石家庄地区儿童支气管哮喘急性发作的常见诱因调查分析

Investigation of the common inducements of asthmatic exacerbation in children with asthma in Shijiazhuang area

【目的】探讨石家庄地区儿童支气管哮喘常见的诱因及预防对策。【方法】对入选的哮喘病例从生后首次喘息开始追溯,分为婴幼儿组(<3岁)和儿童组(≥3岁),通过统一问卷调查,分析常见的诱因。并对入选的患儿在治疗缓解后1周行皮肤过敏原点刺试验,分析常见的过敏原。【结果】首次发病年龄主要集中在6岁以内,特别是3岁以内,发病诱因主要是呼吸道感染,多发季节为秋冬季,好发时间为夜间及凌晨,婴幼儿组发病率为93.5%,儿童组发病率为54%,两组比较差异有统计学意义(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,婴幼儿组为30.1%,儿童组为44.4%,两组比较差异有统计学意义(χ2=4.952,P<0.05);居住/接触的环境过敏原导致哮喘发作,婴幼儿组为26.2%,儿童组43.7%,两组比较差异有统计学意义(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统计学意义(χ2=2.744,P>0.05);共有446例患儿过敏原皮试阳性,占96.3%,尘螨阳性率在婴幼儿组较高为46.8%,在儿童组为35.0%,柳树花粉阳性率在儿童组较高为37.4%,在婴幼儿组为19.8%,尘螨和柳树花粉在婴幼儿组和儿童组差别均有统计学意义(χ2=5.417,12.849,P均<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,改善环境,避免接触过敏原,遵医嘱正确使用控制哮喘的药物,是减少哮喘发作的有效措施。

【Objective】To investigate the common inducements of asthmatic exacerbation in Shijiazhuang area and the way to prevent children with asthma from them.【Methods】All children with asthma were divided into two groups,infantile group（3 years） and children group（over 3 years） and analysed the common causes associated with which led to asthmatic exacerbation in children with asthma through the unified questionnaire survey.And analysed the common allergens through receiving skin prick test on 1 week after remission for the enrolled children.【Results】The first age of onset was mainly concentrated less than 6 years old,especially within 3 years old.Resporatory infection was mainly common inducement,the easily exacerbated seasons were autumn and winter,the easily exacerbated time was night and morning,93.5% in infantile group vs 54% in children guoup,which was significantly different in statistics（χ2=46.122,P0.01）.The other common cause was to quit to inhale corticosteroids or to reduce dosage of inhalation corticosteroids without suggestion by pediatrist,30.1% in infantile group vs 44.4% in children group,which was significantly different in statistics（χ2=4.952,P0.05）.Allergens in living entertainment led to asthmatic exacerbation,26.2% in infantile group vs 43.7% in children group,which was significantly different in statistics（χ2=7.497,P0.05）.Although sports were the important factor cause asthmatic exacerbation in children with asthma,there was no significantly different from both two groups in statistics（χ2=2.744,P0.05）.446 cases in total were positive in skin prick test with allergens,and the ratio was 96.3%.Positive in skin prick test with dust mite and willow pollen were the most common allergen,46.8% and 19.8% in infantile group,35.0% and 37.4% in children goup,significant difference found in statistics（χ2=5.417,12.849,P0.01）.【Conclusions】Respiratory infection is one of the most common causes led to asthmatic exacerbation in children especially infantile with asthma.Non-infection factors become the important cause led to asthmatic exacerbation in children with asthma when growth up.To reduce the risks of resporatory infection,keep out of allergens and inhale corticosteroids regulate are availabe ways to prevent children with asthma from asthmatic exacerbation.