中山市居室内被动吸烟对儿童哮喘及哮喘样症状的影响

Effects of passive smoking on children with asthma and asthmatoid symptoms in Zhongshan, Guangdong

目的探讨中山市居室内被动吸烟对儿童哮喘及哮喘样症状的影响。方法于2016年3—7月在中山市城区采用随机整群抽样方法抽取小学和初中各5所,共有效调查11 611名儿童,采用国际统一的标准问卷[美国胸科协会制定的标准呼吸卫生调查表(ATS)]调查所选学生的哮喘及哮喘样症状及家庭室内被动吸烟等情况,分析被动吸烟对儿童哮喘和哮喘样症状的影响。结果中山市儿童的持续咳嗽、持续咯痰、喘鸣、哮喘和哮喘现患的检出率分别为2.85%(331/11 611),1.20%(139/11 611),6.93%(805/11 611),5.70%(662/11 611)和1.46%(169/11 611),有30.9%(3 588/11 611)的儿童暴露于二手烟。室内被动吸烟、母亲吸烟、母亲妊娠期被动吸烟和两岁前被动吸烟均对儿童哮喘和哮喘样症状有不同程度的影响(P<0.05);家庭成员每日吸烟量≥5支的儿童哮喘现患率(OR=3.66,95%CI:1.68~8.01)和喘鸣发生率(OR=1.76,95%CI:1.04~2.97)均高于非吸烟组,差异均有统计学意义(P<0.05)。多因素非条件logistic回归分析显示,两岁前被动吸烟是儿童哮喘及哮喘样症状的危险因素(OR值为1.51~2.03),室内被动吸烟是儿童持续咯痰的危险因素(OR=1.61,95%CI:1.11~2.35),均有统计学意义(P<0.05)。结论中山市室内被动吸烟是儿童哮喘及哮喘样症状的危险因素,尤其是两岁前被动吸烟。

Objective To explore the effects of indoor passive smoking on asthma and asthma-related symptoms in children in Zhongshan. Methods From March to July in 2016, a total of 11 611 children from five primary schools and junior high schools in downtown of Zhongshan were chosen with a random cluster sampling method. The ATS questionnaire of the international standard questionnaire was used to investigate the asthma and asthma-like symptoms of the selected students and family indoor passive smoking and so on, to analyze the impact of second hand smoke exposure on children with asthma and asthma-like symptoms. Results The prevalence rates of persistent cough, persistent expectoration, wheezing, asthma and asthmatoid systems in children were 2.85%, 1.20%, 6.93%, 5.70% and 1.46%, respectively. 30.9% of children were exposed to secondhand smoke.Univariate analysis showed that the indoor passive smoking, mother smoking, passive smoking during pregnancy and children≤2-year old exposed to passive smoking were all the risk factors of asthma and asthma-like symptoms in children（P〈0.05）.The indoor smoking amount was correlated with the wheezing and asthma in children. With the increase of smoking, the risk of illness increased（OR=1.76-3.66, P〈0.05）. Multivariate logistic regression analysis showed that children ≤2-year old exposed to passive smoking was a risk factor for persistent expectoration in children（OR=1.61, 95%CI： 1.11-2.35）. Both children with asthma and asthma-like symptoms were significantly more likely to have passive smoking（OR=1.51-2.03）. Conclusion Indoor passive smoking is a risk factor for children suffering from asthma and asthma-like symptoms and passive smoking is more dangerous for children≤2-year old.