热带地区儿童变应性鼻炎流行特征:基于海南省海口市的调查

Epidemiological characteristics of allergic rhinitis in children in tropical regions:Based on Haikou City,Hainan Province

[背景]变应性鼻炎(AR)的流行特征在不同国家和地区间不尽相同,目前有关我国热带地区的流行病学调查资料尚属空白。[目的]调查海南省海口市儿童AR的流行特征,探讨可能的患病影响因素。[方法]2019年4—10月期间采用整群抽样的调查方法,通过电子调查问卷对海口市16所幼儿园和小学的2584名儿童进行AR流行病调查,分析其AR自报患病率、临床症状及致敏原分布特点、合并疾病等流行特征,并对患病影响因素进行logistic回归分析。[结果]回收电子调查表2584份,有效问卷2386份,有效率92.3%。被调查儿童平均年龄(7.3±2.4)岁,男1249例,女1137例,海口市儿童AR自报患病率为11.69%,男童、7~12岁儿童、城市儿童、有AR家族史儿童的患病率高于女童、3~6岁儿童、农村儿童、无AR家族史儿童,差异有统计学意义(P<0.05)。各月份间AR发病率比较差异无统计学意义(χ^2=17.804,P=0.086)。儿童AR症状以喷嚏、流涕为主,分别占87.5%、70.6%;致敏原以尘螨为主,占52.3%。AR合并过敏性结膜炎占26.5%,合并支气管哮喘占12.5%。logistic回归分析显示,有AR家族史(OR=2.237,95%CI:1.068~4.683)、男童(OR=1.774,95%CI:1.117~2.817)、7~12岁儿童(OR=1.829,95%CI:1.044~3.205)、城市儿童(OR=1.721,95%CI:1.101~2.691)是儿童自报AR患病的危险因素。[结论]海口市有AR家族史的儿童、男童、7~12岁儿童、城市儿童AR患病水平相对较高。

[Background]The epidemiological characteristics of allergic rhinitis(AR)are different across countries or regions.Such information has been rarely reported in tropical areas in China.[Objective]This study investigates the epidemiological features and influencing factors of AR in children in Haikou.[Methods]A cluster sampling survey on AR using electronic questionnaires was conducted in 2584 children from 16 preschools and primary schools in Haikou.The epidemiological features of self-reported AR prevalence,clinical symptoms,distribution of allergens,and comorbidities were analyzed.Logistic regression analysis was performed on potential influencing factors of AR in children.[Results]Among the 2584 questionnaires returned,there were 2386 valid questionnaires,and the valid response rate was 92.3%.There were 1249 boys and 1137 girls aged(7.3±2.4)years.The self-reported prevalence rate of AR was 11.69%.The prevalence rates of boys,7-to-12-yearold children,urban children,and children with a family history of AR were higher than those of girls,3-to-6-year-old children,rural children,and children without a family history of AR(P<0.05).There was no monthly difference in AR incidence(P>0.05).The main clinical symptoms of AR were sneezing(87.5%)and runny nose(70.6%),and the most common allergens was dust mites(52.3%).Among comorbidities,allergic conjunctivitis accounted for 26.5%,and asthma accounted for 12.5%.The multiple logistic regression analysis results showed that family history of AR(OR=2.237,95%CI:1.068-4.683),boys(OR=1.774,95%CI:1.117-2.817),7-to-12-year-old children(OR=1.829,95%CI:1.044-3.205),and urban residence(OR=1.721,95%CI:1.101-2.691)were independent risk factors for self-reported AR in children.[Conclusion]The prevalence of AR is higher in the children with a family history of AR,boys,7-to-12-year-old children,urban residents in Haikou.