婴幼儿哮喘发病的围生期影响因素的分析

发布时间：2018-11-24 08:29

【摘要】：目的：探讨围生期因素与婴幼儿哮喘发病的相关性,为婴幼儿哮喘的早期预防提供理论根据。方法：以2012年6月至2014年6月在滕州市中心人民医院小儿呼吸科住院治疗的共132例婴幼儿哮喘患儿为研究对象,每例选配1名来自同一社区、同民族、同性别、年龄相差不超过6个月的健康儿童作为对照组。采用问卷调查的方式,分别对两组儿童的围生期临床资料进行采集,包括：(1)患儿母亲产前的一般情况：年龄、过敏史、被动吸烟。(2)母妊娠期情况：合并症、抗生素暴露、放射性物和毒物接触情况、胎膜早破、营养状况等。(3)出生史：妊周、本次妊娠胎儿数目、窒息史、宫内窘迫史、分娩方式、接生方式、患儿性别、出生体重。(4)新生儿期的情况：合并症、喂养方式、早期益生菌添加、湿疹等。建立Epidata3.0数据库,应用SPSS16.0软件包进行统计分析,单因素分析采用X2检验,多因素分析采用Logistic回归以确立独立危险因素,进而探讨围生期因素与婴幼儿哮喘发病的相关性。结果：通过对132组相配对的对照病例分析,经卡方检验,单因素分析显示被动吸烟、妊娠期合并糖尿病、妊娠期抗生素暴露、胎膜早破、羊水胎粪污染、经阴分娩、早产儿、巨大儿、卡介苗按时接种、维生素AD补充、新生儿湿疹、新生儿病理性黄疸、母乳喂养、新生儿早期益生菌添加等对婴幼儿哮喘具有显著统计学差异(P0.05)。多因素回归分析显示孕期被动吸烟、胎膜早破、早产、低出生体重、剖宫产、新生儿病理性黄疸为婴幼儿哮喘的独立危险因素(P0.05)；而早期益生菌添加、母乳喂养等为其保护性因素(P0.05)。结论：通过研究分析发现,孕期被动吸烟、妊娠期合并糖尿病、妊娠期抗生素暴露、胎膜早破、羊水胎粪污染、分娩方式、胎龄、出生体重、卡介苗接种、维生素AD补充、新生儿湿疹、新生儿病理性黄疸、喂养方式、新生儿早期益生菌添加是婴幼儿哮喘的围生期相关因素；其中孕期被动吸烟、胎膜早破、早产、低出生体重、剖宫产、新生儿病理性黄疸为独立危险因素；而早期益生菌添加、母乳喂养等为保护性因素。如果能对上述危险因素给予预防控制,降低各种危险因素的潜在风险,提倡母乳喂养、早期益生菌添加等对减少婴幼儿哮喘的发病有重要意义。
[Abstract]:Objective: to explore the correlation between perinatal factors and infant asthma, and to provide theoretical basis for early prevention of infant asthma. Methods: from June 2012 to June 2014, 132 children with infantile asthma were hospitalized in Department of Pediatric Respiratory, Central people's Hospital of Tengzhou City. One child from the same community, the same nationality and the same sex were selected for each case. Healthy children with an age difference of no more than 6 months served as the control group. The perinatal clinical data of the two groups were collected by questionnaire, including: (1) the general condition of the mother: age, history of allergies, passive smoking. (2) the condition of pregnancy: complications. Exposure to antibiotics, exposure to radioactive and toxic substances, premature rupture of membranes, nutritional status, etc. (3) birth history: gestational week, number of fetuses in this pregnancy, history of asphyxia, history of intrauterine distress, mode of delivery, sex of child, etc. Birth weight. (4) Neonatal status: complications, feeding methods, early probiotics supplementation, eczema, etc. Epidata3.0 database was established, SPSS16.0 software package was used for statistical analysis, X 2 test was used for univariate analysis, and Logistic regression was used for multivariate analysis to establish independent risk factors, and then to explore the correlation between perinatal factors and the incidence of infant asthma. Results: according to the analysis of 132 matched control cases, Chi square test and single factor analysis showed that passive smoking, pregnancy with diabetes mellitus, exposure to antibiotics during pregnancy, premature rupture of membranes, meconium contamination of amniotic fluid, vaginal delivery and premature infants. Macrosomia, BCG vaccination on time, vitamin A D supplementation, neonatal eczema, neonatal pathological jaundice, breast-feeding, early neonatal probiotics supplementation were significantly different for infant asthma (P0.05). Multivariate regression analysis showed that passive smoking, premature rupture of membranes, premature delivery, low birth weight, cesarean section and pathological jaundice of newborn were independent risk factors of asthma in infants (P0.05). Early probiotic addition and breastfeeding were protective factors (P0.05). Conclusion: passive smoking during pregnancy, gestation with diabetes mellitus, exposure to antibiotics during pregnancy, premature rupture of membranes, meconium contamination of amniotic fluid, delivery mode, gestational age, birth weight, BCG vaccination, vitamin A D supplementation were found. Neonatal eczema, pathological jaundice of newborn, feeding mode and early probiotic supplementation of newborn were the perinatal related factors of infant asthma. Among them, passive smoking during pregnancy, premature rupture of membranes, premature delivery, low birth weight, cesarean section and pathological jaundice of newborn were independent risk factors, while early probiotics and breast feeding were protective factors. If the above risk factors can be prevented and controlled, the potential risk of various risk factors can be reduced, breast feeding and early probiotics supplementation are important to reduce the incidence of asthma in infants.
【学位授予单位】：山东大学
【学位级别】：硕士
【学位授予年份】：2014
【分类号】：R725.6

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