上海市城区儿童青少年慢性咳嗽的环境危险因素研究

Study on environmental risk factors for chronic cough in school children in urban,Shanghai

【目的】探讨学龄儿童青少年慢性咳嗽的患病率以及影响慢性咳嗽的危险因素。【方法】采用整．群随机抽样的方法选取上海市城区内、中、外环2所幼儿园、8所小学和6所中学的4～17岁儿童青少年进行呼吸道疾病和症状的流行病学调查，同时收集学龄儿童青少年家庭社会经济状况以及居室环境因素的资料。【结果】共调查6551例学龄儿童青少年，有效应答率90．6％。学龄儿童青少年的总体慢性咳嗽患病率为7．92％，男、女患病率分别为8．07％、7．76％，差异无显著性（P〉0．05）。学龄儿童青少年慢性咳嗽的患病率随年龄的增长有明显降低的趋势（P〈0．01）。多因素Logistic回归分析结果显示：在控制年龄、父母过敏、居住的城区和其它环境因素影响后，母亲吸烟、父亲吸烟、室内生霉斑、通风不良和室内有蟑螂是慢性咳嗽的危险因素。学龄儿童青少年慢性咳嗽归因于潜在可改变的室内环境危险因素母亲吸烟、父亲吸烟、室内生霉斑、通风不良和室内有蟑螂的比例分别为1．9％、7．9％、5．1％、13．8％、6．7％。【结论】慢性咳嗽是上海市学龄儿童青少年常见的呼吸道症状并随年龄的增长患病率有下降的趋势；针对危险因素采取预防措施可降低慢性咳嗽症状的发生。

[Objective] To study the prevalence of chronic cough and its risk factors in school children in urban, Shanghai. [Method] Using a questionnaire with uniform scheme, a cluster randomized sampling survey was conducted among 2 kindergartens, 8 primary schools and 6 middle schools in urban Shanghai. [Results] There were 6 551 cases with complete data from 7 000 children including 3 381 males,3 170 females with an average age of 10.96 years old. The total prevalence of chronic cough was 7.92%. Difference in prevalence of chronic cough between males and females showed no significance（8.07 % vs 7.76 %,p〉0.05）, but had significance betweein age groups（P〈0.05）. In a multiple regression analysis,each case the odds ratio was adjusted for all the other environmental factors and for age, parent sensitive history and the region, chronic cough in association with mother smoking, father smoking, mold growth, poor ventilation and roach in home. Mother smoking,father smoking, mold growth, poor ventilation and roaeh in home accounted for 1.9%, 7.9%,5.1%, 13.8%, 6. 7 %. respectively. [ Conclusions] Chronic cough is a common disorder in school children in Shanghai and there is significant difference in prevalence among age groups. Mother smoking,father smoking, mold growth, poor ventilation and roach in home are important home environment risk factors of chronic cough in school children.