儿童支气管哮喘急性发作的常见诱因调查与分析

Investigate the Common Causes of Asthmatic Exacerbation in Children with Asthma

目的:探讨儿童支气管哮喘常见的诱因及预防对策。方法:通过自行设计问卷调查表,调查229例在我院门、急症就诊的哮喘急性发作的患儿,分为婴幼儿组(<3岁)和儿童组(≥3岁),分析常见的诱因。并对入选的患儿在治疗缓解后1周进行过敏原皮肤点刺试验,分析常见的过敏原。结果:呼吸道感染是哮喘发作最常见的诱因,婴儿组为93.2%,在儿童组为54%,两组比较差异有显著性(χ2=46.122,p<0.01);吸入激素自行减量及停药是诱发哮喘的另一重要诱因,婴儿组为30.1%,儿童组44.4%,两组比较差异有显著性(χ2=4.952,p<0.05);居住/接触的环境过敏原导致哮喘发作,婴儿组为26.2%,儿童组43.7%,两组比较差异有显著性(χ2=7.497,p<0.05);虽然运动是诱发哮喘的重要诱因之一,但两组间比较差异无显著性(χ2=2.744,p>0.05);共有172例患儿过敏原皮试阳性,占77.1%;其中尘螨是最主要的过敏原,婴儿组屋尘螨阳性率为54.4%,儿童组为77%,两组比较差异有显著性(χ2=13.072,p<0.01);婴儿组粉尘螨阳性率43.7%,儿童组为62.7%,两组比较差异有显著性(χ2=8.248,p<0.01);结论:呼吸道感染是儿童哮喘最常见的诱因,尤其是婴幼儿。随着年龄增大,非感染因素逐渐成为诱发哮喘的主要诱因。减少呼吸道感染,环境控制,避免接触过敏原,遵照医嘱使用哮喘控制药物,是减少哮喘发作的有效措施。

Objective To investigate the common motivations of asthmatic exacerbation and the way how to prevent children with asthma from them. Methods 229 asthmatic exacerbation children in pediatrics outpatient or emergency department were enrolled, 126 cases were assigned into over 3 years group and the other 103 cases into infantile group. Causes were corrected by query sheets and investigated the potential causes associated with which led to asthmatic exacerbation in children with asthma. Result Respiratory tract infection was one of the most common causes led to asthmatic exacerbation in children with asthma,93.2% in infantile group vs. 54% in over 3years group, which were significant different in statistics （χ^2=46.122, p 〈0.01 ） . The other common cause was to quit to inhale corticosteriods or to reduce dosage of inhalation corticosteriods without suggestion by pedestrians, 30.1% in infantile group vs. 44.4% in over 3years group, which were significant different in statistics （χ^2 =4.952, p 〈0.05） . Allergens in living entertainment led to asthmatic exacerbation, 26.2% in infantile group vs. 43.7% in over 3years group, which were significant different in statistics （χ^2 =7.497, p 〈0.05 ） . Although sports were the important factor cause asthmatic exacerbation in children with asthma, there were no significant differencet from both two groups in statistics （χ^2 =2.744, p 〉0.05 ） . 172 cases in total were positive in skin prick test with allergens, and the ratio was 77.1%, among which mites were major allergen, positive in skin prick test with house mite and powder mite were the most common allergen, 54.4% and 43.7% in infantile group, 77% and 62.7% in over 3 years group, significant different in statistics （χ^2 =13.072 and 8.248 respectively, p 〈0.01） . Conclusion Respiratory tract infection was one of the most common causes led to asthmatic exacerbation in children especially infantile with asthma .Non- infection factors became the important cause led to asthmatic exacerbation in children with asthma when growth up. To reduce the risks of respiratory tract infection, keep out of allergens and inhale corticosteriods regulate were available ways the prevent children with asthma from asthmatic exacerbation.