开封市市区0～14岁儿童哮喘流行病学调查

Epidemiological study on childhood asthma aged 0 to 14, in Kaifeng city

目的 调查分析开封市区儿童哮喘患病率、危险因素及治疗状况与卫生经济学的关系。方法 用随机整群抽样方法 ,对开封市市区 110 0 0名 0～ 14岁儿童进行哮喘流行病学调查。采用回顾性询问填表法初筛出可疑对象 ,并按全国统一诊断标准逐个体格检查 ,明确诊断 ,填写统一调查表 ,并进行统计学处理。结果 ①患病率为 1.16 % (现患率为 0 .91% ) ,男女比为 1.72∶1;各年龄组患病率差异有非常显著性 (P <0 .0 0 1) ,以 3～ 5岁组患病率最高。工业区儿童患病率明显高于居民区 ,比值比 (OR)为 2 .13∶1(P <0 .0 0 1)。②相关因素分析 :以过敏性疾病史、上呼吸道感染史、家族史为主要因素 ;与民族类别和狗、猫接触史差异无显著性 (0 .0 5 <P <0 .1)。③治疗与卫生经济学分析 :确诊患儿中按吉纳方案规范治疗者仅占 10 .15 % ,年人均花费为 6 5 3.6 8元。非规范治疗年人均花费 2 375 .2 2元 ,经统计学处理 ,差异有非常显著性 (P <0 .0 0 1)。结论 开封地区儿童哮喘发病率比 10年前上升2倍以上 ;哮喘发病率与过敏性疾病史、上呼吸道感染史、家族史密切相关 ;接受规范治疗 ,可降低患者的医疗费用。

Objective To understand childhood asthma from age 0 to 14 in Kaifeng city and the relevant risk factors, effects of therapy and costs. Methods Eleven thousand children aged 0 to 14 were chosen in Gulou area,Shunhe area using cluster sampling. Results ①The overall prevalence of childhood asthma was 1.16 % sex ratio 1.72 ∶1. Significant difference was found among every age group ( P < 0.001 ), with the highest from 0 to 3,the prevalence ratein industrial area was singificantly higher than that of residential area, with a ratio of 2.13 ∶1 ( P < 0.001 ). ②Major relevant factors were found to be: history of hypersensitivity,upper respiratory infection and family history; while nationalities,history of contact with pets were not found to be related to childhood asthma ( P > 0.05 ). ③The expenditure was sigificanly different between non specific therapy and specified therapy ( P < 0.001 ). Among those children with asthma, 89.8 % did not get specified treatment and the average expenditure was 2 375.2 Yuan per year,which was 10.2 % of accepted specified therapy, namely under GINA program, with average expenditure 653.68 Yuan every year. Conclusion The result of this study provided scientific basis for child asthma prevention and cure in this area.