支气管哮喘患儿负面情绪现状及相关影响因素分析

Current status and influencing factors of negative emotions of children with bronchial asthma

目的探讨支气管哮喘(BA)患儿负面情绪现状及相关影响因素。方法选取2018年1月至2019年9月上海交通大学附属儿童医院呼吸科收治的BA患儿148例,根据患儿有无负面情绪分为负面情绪组86例和对照组62例。记录患儿各项临床资料,并进行多因素Logistic回归分析。结果在148例BA患儿中,产生负面情绪86例(58.11%),其中抑郁情绪42例(28.38%)、焦虑情绪78例(52.70%),两种情绪合并发生34例(22.97%)。Logistic回归分析显示,BA病程长(OR=2.762,P=0.013)、第1秒用力呼气容积(FEV1)低(OR=2.065,P=0.004)、1年内住院次数多(OR=3.337,P=0.012)、BA程度重度(OR=3.133,P=0.020)、主要照顾者有负面情绪(OR=3.515,P=0.003)、睡眠不良(OR=2.855,P=0.025)均为影响BA患儿产生负面情绪的独立危险因素,而哮喘控制良好(OR=0.330,P=0.022)、规律用药(OR=0.378,P=0.006)为影响BA患儿产生负面情绪的保护因素。结论BA患儿负面情绪发生率较高,临床可重点关注BA病程长、FEV1低、1年内住院次数多、BA程度重度、主要照顾者有负面情绪、睡眠不良、哮喘控制差、无规律用药的患儿。

Objective To investigate current status and influencing factors of negative emotions of children with bronchial asthma(BA).Methods A total of 148 BA children who admitted to Department of Respiratory Medicine,The Affiliated Children’s Hospital of Shanghai Jiaotong University from January 2018 to September 2019 were selected.According to presence or absence of negative emotions,they were divided into negative emotion group(86 cases)and control group(62 cases).The scale of Screening for Child Anxiety Related Emotional Disorders(SCARED)was used to evaluate axiety of the children and Depression Self-rating Scale for Children(DSRSC)was used to evaluate depression of the children.Hamilton Anxiety Scale(HAMA)was used to evaluate anxiety of the main caregivers and Hamilton Depression Scale(HAMD)was used to evaluate depression of the main caregivers.The clinical data of the patients were recorded and analyzed by using multivariate logistic regression analysis.Results Of 148 BA children,86 children had negative emotions(58.11%),including 42 cases of depression(28.38%),78 cases of anxiety(52.70%)and 34 cases of combination of depression and anxiety(22.97%).Logistic regression analysis showed that long BA course(OR=2.762,P=0.013),low forced expiratory volume in one second(FEV1)(OR=2.065,P=0.004),frequent hospitalization within 1 year(OR=3.337,P=0.012),severe BA(OR=3.133,P=0.020),negative emotions in main caregivers(OR=3.515,P=0.003)and poor sleep(OR=2.855,P=0.025)were independent risk factors of negative emotions of BA children,while good asthma control(OR=0.330,P=0.022)and regular medication(OR=0.378,P=0.006)were the protective factors.Conclusion The incidence of negative emotions is relatively high in BA children.Clinically,close attention should be paid to those children with long BA course,low FEV1,frequent hospitalization within 1 year,severe BA,negative emotions in main caregivers,poor sleep,poor asthma control and irregular medication.