内蒙古包头市城区0～14岁儿童支气管哮喘流行病学调查

Epidemiological investigation of asthma in children aged 0 ～ 14 years in Inner Mongolia Autonomous Region, Baotou urban

目的了解内蒙古包头市儿童支气管哮喘（哮喘）患病情况、变化趋势、影响因素及对儿童、家庭和社会的影响。方法采用整群抽样的方法，按照全国儿童哮喘协作组制定的全国统一调查方案进行调查。结果1．共调查0～14岁儿童11398例，实查11323例，应答率为99．34％。检出哮喘121例，总患病率为1．07％（121／11323例，95％CI：0．88～1．26），咳嗽变异性哮喘6例，患病率为0．05％（6／11323例，95％CI：0．01～0．09），可疑哮喘24例，患病率为0．21％（24／11323例，95％CI：0．13～0．29）。2009年至2010年现患病例96例，2年现患牢为0．85％（96／11323例，95％CI：0．68～1．02）。1990年、2000年和2010年包头市儿童哮喘患病率分别为0．55％、0．88％和1．07％，每10年增加分别为60．0％、21．6％，20年内增长了1．7～2．0倍。2．0～3岁患病率较低，4～10岁患病率最高，10岁以上逐渐降低。3．发病诱因主要为h呼吸道感染78．5％（95／121例）。4．首次发作年龄在3岁内39．7％，3岁后首次发作年龄与首次诊断年龄较一致。5．影响儿童哮喘发牛的危险因素为家族过敏史、变应性鼻炎、慢性咳嗽、反复呼吸道感染。6．应用全身糖皮质激素由2000年的60．2％减少到2010年的27．2％，吸入糖皮质激素rb2000年的13．6％上升至2010年的85．1％。7．本调查哮喘儿童无一例刚病留级或停学，81．9％（86／105例）的哮喘儿童体育活动基本不受影响；家庭成员因孩子患病就医，无缺勤累计〉60d／年；或常年缺勤者；因哮喘就医对影响家庭经济不能承受者仅占2．5％（3／121例）。结论包头市儿童哮喘患病率呈明显上升趋势，发病诱因主要为上呼吸道感染。影响儿童哮喘发生的主要危险因素为慢性咳嗽、反复呼吸道感染、家族过敏史和变应性鼻炎。

Objective To realize the asthma prevalence,the variation trend,and the influencing factors for it in children living in Baotou district,and the impact on the sick children,their families and the society. Methods Ac- cording to unified national survey method which was established by the National Pediatric Cooperation Group on Asthma Research,the investigation was conducted. Results 1. All of l 1 398 children aged 0 - 14 years were surveyed,and a- mong them, 11 323 were examined actually and the response rate was 99.34%. One hundred and twenty-one were diag- nosed as asthma, the total prevalence was 1.07% （ 121/11 323 cases ,95% CI：O. 88 - 1.26） ,6 eases of cough variant asthma （0.05% ,6/11 323 cases ,95% CI：O. 01 - 0.09） ,24 cases of questionable asthma （0.21% ,24/11 323 eases, 95% CI：O. 13 -0.29）. The prevalence cases were 96 cases from 2009 to 2010, and the prevalence rate was 0.85% （96/11 323 cases,95% CI：O. 68 -1.02）. The prevalence rates of the children with asthma in Baotou in 1990,2000 and 2010 were 0.55% ,0.88% and 1.07% ,respectively,increasing 60.0% and 21.6% per 10 years respectively,in- creased by 1.7 - 2.0 times during the 20 years. 2. Asthma occurred the lowest in children aged 0 - 3 years, the highest prevalence was at the age of 4 - 10 years, and the prevalence of children more than 10 years old was gradually redu- cing. 3. The main cause of the predisposing factors was the upper respiratory infection（78.5% ,95/121 cases）. 4. The first attack age was 39.7% in chihtren at less than 3 years old, and the age of the first attack was more in line with the first diagnosis age after 3 years old. 5. Dangerous factors affecting children＇s asthma were the family history of allergies, the anaphylactic rhinitis, the chronic cough, and the recun＇ent respiratory tract infection and so on. 6. The application of the systemic cortieosteroid drug decreased from 60.2% in 2000 to 27.2% in 2010,and the inhaled corticosteroids went up to 85.1% in 2010 from 13.6% in 2000. No case from the surveyed children failed to go up to the higher grade or drop out of school, there was no influence in the main sports activities for the 81.9% （86/105 cases） asthma children, for the family members of children, no one was absence of duty more than 60 days a year, or absentee year in year out, because of taking their children to see doctors for asthma, and only 2.5% （31/121 cases） family could not bear the e- conomic burden of treatment. Conclusions There is an increasing trend of asthma prevalence. The predisposing factor is mainly respiratory tract infection. The dangerous factors for children＇s asthma are the chronic cough ,the recurrent re- spiratory tract infection, the family history of allergies, the anaphylactic rhinitis and so on.