157例支气管哮喘儿童生命早期相关因素分析

Analysis on correlative factor of bronchial asthma in children's early life

目的探讨儿童支气管哮喘生命早期相关因素,为临床预防和治疗提供参考。方法选择2015年8月~2016年8月在上海中医药大学附属岳阳中西医结合医院儿科门诊诊断的0~14岁哮喘患儿157例,以及与相关病例同时就诊的年龄、性别、民族、居住地相同的没有心身相关疾病或反应的非呼吸道疾病儿童224例成组匹配。对157例哮喘患儿和224例非哮喘儿童进行病例对照研究,利用χ2检验,二分类Logistic回归分析儿童支气管哮喘生命早期危险因素。结果单因素分析结果示:早孕反应,妊娠高血压,母孕期情绪稳定,孕期吸烟或被动吸烟,剖宫产,早产,母乳喂养,母乳期间食用蛋、大豆、鱼和贝壳类、花生和坚果类等,1岁以内使用抗生素,饲养宠物,反复呼吸道感染11个因素与哮喘有关;Logistic回归分析结果示:孕期吸烟或被动吸烟,剖宫产,早产,母孕期间食用蛋、大豆、鱼和贝壳类、花生和坚果类等,1岁以内使用抗生素,反复呼吸道感染6个因素为危险因素;母乳喂养、母孕期情绪稳定以及饲养宠物为保护因素。结论让孕妇和患儿远离各种危险因素,加强保护因素,降低儿童哮喘的发病率。

Objective To provide reference for clinical prevention and treatment of child bronchial asthma by discussing its related factors in early stage of life. Methods 157 cases of children with asthma and 224 cases of children with non-respiratory illnesses were selected into groups for control study. They were all 0 to 14 years old and diagnosed by pediatric clinic of Yueyang Hospital of Integrated Chinese and Western Medicine, Shanghai University of Traditional Chinese Medicine during August 2015 to August 2016. Children in the same group had related illness, same age, sex, nationality, place of residence of psychosomatic related diseases or reaction case-control studies were conducted between 157 cases of children with asthma and 224 cases of normal children, in which χ2 test and Logistic regression model analysis methods were adopted to analyze the risking elements in the early life stage of bronchial asthma children. Results The result of univariate analysis indicated that： 11 elements might be related with asthma, which includes morning sickness, hypertension of pregnancy, emotional stability, smoking or passive smoking during pregnancy, caesarean section, premature birth, breast feeding, eat egg, soy, fish and shellfish, peanuts, nuts during breast feeding, use of antibiotics within one year of age, keeping pets, recurrent respiratory tract infection. Logistic regression analysis results showed that： risking factors were smoking or passive smoking during pregnancy, caesarean section, premature birth, eat egg, soy, fish and shellfish, peanuts, nuts during breast feeding, use of antibiotics within one year of age and recurrent respiratory tract infection. Protective factors were breast feeding, Emotional stability and keeping pets. Conclusion Pregnant women and children a should be kept away from all kinds of risking factors and strengthen the protection factors.