成都地区0～14岁城乡儿童哮喘流行病学调查及社会经济学分析

Epidemiological Survey and Social Economics Analysis of Asthma in Children Aged 0-14Years Old in Urban and Rural Areas of Chengdu Region

目的 对成都地区儿童支气管哮喘（简称哮喘）的社会经济学相关因素进行分析评价.方法 对成都市中心城区、金堂城镇及金堂农村3个层面0~14岁儿童采取随机、整群、不等比抽样方法抽出所需调查的学校、幼儿园及社区的全部儿童为调查对象,向家长发放问卷初筛表,然后筛选出相关疾病的可疑患者,再经呼吸专科医师问诊和查体明确诊断.对筛查出的843例哮喘儿童进行有关社会经济学的调查.结果 中心城区、城镇及农村3个层面实际调查人数分别为12 082例、5 677例及5 590例,确诊哮喘、咳嗽变异性哮喘患儿分别为551例、150例及142例,累计患病率分别为4.56%、2.64%及2.54%,中心城区累计患病率明显高于城镇和农村.因病缺席（〈10 d）学习轻微受影响的患儿百分率中心城区及金堂城镇分别为79.13%、86.67%,城区明显低于城镇.1年费用支出〈2 000元的家庭中心城区及金堂城镇分别占37.93%、67.33%,城区明显低于城镇.843例哮喘儿童1年累计缺课41 616 d,严重影响患儿的学习成绩.累计直接经济损失299.15万元/年,间接经济损失457.56万元/年.结论 哮喘的发病率与人口密度和生活环境密切相关,经济收入、文化程度差异影响哮喘的治疗.哮喘对社会及家庭造成巨大的经济损失,全社会及医务工作者应给予足够的重视与关心,将损失降到较低水平.

Objective To evaluate the relative factors of social economics of asthma in children through the investigation of children asthma epidemiology and social economics in Chengdu region. Methods Children aged 0-14 years old who were selected from urban of Chengdu, suburban and rural areas of Jintang, were included in the study. The subjects were selected from all children aged 0-14 years in schools,kindergartens and communities by random, cluster and non-proportional sampling. Parents were surveyed by questionnaire to find out suspected cases, which were then confirmed by inquiry and physical examination in the department of respiratory medicine. Results A total of 12 082 children from the urban areas,5 677 from suburban areas and 5 590 from the rural areas were included in the study, and accordingly, of all the subjects, 551 （4.56 % ） , 150 （ 2.64 % ） and 142 （ 2.54 % ） had suspected asthma or cough variant asthma（CVA）. The prevalence rate of asthma and CVA was higher in the urban areas, followed by the suburban and urban areas. The percentage of absence from school for asthma（〈 10 days）was lower in the urban areas（79.13 % ）than in suburban areas（86.67 %）. The percentage of the cost below RMB 2000 afforded yearly was lower in the urban areas（37. 93%）than in suburban areas（67. 33%）. There were totally 41 616 days for the asthmatic children absent from class because of the illness. The overall direct economic loss was RMB 2 991 500 and indirect loss was RMB 4 575 600 yearly. Conclusion Population density and living environment are associated with the prevalence of asthma. Economic level and schooling affect the treatment of asthma. Asthma exerts massive economic loss on the society and families. The whole society and medical workers should pay more attention to it and try to reduce its harm to a relatively low level.