长沙城区0-14岁儿童哮喘流行病学调查及其影响因素分析

发布时间：2018-12-18 16:25

【摘要】：目的：了解目前长沙市0-14岁儿童哮喘的患病率及分布特征,探讨影响儿童哮喘发病的危险因素,为进一步改进儿童哮喘的防治工作提供依据。方法：①采用整群随机抽样方法,随机抽取长沙市芙蓉区0~14岁儿童(1996年7月1日零点-2010年6月31日11时59分出生的儿童)13929人作为调查对象。对所有调查对象发放“儿童哮喘与过敏性疾病初筛表”,由工作人员或家长逐项填写完整,要求有效问卷回收率90%。问卷回收后用EPIinfo软件统一录入电子版。②初筛表1~6项任何一项阳性者进入疑似儿童哮喘诊断流程,确诊为哮喘的儿童由工作人员填写“0~14岁哮喘儿童调查表”。③采用成组病例对照调查方法,随机选择271名本次确诊的哮喘儿童为病例组,同时在相应人群中选择性别、民族和年龄构成相近的健康儿童271名作为对照组,填写“0~14岁非哮喘儿童调查表”,进行儿童哮喘危险因素病例对照研究。④统计方法：全部资料使用Epi-info2002软件录入,统计儿童哮喘发病相关数据。病例对照资料采用SPSS软件进行logistic回归分析。结果：①本次共调查长沙城区0~14岁儿童13929人,回收合格问卷12719份,有效应答率91.31%。12719名儿童中诊断儿童哮喘(包括婴幼儿期哮喘)353例,咳嗽变异性哮喘48例,可疑哮喘或喘息性支气管炎81例,共4：82例,患病率为3.79%。其中以1~2岁和6~7岁患病率最高,分别为6.28%和6.26%。②患病性别比：482例哮喘儿童中,男296例,女186例,男女比例为1.59：1。性别差异有显著意义(p0.05)③首次发病平均年龄为2.36岁,30.1%的患儿在一岁以内出现喘息,70.7%的患儿在3岁之前发病,6岁以上发病仅占6.2%。④发病诱因主要为呼吸道感染(87.3%)、天气变化/接触冷空气(57.1%)、各种刺激性气味(56.1%)、食物(16.6%)、运动(13.2%)等；⑤病例对照研究结果：家族哮喘或过敏史(OR=3.174)、个人药物过敏史(OR=2.980)、过敏性鼻炎史(OR=2.312)、皮肤过敏史(OR=2.693)、食物过敏史(OR=2.391)、剖宫产(OR=1.631)、1岁以内使用抗生素(OR=2.602)、家装使用墙面壁纸(OR=0.382)、家具使用防火板(OR=2.051)9个因素进入logistic回归方程,p0.05。结论：①长沙城区0~14岁儿童哮喘患病率达到3.79%,哮喘给患儿家庭带来较大经济负担和社会影响。②儿童哮喘的发病与多种因素相关,家族过敏或哮喘史、个人药物过敏史、过敏性鼻炎史、皮肤过敏史、食物过敏史、剖宫产、使用抗生素、家具使用防火板可能为哮喘发病的危险因素。
[Abstract]:Objective: to investigate the prevalence and distribution of asthma in children aged 0-14 years in Changsha, and to explore the risk factors affecting the incidence of asthma in children, so as to provide the basis for further improving the prevention and treatment of asthma in children. Methods: (1) A total of 13929 children (children born at 014 years old from July 1, 1996 to 11:59 on June 31, 2010) in Furong District of Changsha City were randomly selected by cluster random sampling method. All the subjects were given the "Children's Asthma and allergic Disease screening form", which was completed by the staff or parents, and the effective questionnaire recovery rate was 90%. After the questionnaire was recovered, the electronic version was recorded by EPIinfo software. (2) in the first screening table, any one of the 6 positive individuals entered the diagnostic procedure of suspected asthma in children. The children who were diagnosed with asthma were filled out by the staff members of the questionnaire for Children with Asthma at the age of 14. 3 by using a group case-control investigation method, 271 children with asthma were randomly selected as the case group, and at the same time, the sex was selected among the corresponding population. 271 healthy children with similar ethnic and age composition were used as control group. The questionnaire of non-asthmatic children aged 14 years old was filled out and the case-control study on risk factors of asthma in children was carried out. 4 Statistical methods: all data were recorded with Epi-info2002 software. Statistics of children asthma related data. Case control data were analyzed by logistic regression with SPSS software. Results: 1 A total of 13929 children aged 14 years old from 0 to 14 years old were investigated in Changsha City. 12719 eligible questionnaires were collected. The effective response rate was 91.31.12719 children with diagnosed asthma (including infantile asthma) 353 cases, cough variant asthma 48 cases. There were 81 cases of suspected asthma or wheezing bronchitis, there were 4:82 cases, the prevalence rate was 3.79. Among them, the prevalence rate of 1 and 7 years old was the highest (6.28% and 6.26.2%, respectively): in 482 asthmatic children, 296 cases were males and 186 cases were females, the ratio of males to females was 1.59: 1. The mean age of the first onset was 2.36 years old. 30.1% of the children had wheezing within one year old, 70.7% of the children had the disease before the age of 3 years, and the average age of the first onset was 2.36 years old (p0.05). The main inducements were respiratory tract infection (87.3%), weather change / exposure to cold air (57.1%), irritating odor (56.1%), food (16.6%). Exercise (13.2%) and so on; 5Case-control study results: family history of asthma or allergy (OR=3.174), history of personal drug allergy (OR=2.980), history of allergic rhinitis (OR=2.312), history of skin allergy (OR=2.693), history of food allergy (OR=2.391), Cesarean section (OR=1.631), using antibiotics (OR=2.602) less than 1 year old, wall wallpaper (OR=0.382) and fireproof panel (OR=2.051) for furniture, entered the logistic regression equation, p0.05. Conclusion: (1) the prevalence of asthma in children aged 14 years in Changsha is 3.79, which brings greater financial burden and social impact to children's families. 2 the incidence of asthma in children is related to many factors, family allergies or history of asthma. A history of personal drug allergy, allergic rhinitis, skin allergy, food allergy, cesarean section, antibiotic use, and fireproof panel furniture may be risk factors for asthma.
【学位授予单位】：中南大学
【学位级别】：硕士
【学位授予年份】：2012
【分类号】：R725.6

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