儿童哮喘发病危险因素分析及急性发作原因调查

Study on risk factors and the cause of acute attack of asthma in children

目的探讨儿童哮喘发病危险因素及急性发作原因，以便制定有效干预措施，迅速控制哮喘发作并降低患儿发病率、复发率及病死率。方法收集2007年1月至2009年3月河北省儿童医院呼吸科诊治的哮喘患儿及非哮喘患儿各500例，按年龄、性别、居住地区对2组患儿进行1：1配对，形成500个匹配组，以问卷形式调查，对入选的病例从生后即开始调查记录，查找哮喘发病危险因素，并对引起患儿哮喘急性发作的原因进行调查。结果本研究调查了33种因素，经条件Logistic回归分析，得出高危因素6种、中危因素2种、低危因素12种。常见的可引起患儿哮喘急性发作的原因有呼吸道感染、不规律用药、天气变化等。结论哮喘的发生与遗传因素密切相关，特应性体质是儿童哮喘的危险因素，频发的呼吸道感染可促使哮喘发展为持续性，且是引起哮喘急性发作的最常见原因。

Objective To investigate the risk factors and cause of acute attack of children with asth- ma, in order to adopt the valid treatment to decrease the morbidity, relapse rate and mortality of children with asthma. Methods One thousand patients including 500 cases of asthma and 500 cases of non-asthma were collected, who were treated in the respiratory department of Hebei Provincial Children＇ s Hospital from June, 2007 to March,2009. The asthmatic patients were 1：1 matched with non-asthmatic children by the same age, sex,place of residence,thus 500 paired groups were formed. Then the investigation was carded out using a questionnaire in order to find out risk factors among children with asthma. The case history was traced back from the first wheeze after birth in all the asthmatic cases. The cause of acute attack of case group was also studied. Results The study revealed 33 risk factors according to logistic regression analysis. There were 6 high risk factors,2 mid-range risk factors and 12 low risk factors. The most common causes of acute asthma attack included respiratory tract infection, irregular treatment, weather change. Conclusion Genetic factors are closely related to the development of asthma in children. The atopy constitution is a risk factor of asthma. Frequent respiratory tract infection may induce the persistent asthma and becomes the most common reason that causes acute asthma attack.