东北寒区作训官兵支气管哮喘流行病学调查分析

Epidemiological investigation and analysis of bronchial asthma in combat troops garrisoned in the cold areas of northeast China

目的了解东北寒区作训官兵支气管哮喘的发病率和相关危险因素,探讨支气管哮喘的防护策略。方法选择2012年沈阳军区部分入伍新兵作为研究对象,对2012年度新兵共进行三轮问卷调查,对疑诊哮喘的官兵行肺功能检查进行确诊。第一轮调查在新兵入伍集训时进行,第二轮调查在入选新兵入伍2年的冬训后进行,第三轮调查在入选士兵退伍前进行。结果在第一轮调查中,新入伍官兵的哮喘患病率为3.55‰,第二轮发现可疑患病人员1067人,第三轮确诊26人,发病率为1.73‰。哮喘官兵首次发作症状最常见的是咳嗽(88.5%)和喘息(56.3%)。哮喘官兵发作诱因主要是呼吸道感染(76.9%)和接触冷空气(65.4%),哮喘好发时间为凌晨(30.8%)和清晨(23.1%)。26例哮喘患者中有19例(73.1%)发生在冬季,10例(38.5%)发生在春季,呈现出明显的季节特征。劳累、个人过敏史、接触冷空气、慢性支气管炎、吸烟、训练中吸入弹药气味和情绪不良等均能增加哮喘的发病率。结论劳累对官兵哮喘发病率的影响最大,个人过敏史、接触冷空气、慢性支气管炎、吸烟、吸入弹药气味、情绪等是诱发哮喘的危险因素。

Objective To investigate the incidence and related risk factors of occurrence of bronchial asthma in troops garrisoned in the cold areas of northeast China, and explore the corresponding prevention strategy. Methods A portion of the recruits enlisted in 2012 to Shenyang Command were enrolled as the subjects of the study with three questionnaires. The first questionnaire was carried out during training just after recruit. The second survey was carried out after winter training in selected recruits entering the army for two years, and the last questionnaire was carried out to select recruits just before their discharge from army. The final diagnosis of bronchial asthma in the suspected cases was established by pulmonary function test. Results In the first period of the survey, the prevalence of asthma was found to be 3.55‰ in the newly enlisted recruits; in the second survey 1067 cases were found to be suspicious to have asthma; in the last survey, 26 subjects were finally diagnosed to have asthma, the incidence was 1.73‰. The most common symptoms of the illness at first attack were cough（88.5%） and wheeziness（56.3%）, and the main inducing factors were respiratory tract infection（76.9%） and exposure to cold air（65.4%）, and it frequently appeared at early morning（30.8%） and forenoon（23.1%）. Asthmatic attack presented obvious seasonal predisposition, and it occurred in 19 of 26 patients（73.1%） during winter, and 10（38.5%） during spring. The attacks of asthma could be increased by fatigue, allergy, exposure to cold air, chronic bronchitis, smoking, inhalation of gunpowder exhaust, or dysthymia. Conclusion Fatigue may be the most frequent factor in inducing asthma, and allergy, exposure to cold air, chronic bronchitis, smoking, inhalation of gunpowder exhaust and dysthymia are the risk factors of asthmatic attack.