武汉地区儿童支气管哮喘患病率及危险因素调查

Investigation of childhood asthma morbidity rate and risk factors in Wuhan area

目的探讨儿童支气管哮喘（哮喘）的相关危险因素。方法选取武汉地区0～14岁儿童，共4132例。对儿童哮喘的发病现状进行随机抽样调查，开展问卷调查及临床体检，对儿童哮喘与其他变应性疾病进行相关性分析，采用SPSS17．0统计软件进行数据分析，并采用多元逐步Logistic回归分析进行危险因素筛选及排序。结果筛查出173例哮喘儿童，哮喘累积患病率为4．2％，其中男童的哮喘患病率高于女童（4．8％比3．6％）。4岁是一个关键年龄点，变应性鼻炎、湿疹、药物过敏及食物过敏等疾病发病率均于4岁后大幅上升。哮喘与变应性鼻炎相关性最高（r=0．30，P〈0．01），其次为湿疹（r=0．24，P〈0．01）。对哮喘危险因素进行筛选并排序，依次为变应性鼻炎（OR=5．61，95％CI：3．88～8．13）、反复呼吸道感染（OR：3．99，95％CI：2．78～5．74）、湿疹（OR=3．38，95％CI：2．35—4．87）、药物过敏（OR=2．20，95％CI：1．44～3．36）、一级亲属哮喘史（OR=3．14，95％C1：1．60～6．13）及二级亲属哮喘史（OR=1．92，95％CI：1．13—3．28）。结论变应性鼻炎和反复呼吸道感染是儿童哮喘发病的前2位高危因素，应加强对相关患儿的健康管理，防止其发展为变应性哮喘。

Objective To investigate the relative risk factors of childhood asthma. Methods An investigation was carried out by random sampling in Wuhan city. The investigation included questionnaire and clinic examination. The studied atients were the infants and children aged from 0 to 14 years old,and the sample size was of 4132 eases. The relative analysis between childhood asthma and other allergic diseases was carried out, and high risk factors were screened by multiple Logistic regression analysis with SPSS 17.0 software. Results There were 173 children with asth- ma, and the accumulation incidence rate was 4.2% , during which the rate of male children were higher than that of fe- male children （4.8% vs 3.6% ）. Four years old was a key point,because the incidence rates of allergic rhinitis, ecze- ma, drug allergy and food allergy were obviously increased after this point. The relative analysis results showed that al- lergic rhinitis was the first factor related to asthma （ r = 0.30,P 〈 0.01 ）, the second factor was eczema （ r = 0.24, P 〈 0.01 ）. The multiple Logistic regression analysis results showed that the risk factors of asthma were listed by risk degree as allergic rhinitis （ OR = 5.61,95% C1：3.88 - 8.13 ）, repeated respiratory infection （ OR = 3.99,95% CI： 2.78 - 5.74 ） , eczema （ OR = 3.38,95 % C1：2.35 - 4.87 ） , drug allergy （ OR = 2. 20,95 % CI ： 1.44 - 3.36） , asthma history of the first degree relative （ OR = 3. 14,95% CI： 1.60 - 6.13 ） and asthma history of the second degree relative （ OR = 1.92,95%CI：1.13- 3.28）. Conclusions Allergic rhinitis and repeated respiratory infection are the first and the second important risk factors of asthma. It is necessary to enhance the heahh management of the related children to pre- vent them from developing asthma.