2~7岁儿童功能性便秘影响因素分析

Analysis of influential factors of functional constipation in children aged 2-7 years

目的分析2~7岁儿童功能性便秘的影响因素。方法采用病例对照研究方法,选取2019年5月20日至2019年9月20日在北京大学第三医院儿科就诊的2~7岁功能性便秘儿童及同期同年龄健康对照儿童为研究对象。通过问卷研究对象收集一般情况、排便情况及可能影响便秘产生的因素,包括0.5岁内抗生素使用、乳儿期喂养情况、饮食偏好、运动、过敏相关病史、父母病史、家庭收入、主要看护人等信息,采用二元Logistic回归模型分析功能性便秘的影响因素。结果共纳入研究对象203例,其中便秘组儿童81例,健康对照组122例。粪便粗大、粪便干结、排便疼痛和排便次数减少是功能性便秘最常见的症状。添加辅食及上幼儿园是该年龄段儿童出现功能性便秘最常见的诱因。单因素分析发现,6月龄内应用抗生素史、挑食偏食习惯、运动量及变应性疾病、便秘相关家族史及父亲变应性疾病背景、主要看护人是否为父母差异均有统计学意义(均P<0.05)。二元Logistic回归分析显示,父亲有变应性疾病病史(OR=2.302,95%CI:1.109~4.780)、0.5岁内应用抗生素(OR=2.300,95%CI:1.053~5.022)、父母有便秘病史(OR=2.151,95%CI:1.106~4.128)及偏好主食的饮食习惯(OR=3.526,95%CI:1.402~8.867)是2~7岁儿童发生功能性便秘的影响因素。结论父母有便秘病史、父亲有变应性疾病病史及偏好主食的饮食习惯可能是功能性便秘发生的影响因素。

Objective To analyze the risk factors of functional constipation in children aged 2-7 years.Methods A case-control study was performed on 2-7-year-old children with functional constipation who were treated in the Department of Pediatrics,Peking University Third Hospital from May 20,2019 to September 20,2019 and healthy control children with same age.The general situation,defecation situation and factors that might affect the occu-rrence of constipation were collected through the questionnaire,the influence factors included antibiotic use before half year old,breastfeeding,dietary preferences,exercise,allergy-related medical history,parental medical history,family income and primary caregivers,which were analyzed by using a binary Logistic regression model.Results A total of 203 subjects were included,including 81 children in the constipation group and 122 children in healthy control group.Thick stools,dry stools,painful bowel movements and reduced bowel movement frequency were the most common symptoms of functional constipation.The main causes children at this age were food supplements and going to kindergarten.The univariate analysis indicated that the history of anti-biotics before half year old,picky eating habits,exercise volume and allergy-related diseases,constipation-related family history,father′s allergic disease background,and whether the main caregivers were parents were significantly different between two groups(all P<0.05).The binary Logistic regre-ssion analysis revealed that father′s history of allergic diseases(OR=2.302,95%CI:1.109-4.780),the use of anti-biotics within 6 months after birth(OR=2.300,95%CI:1.053-5.022),parents′history of constipation(OR=2.151,95%CI:1.106-4.128),and dietary preference of staple food(OR=3.526,95%CI:1.402-8.867)were the risk factors for functional constipation in 2-7-year-old children.Conclusions Parents′history of constipation,father′s history allergic diseases and a dietary preference for staple food may be the risk factors for functional constipation.