德国家庭吸烟状况与6～7岁儿童哮喘关系研究

Association of Smoking Condition at Home with Childhood Asthma in Germany

目的分析家庭吸烟状况与儿童哮喘的关系，为预防儿童哮喘提供依据。方法以2000～2002年德国Wilhelmshaven镇和Delmenhorst镇小学入学儿童为研究对象，共4039人。采用国际儿童哮喘与过敏性疾病研究第一阶段问卷的核心问题进行问卷调查。吸烟状况（包括家庭吸烟人数、吸烟成员及家庭吸烟量）与儿童哮喘关系分别按家族史在Logistic回归模型中进行分析。结果有阳性过敏性疾病家族史的儿童，家庭内吸烟率相对于非吸烟率明显降低。回归模型结果分析显示，对过敏性疾病阴性家族史的儿童，随着家庭中吸烟人数的增加，儿童哮喘危险度增大；母亲吸烟危害大于父亲吸烟，双亲吸烟危害大于单亲；随眷家庭成员每日吸烟量增加，危险性呈上升趋势。对家族史阳性的儿童，此现象甚至呈相反趋势。结论阳性过敏性疾病家族史可导致吸烟率明显下降，并显著影响吸烟状况与儿童哮喘的关系；对过敏性疾病阴性家族史的儿童，吸烟与儿童哮喘有显著的相关性；母亲吸烟危害大于父亲吸烟。

Objective To analyze association of smoking condition at home with childhood asthma, and to provide evidence for preventing childhood asthma. Methods From 2000 - 2002, core questionnaire from ISAAC phase Ⅰ were adopted to collect data among school beginners in two small towns in northem Germany. Association of smoking condition （including number of smokers, concrete smoking members and daily consumed cigarettes） and childhood asthma was analyzed in logistic regression models by family history respectively. Results Percentage of smokers was much lower than that of non-smokers for children with positive family history allergic diseases. Logistic regression analysis indicated that for children with negative family history, with increase of smoking numbers at home, children had more risk factors to asthma; mother smoking had more influence on children than paternal smoking; both parental smoking had more influence than either; the more daily consumed cigarettes were, the more risk it was for children to have asthma. For children with positive family history, such trend disappeared. Conclusion Positive family history of allergic diseases results in lower percentage of smokers, which has obvious effects on the relationship between smoking condition and childhood asthma as well： for children with negative family history, smoking has obvious association with childhood asthma; mother smoking has more influence on children than father smoking.