4～11岁哮喘儿童控制水平及影响因素分析

Analysis of the control level and the affecting factors in 4- 11 years old children with asthma

目的：评估4～11岁哮喘儿童控制水平及探讨影响哮喘控制水平的相关因素.方法：对2013年10月至2014年2月在北京大学第三医院儿科门诊就诊的4～11岁哮喘患儿进行横断面研究,按照哮喘测试量表（asthma control test,ACT）评分进行控制水平分级,可分为3级：完全控制、部分控制、未控制,将部分控制和未控制合并为未完全控制组.比较完全控制组和未完全控制组两组生活质量,分析影响控制水平的相关因素.EpiData软件录入数据,SPSS 17.0软件进行分析.结果：共有90例哮喘患儿纳入研究,完全控制和未完全控制组分别占61.1％（55/90）和38.9％ （35/90）,完全控制组患儿生活质量高于未完全控制组.完全控制组和未完全控制组在体质指数、家长受教育程度、家长吸烟、近3个月内发生呼吸道感染次数、就诊4周内是否使用哮喘控制药物和是否遵医嘱治疗方面差异均无统计学意义（P＞0.05）.二元Logistic回归分析得出3个影响控制水平的相关因素,分别是：未规律随诊（OR =8.364,95％ CI：1.816～38.532,P＜0.05）、患有或被诊断为变应性鼻炎（OR=6.728,95％ CI：1.699～ 26.644,P＜0.05）、伴发其他过敏性疾病（OR=3.926,95％ CI：1.210 ～ 12.744,P＜0.05）.结论：4～ 11岁哮喘患儿的哮喘完全控制率不高,完全控制组患儿生活质量高于未完全控制组.未规律随诊和患有变应性鼻炎是4 ～11岁哮喘患儿控制水平的相关因素,而伴有特应性皮炎、食物过敏等其他过敏性疾病则是哮喘控制水平的保护因素.本研究提示的结论需要多中心或进一步数据来论证.

Objective：To assess the control level of 4-11 years old children with asthma and to explore the correlative factors affecting the control level of asthma.Methods：One cross-sectional study was conducted of the 4-11 years old children with asthma from Pediatrics Outpatient Department of Peking University Third Hospital from October 2013 to February 2014.According to asthma control test （ACT）,the control levels of asthma children could be divided into three levels：fully controlled,partly controlled and noncontrolled.The partly controlled group and the non-controlled group were merged into the non-full controlled group.Life quality was compared between the full controlled group and the non-full controlled group.The correlative factors affecting the controlled level of asthma were analyzed by Logistic regression.The correlative case information was collected and the data were entered with EpiData software and analyzed with SPSS 17.0 software.Results：Ninety asthma children were enrolled.The children from the full controlled group and the non-full controlled group accounted for 61.1％ （55/90） and 38.9％ （35/90）,respectively.Life quality of the full controlled group was higher than that of the non-fully controlled group.There was no significant difference between the two groups on body mass index （BMI）,education level of parents,parents or relative smoking,times of respiratory tract infection within 3 months,using asthma control drugs within 4 weeks before seeing a doctor and regularly taking medicine according to the doctor＇s advice （P ＞0.05）.The binary Logistic regression analysis obtained three correlative factors affecting the control level of asthma：non-regular follow-up （OR =8.364,95 ％ CI：1.816-38.532,P ＜ 0.05）,being diagnosed with or suffering from allergic rhinitis （OR =6.728,95％ CI：1.699-26.644,P ＜ 0.05） and accompanying with other allergic diseases （OR =3.926,95％ CI：1.210-12.744,P ＜0.05）.Conclusion：The results from the single center have shown that the asthma full-controlled rate of 4-11 years old children with asthma is not high.The higher control level,the better the life quality.Non-regular followup and being diagnosed with or suffering from allergic rhinitis are the correlative factors affecting the control level of 4-11 years old children with asthma.Meanwhile,accompanying with other allergic diseases,such as atopic dermatitis and food allergy is the protective factor for asthma control.The data from the multi-center and further study will be needed to demonstrate the results of this study.