学龄期支气管哮喘患儿身体活动水平调查

Survey of physical activity level of asthmatic school-age children

目的了解学龄期支气管哮喘(哮喘)患儿身体活动水平和久坐时间现况。方法2021年3月至5月连续纳入在线使用《中国儿童哮喘行动计划》智能手机客户端的6~17岁哮喘患儿,发放国际体力活动问卷(IPAQ)短卷评估其身体活动水平、学龄儿童健康行为(HBSC)问卷评估其久坐行为、儿童哮喘控制测试(C-ACT)和哮喘控制测试(ACT)评估哮喘控制水平。收集年龄、性别、体质量指数(BMI)、运动后呼吸道症状、是否坚持用药等临床信息。结果共收集265份有效问卷,年龄中位数9.4(7.5,11.6)岁,ACT/C-ACT得分≥20分者占比74.0%(196例),达到高、中、低活动水平者分别为52例、110例、103例。活动水平与性别、BMI、是否规律用药、父母文化程度无显著相关性(均P>0.05)。每日久坐时间≥2 h的患儿在学习日和周末分别为204例和233例,周末显著多于学习日(87.9%比77.0%,χ^(2)=10.967,P=0.001)。160例(60.4%)患儿曾出现运动后呼吸道症状,最常见症状依次为咳嗽(72例)、喘息(53例)、呼吸困难(42例)、胸痛(16例)、胸闷(15例),但79.6%(211例)的患儿有参加身体活动的主观意愿。ACT/C-ACT得分≥20分者出现运动后症状比例显著低于得分≤19分的患儿(37.8%比72.5%),差异有统计学意义(χ^(2)=10.967,P<0.001)。结论学龄期哮喘患儿身体活动多数处于中低水平,且久坐时间长;哮喘控制不良的患儿更易出现运动后呼吸道症状。应制定规范化、个体化的运动处方,指导哮喘患儿进行安全有效的运动。

Objective To investigate the physical activity level and sedentary time of school-age children with bronchial asthma(asthma).Methods Asthmatic children aged 6 to 17 years old who used Chinese Children′s Asthma Action Plan on smartphones from March to May 2021 were included in the study.International Physical Activity Questionnaire(IPAQ)was employed to assess exercise level,and Health Behavior in School-Aged Children(HBSC)was employed to evaluate sedentary behavior.The Childhood Asthma Control Test(C-ACT),and the Asthma Control Test(ACT)were employed to assess asthma control status.Clinical information was collected,including age,gender,body mass index(BMI),respiratory symptoms after exercise and adherence to medication.Results A total of 265 valid questionnaires were collected,with a median age of 9.4(7.5,11.6)years old.The rate of ACT/C-ACT score≥20 was 74.0%(196 cases).There were 52 cases with high,110 cases with medium and 103 cases with low activity levels.There was no significant correlation between activity level and gender,BMI,regular drug use or educational level of parents(P>0.05).The number of children with sedentary time≥2 hours was 204 on weekdays and 233 on weekends,respectively,and the number on weekends was significantly higher(87.9%vs.77.0%,χ^(2)=10.967,P=0.001).There were 160 cases(60.4%)with respiratory symptoms after exercise,with the most common symptoms including cough(72 cases),wheezing(53 cases),dyspnea(43 cases),chest pain(16 cases)and chest tightness(15 cases).Despite the symptoms,79.6%(211 cases)of all children had the subjective intention to participate in physical activities.The incidence of post-exercise symptoms in children with ACT/C-ACT scores≥20 was significantly lower than that in children with ACT/C-ACT≤19(37.8%vs.72.5%,χ^(2)=10.967,P<0.001).Conclusions Most school-age children with bronchial asthma had low to moderate levels of physical activity,and the sedentary time is long.Children with poorly controlled asthma are more likely to develop respiratory symptoms after exercise.Standardized and individualized exercise prescriptions should be further formulated to guide children with asthma to carry out reaso-nable physical exercise.