儿童喘息高风险因素分阶段干预的可行性研究

Feasibility study of staged intervention on high risk factors of wheezing in children

目的探讨对喘息高风险因素儿实施分阶段干预的意义及可行性。方法选取2017年1-6月在丹阳市妇幼保健院及丹阳市儿童医院建立孕期保健卡且有喘息高危因素的早期孕妇386例,根据自愿原则,将对象分为干预组(n=241)和对照组(n=145),干预组接受分阶段干预,对照组不接受干预;比较两组喘息发病情况及喘息首次发作时患儿痰液病原菌、呼出气一氧化氮(FeNO)、血液T细胞亚群及IgE检测情况,并对比两组儿童出生12个月时生长发育指标。结果干预组1年内喘息发病率为16.60%,明显低于对照组的35.86%(P<0.05);且干预组喘息发作月龄明显大于对照组(P<0.05),发作次数、急诊次数、住院次数均明显少于对照组(P<0.05)。喘息首次发作时,干预组较对照组肺炎支原体/肺炎衣原体、病毒、细菌检出率及FeNO、CD4+、CD4+/CD8+及IgE水平均明显低于对照组,差异有统计学意义(P<0.05)。两组儿童12个月时身高、体重、头围比较差异无统计学意义(P>0.05)。结论分阶段干预能够有效降低喘息高风险因素儿喘息发病率,缓解病情严重程度,可行性较高。

Objective To explore the significance and feasibility of phased intervention in children with high risk factors for wheezing.Methods A total of 386 early-stage pregnant women with high risk factors for wheezing who received health care in Danyang Maternal and Child Health Hospital and Danyang Children's Hospital during the period from January to June 2017 were selected.According to their own intention,they were divided into the intervention groups(n=241)and the control group(n=145).The intervention group was given phased intervention,while the control group was not given any intervention.The incidence of wheezing,sputum pathogens,exhaled nitric oxide(FeNO),blood T cell subsets and IgE at initial attack of wheezing were compared between the two groups.The growth and development indicators of the two groups of children at 12 months after birth were compared.Results The incidence of wheezing in the intervention group was 16.60%within one year,which was significantly lower than that in the control group(35.86%)(P<0.05).The onset age of wheezing in the intervention group was significantly larger than that in the control group(P<0.05).The episodes,frequency of emergency treatment and hospitalizations were significantly less than those in the control group(P<0.05).At the first episode of wheezing,the detection rates of Mycoplasma pneumoniae/chlamydia pneumoniae,virus and bacteria,levels of FeNO,CD4+,CD4+/CD8+and IgE were significantly lower in the intervention group than in the control group(P<0.05).There was no significant difference in height,weight and head circumference between the two groups of children at 12 months old(P>0.05).Conclusion Phased intervention can effectively reduce the incidence of wheezing in children with high-risk factors and relieve the severity of illness,with high feasibility.