广州地区5岁以下儿童哮喘发生及持续发展的危险因素分析

The risk factors of occurrence and development of asthma in children under 5 years old in Guangzhou area

目的 探讨5岁以下儿童哮喘发生及持持发展的危险因素.方法 通过对广州地区确诊的5岁以下哮喘患儿150例进行统一标准的问卷调查,并与同地区同年龄段健康儿童117例进行病例对照比较,并结合血嗜酸性粒细胞计数、血清过敏原、血清九项呼吸道病原学、血清支原体IgM抗体测定及病毒咽拭子PCR检测等实验室检查,分析哮喘发生的危险因素,并对研究对象进行跟踪随访,将哮喘组分为哮喘稳定组及哮喘持续组,进行比较分析导致年幼儿童哮喘发生及持续发展至5岁以后的重要危险因素.结果 生后第1年有被动吸烟暴露史、家居环境（潮湿、多花草、有布艺沙发、地毯或毛绒玩具、蟑螂多）、父母及1、2级亲属有过敏史、其他有过敏性疾病史、螨类、屋尘、牛奶、鸡蛋过敏是5岁以下儿童哮喘发病的危险因素（x2=4.99、5.37、16.29、37.32、47.73、48.27、15.27、25.45、25.45、138.47、26.81、9.25、24.35和4.51,均P＜0.05）.哮喘组中病毒感染阳性率45.33％,支原体感染占44.00％;哮喘稳定组与哮喘持续组的比较显示哮喘持续组的螨类过敏阳性率为76.92％,较哮喘稳定组的27.93％明显升高且差异有统计学意义（xz=28.71,P＜0.01）.结论 导致5岁以下儿童哮喘发病的危险因素包括吸烟暴露、家居环境、父母过敏史、自身过敏史、病菌感染等因素,其中螨虫过敏是导致5岁以下儿童哮喘症状持续至较大年龄的重要危险因素.

Objective Through the investigation of asthma in children under 5 years old and the healthy children in the same age in Guangzhou area,to analyze the important risk factors of asthma.Methods Through the questionnaire investigation of 150 asthma in children under 5 years old in Guangzhou area,combined the examination with blood eosinophil counts,serum allergen and serum levels of respiratory pathogens,mycoplasma antibody and virus swab PCR,the risk factors of asthma were analyzed.And then,the research subjects were followed up.The asthma group was divided into stable group and sustainable development group.The important risk factors with asthma who had been in the development continuously of young children still after 5 years were compared between the two groups.Results Exposure to smoking history after the first year,household environment （damp,many flowers and plants,cloth art sofa,carpet or plush toys,cockroaches）,parents and relatives had allergy history,had a history of allergic disease,mites,house dust,milk or egg allergy were the risk factors for asthma children under 5 years old （x2 =4.99,5.37,16.29,37.32,47.73,48.27,15.27,25.45,25.45,138.47,26.81,9.25,24.35,4.51,all P 〈 0.05）.The positive rate of viral infection and mycoplasma infection in asthma group accounted for 45.33% and 44.0%.The positive rate of mites allergic was 76.92% in the sustainable development group of asthma,it was higher than the stable group （27.93%） （x2 =28.71,P 〈 0.01）.Conclusion Exposure to smoking history,household environment,parents had allergy history had a history of allergic disease,bacteria infection etc.are the risk factors for asthma children under 5 years old.Mite allergy is the continuous risk factor of asthma symptoms in children under 5 years old.