risk factors for children under 5 years of age were not too perfect. Most of them were only questionnaires, such as the diagnosis of the allergen based on a previous physician's diagnosis or family history rather than the laboratory examination of the children; and the asthmatic phase of the younger children. The older children may be more related to the virus infection, the allergen exposure and the heredity. Therefore, the study of the risk factors of childhood asthma from different angles can provide a theoretical basis for the effective prevention and control of the occurrence of asthma.
Objective: To investigate the risk factors of asthma in children under 5 years of age through a case-control study to explore the risk factors of childhood asthma in young children in this area, and to provide a theoretical basis for the prevention and control of asthma in children. For persistent wheezing.
Methods: a case-control study was used in this study. Objective: to select 224 asthmatic children aged 5 and below in the First Affiliated Hospital of Guangzhou Medical College from January 2010 to June 2011 to diagnose asthma, including 141 males and 83 females with age of 2 1.46 years. A total of 151 children in the same age group were selected. In the control group, there were 71 males and 80 females, aged 2.5 0.3 years old. The two groups were investigated by questionnaires to investigate the factors associated with childhood asthma. The standard of childhood asthma diagnosis was referred to the unified standard established by the National Children Asthma cooperation group in 2008. The venous blood 4ml was extracted from all the subjects and the serum was separated. Serum TIgE and 16 common serum allergens were detected by enzyme linked immunosorbent assay (SIgE.) and venous blood 1ml was extracted to perform peripheral blood routine examination. Therefore, the children of the asthma group were extracted from the venous blood and the saliva specimens for the PCR DNA of the virus swabs and the serum antibody test of the sera of the serum. A total of 171 questionnaires were completed and the qualified rate was 76.34%, including 127 men and 44 women, with an average age of 2.67 1.64 years. The health control group was excluded from the investigation, the unmatched questionnaire was 24, the actual data were complete and the qualified data were 127 questionnaires, The qualified rate was 84.11%, of which 62 were male and 65 for women, the average age was 2.94 + 1.38. The two groups had no obvious difference in age, weight and height. The results of the investigation were recorded in the computer, and the database was established and analyzed by SPSS17.0 software. First, the variables were assigned to the single factor Logistic regression analysis, and then the single factor analysis was used. The variables of statistical significance were used to fit the main effect model in multi factor non stripe Logistic regression analysis. The optimal effect equation was used to estimate the comprehensive relative risk of various risk factors to children's asthma, and the effect of various factors was further investigated.
Results: 1, the results of the single factor analysis were as follows: (1) the relationship between birth history and asthma: male (OR = 3.026); premature birth or birth weight < 2.53 R = 2.547); birth oxygen inhalation (OR = 3.603); recurrent phlegm (OR = 24.671) during neonatal period (P < 0.05); vaginal delivery was the protection of asthma Factors (OR = 0.363, P < 0.01). The relationship between feeding history and asthma: breast feeding duration more than 6 months (OR = 0.288); addition of probiotics for more than 6 months, vitamin D, calcium duration for more than 1 years is a protective factor for asthma (OR = 0.273 and OR = 0.450, P < 0.05) (P < 0.05) (P < 0.05); the home environment and the surrounding environment and asthma customs Department: first years after birth (OR = 1.752); humid (OR = 5.573); flowers and plants (OR = 4.828); cloth sofa or home carpets (OR = 3.874); cockroaches (OR = 6.495); plush toys (OR = 10.624); residence in city (OR = 2.642); close to a factory (OR = 1.969); home near the street (OR = 1.901); home and week; home and week Environmental dust (OR = 4.543) was a risk factor for asthma (P < 0.05). Convective ventilation in houses (OR = 0.118); regular cleaning of filter network (OR = 0.472); sanitary cleaning cycle more than 3 times / week (OR = 0.049) was a protective factor for asthma (P < 0.05). The living area of the asthma group was 23.25 + 11.24m~2, and the control group was 33.92 + 17.86m. ~2, a large per capita living area is a protective factor for asthma (OR = 0.250, P < 0.001). (4) the relationship between nutritional diseases and asthma in children: rickets, other nutritional diseases (including malnutrition, anemia, zinc deficiency, etc.) is a risk factor for asthma (OR = 10.702 and 12.524, P < 0.01); (5) the relationship between allergic history and asthma: allergy to children: allergy to children History (OR = 128.348); parents' allergy history (OR = 21.888); mother's allergic history (OR = 16.109); father's allergic history (OR = 7.687); other 1,2 level kinship allergies (OR = 34.791) is a risk factor for asthma (P < 0.01). (6) the relationship between cough and asthma: first times of lower respiratory infection age. June (OR = 2.926); 1 years of lower respiratory tract infection (bronchitis or bronchopneumonia) times (OR = 6.250); coughing duration more than 2 weeks (OR = 5.889); coughing time regularity (often in the morning or night coughing attack) (OR = 8.830); winter and Spring Festival coughing (OR = 2.871); dry cough symptoms (OR = 7.950); (activity, = 7.950); Cough and asthma exacerbated (OR = 6.103); sudden severe cough (OR = 37.539); cough often accompanied by rhinitis (OR = 5.887); skin itching or itching (OR_ (with skin itching) = 38.473, OR_ (accompanied by itching) = 17.567); frequent use of antibiotics more than 1 times / month (OR = 9.389); respiratory infection hospitalization (O); O R = 120.780) was a risk factor for asthma (P < 0.05). Serum allergen, blood eosinophil and asthma: TIgE positive rate and SIgE positive rate in asthma group were higher than those of control group (OR_ (TIgE > 1 positive rate) = 2.888 and OR_ (SIgE > 1 positive rate) = 4.034, P < 0.01). Asthma group inhalation allergy The former was mainly acaroid, house dust allergy, food allergen was mainly milk allergy, followed by whole egg allergy. Two other auxiliary examinations were compared and analyzed: the positive rate of virus infection in children with asthma and the positive rate of mycoplasma infection were higher than those of healthy children. It was the risk factor of asthma (OR = 14.974, and OR = 7.944, P < 0.01).
2, the results of multiple factors analysis showed that sex (OR = 6.554), flowers and grass more (OR = 6.155), home and surrounding environment dust (OR = 7.389), parents' allergic history (OR = 75.048), early morning or night coughing (OR = 20.172), more in winter and spring (OR = 6.495), dry cough (OR = 25.413), positive rate of mites > 1 (OR = 18.704), TIgE more than 2 times positive The rate (OR = 10.201) was statistically significant compared with the control group. It was an important risk factor for asthma in children under 5 years of age (P < 0.05). Vitamin D was added, calcium duration was more than 1 years, and the duration of probiotics longer than 6 months was a protective factor for asthma (OR = 0.189, OR = 0.192, P < 0.05).
Conclusion: by case-control analysis, it can be seen that the factors such as allergen, virus, home environment, cough symptoms and regularity are important risk factors for young children's asthma. The virus may be one of the risk factors that cause recurrent or aggravated asthma symptoms in young children. Early prevention and treatment of childhood asthma is of great significance in preventing the continuous development of asthma. This paper studies and analyzes the risk factors of asthma in children under 5 years of age, in order to clarify the pathogenesis of asthma, and it is of certain significance for early detection of asthma, early diagnosis and treatment of asthma, avoiding the development of childhood asthma and continuing to adult stage.
【学位授予单位】：广州医学院
【学位级别】：硕士
【学位授予年份】：2012
【分类号】：R725.6
本文编号：2164755
[Abstract]:Background: bronchial asthma (asthma) is a chronic airway inflammation involving a variety of inflammatory cells, including eosinophils, mast cells, T lymphocytes and epithelial cells and their cell components. The clinical manifestations are recurrent wheezing, dyspnea, chest tightness, cough and other symptoms. Asthma is a serious threat to the public worldwide. Asthma, a chronic disease in the developed and developing countries, has become a major threat to human health. Bronchial asthma is the most common chronic respiratory disease in childhood, and the prevalence rate is on the rise. The prevalence rate of childhood asthma in 2000 and 1990 in China's pediatric asthma cooperation group has been carried out in China. The results showed that the incidence of asthma in children in China rose from 0.91% in 1990 to 1.5% in 2000, up 64.84%. In 2000, a survey showed that 90.33% asthma children were first wheezing for the first time at 5 years of age, 69.26% under 3 years of age and 29.74% under 1 years of age. The onset of persistent asthma begins before school age. In children under 5 years of age, in addition to the general characteristics of asthma symptoms, the variability of asthma symptoms is more prominent at this age. In addition, it is difficult to objectively evaluate airflow limitation and airway inflammation due to the lack of reference to pulmonary function examination or pulmonary function examination in this age group. So far, there is no gold standard for diagnosis of asthma in young children. In the past, the definition of childhood asthma has been revised several times, but so far there is still no exact definition for all children. This point also reflects the complexity of the pathogenic factors of asthma in young children. Although a lot of studies have been made on the cause of asthma in young children, it is still not clear to date. The global strategy for asthma prevention and management under the age of 5 and 5 years of age was published in May,.2009, the global strategy for asthma diagnosis and management for children under the age of 5 and under the age of 5. This is the first guide to asthma management for children under 5 years of age. The epidemiological investigation of risk factors for children with asthma is mainly aimed at children over 5 years of age, with more domestic data. The data of the risk factors for children under 5 years of age were not too perfect. Most of them were only questionnaires, such as the diagnosis of the allergen based on a previous physician's diagnosis or family history rather than the laboratory examination of the children; and the asthmatic phase of the younger children. The older children may be more related to the virus infection, the allergen exposure and the heredity. Therefore, the study of the risk factors of childhood asthma from different angles can provide a theoretical basis for the effective prevention and control of the occurrence of asthma.
Objective: To investigate the risk factors of asthma in children under 5 years of age through a case-control study to explore the risk factors of childhood asthma in young children in this area, and to provide a theoretical basis for the prevention and control of asthma in children. For persistent wheezing.
Methods: a case-control study was used in this study. Objective: to select 224 asthmatic children aged 5 and below in the First Affiliated Hospital of Guangzhou Medical College from January 2010 to June 2011 to diagnose asthma, including 141 males and 83 females with age of 2 1.46 years. A total of 151 children in the same age group were selected. In the control group, there were 71 males and 80 females, aged 2.5 0.3 years old. The two groups were investigated by questionnaires to investigate the factors associated with childhood asthma. The standard of childhood asthma diagnosis was referred to the unified standard established by the National Children Asthma cooperation group in 2008. The venous blood 4ml was extracted from all the subjects and the serum was separated. Serum TIgE and 16 common serum allergens were detected by enzyme linked immunosorbent assay (SIgE.) and venous blood 1ml was extracted to perform peripheral blood routine examination. Therefore, the children of the asthma group were extracted from the venous blood and the saliva specimens for the PCR DNA of the virus swabs and the serum antibody test of the sera of the serum. A total of 171 questionnaires were completed and the qualified rate was 76.34%, including 127 men and 44 women, with an average age of 2.67 1.64 years. The health control group was excluded from the investigation, the unmatched questionnaire was 24, the actual data were complete and the qualified data were 127 questionnaires, The qualified rate was 84.11%, of which 62 were male and 65 for women, the average age was 2.94 + 1.38. The two groups had no obvious difference in age, weight and height. The results of the investigation were recorded in the computer, and the database was established and analyzed by SPSS17.0 software. First, the variables were assigned to the single factor Logistic regression analysis, and then the single factor analysis was used. The variables of statistical significance were used to fit the main effect model in multi factor non stripe Logistic regression analysis. The optimal effect equation was used to estimate the comprehensive relative risk of various risk factors to children's asthma, and the effect of various factors was further investigated.
Results: 1, the results of the single factor analysis were as follows: (1) the relationship between birth history and asthma: male (OR = 3.026); premature birth or birth weight < 2.53 R = 2.547); birth oxygen inhalation (OR = 3.603); recurrent phlegm (OR = 24.671) during neonatal period (P < 0.05); vaginal delivery was the protection of asthma Factors (OR = 0.363, P < 0.01). The relationship between feeding history and asthma: breast feeding duration more than 6 months (OR = 0.288); addition of probiotics for more than 6 months, vitamin D, calcium duration for more than 1 years is a protective factor for asthma (OR = 0.273 and OR = 0.450, P < 0.05) (P < 0.05) (P < 0.05); the home environment and the surrounding environment and asthma customs Department: first years after birth (OR = 1.752); humid (OR = 5.573); flowers and plants (OR = 4.828); cloth sofa or home carpets (OR = 3.874); cockroaches (OR = 6.495); plush toys (OR = 10.624); residence in city (OR = 2.642); close to a factory (OR = 1.969); home near the street (OR = 1.901); home and week; home and week Environmental dust (OR = 4.543) was a risk factor for asthma (P < 0.05). Convective ventilation in houses (OR = 0.118); regular cleaning of filter network (OR = 0.472); sanitary cleaning cycle more than 3 times / week (OR = 0.049) was a protective factor for asthma (P < 0.05). The living area of the asthma group was 23.25 + 11.24m~2, and the control group was 33.92 + 17.86m. ~2, a large per capita living area is a protective factor for asthma (OR = 0.250, P < 0.001). (4) the relationship between nutritional diseases and asthma in children: rickets, other nutritional diseases (including malnutrition, anemia, zinc deficiency, etc.) is a risk factor for asthma (OR = 10.702 and 12.524, P < 0.01); (5) the relationship between allergic history and asthma: allergy to children: allergy to children History (OR = 128.348); parents' allergy history (OR = 21.888); mother's allergic history (OR = 16.109); father's allergic history (OR = 7.687); other 1,2 level kinship allergies (OR = 34.791) is a risk factor for asthma (P < 0.01). (6) the relationship between cough and asthma: first times of lower respiratory infection age. June (OR = 2.926); 1 years of lower respiratory tract infection (bronchitis or bronchopneumonia) times (OR = 6.250); coughing duration more than 2 weeks (OR = 5.889); coughing time regularity (often in the morning or night coughing attack) (OR = 8.830); winter and Spring Festival coughing (OR = 2.871); dry cough symptoms (OR = 7.950); (activity, = 7.950); Cough and asthma exacerbated (OR = 6.103); sudden severe cough (OR = 37.539); cough often accompanied by rhinitis (OR = 5.887); skin itching or itching (OR_ (with skin itching) = 38.473, OR_ (accompanied by itching) = 17.567); frequent use of antibiotics more than 1 times / month (OR = 9.389); respiratory infection hospitalization (O); O R = 120.780) was a risk factor for asthma (P < 0.05). Serum allergen, blood eosinophil and asthma: TIgE positive rate and SIgE positive rate in asthma group were higher than those of control group (OR_ (TIgE > 1 positive rate) = 2.888 and OR_ (SIgE > 1 positive rate) = 4.034, P < 0.01). Asthma group inhalation allergy The former was mainly acaroid, house dust allergy, food allergen was mainly milk allergy, followed by whole egg allergy. Two other auxiliary examinations were compared and analyzed: the positive rate of virus infection in children with asthma and the positive rate of mycoplasma infection were higher than those of healthy children. It was the risk factor of asthma (OR = 14.974, and OR = 7.944, P < 0.01).
2, the results of multiple factors analysis showed that sex (OR = 6.554), flowers and grass more (OR = 6.155), home and surrounding environment dust (OR = 7.389), parents' allergic history (OR = 75.048), early morning or night coughing (OR = 20.172), more in winter and spring (OR = 6.495), dry cough (OR = 25.413), positive rate of mites > 1 (OR = 18.704), TIgE more than 2 times positive The rate (OR = 10.201) was statistically significant compared with the control group. It was an important risk factor for asthma in children under 5 years of age (P < 0.05). Vitamin D was added, calcium duration was more than 1 years, and the duration of probiotics longer than 6 months was a protective factor for asthma (OR = 0.189, OR = 0.192, P < 0.05).
Conclusion: by case-control analysis, it can be seen that the factors such as allergen, virus, home environment, cough symptoms and regularity are important risk factors for young children's asthma. The virus may be one of the risk factors that cause recurrent or aggravated asthma symptoms in young children. Early prevention and treatment of childhood asthma is of great significance in preventing the continuous development of asthma. This paper studies and analyzes the risk factors of asthma in children under 5 years of age, in order to clarify the pathogenesis of asthma, and it is of certain significance for early detection of asthma, early diagnosis and treatment of asthma, avoiding the development of childhood asthma and continuing to adult stage.
【学位授予单位】：广州医学院
【学位级别】：硕士
【学位授予年份】：2012
【分类号】：R725.6
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