学龄前患儿哮喘复发的影响因素分析

Influencing factors of asthma recurrence in preschool children

目的分析学龄前患儿哮喘复发的影响因素。方法选取2019年1月—2020年12月河南省直第三人民医院儿科住院部160例学龄前哮喘患儿为研究对象, 进行规范化治疗后停药随访1年, 剔除失访与退出6例, 最终纳入154例, 根据有无复发分为复发组(91例)与未复发组(63例)。收集与记录患儿资料, 采用logistic回归分析探讨患儿哮喘复发的影响因素, 并探讨对应的干预策略。结果单因素分析结果显示:两组哮喘患儿在监护人文化程度、哮喘家族史、哮喘严重程度、共存过敏性鼻炎、共存鼻窦炎、规范用药疗程、联合用药情况、停药季节、坚持定期复诊等方面差异均有统计学意义(均P<0.05);多因素logistic回归分析显示:患儿监护人文化程度低(初中及以下)(OR=1.960, 95%CI:1.714~2.206)、有哮喘家族史(OR=2.277, 95%CI:1.850~2.705)、共存过敏性鼻炎(OR=2.034, 95%CI:1.520~2.548)、重度哮喘(OR=1.866, 95%CI:1.026~2.707)、春冬季节停药(OR=1.861, 95%CI:1.704~2.018)是哮喘复发的危险因素, 而规范用药疗程>12个月(OR=0.465, 95%CI:0.304~0.712)、联合用药(OR=0.458, 95%CI:0.297~0.705)、坚持定期复诊(OR=0.559, 95%CI:0.389~0.803)是患儿哮喘复发的保护因素(均P<0.05)。结论哮喘家族史、是否共存过敏性鼻炎、哮喘严重程度、是否坚持定期复诊以及是否规范、联合用药等为影响学龄前患儿哮喘复发的主要因素, 临床可据此制定相应的干预策略。

Objective To investigate the influencing factors of asthma recurrence in preschool children.Methods From January 2019 to December 2020,a total of 160 preschool children with asthma in the pediatric inpatient department of the Third People′s Hospital of Henan Province were included as the research subjects.After standardized treatment,the drug was discontinued and the patients were followed up for 1 year.A total of 6 cases were lost or withdrawn during the follow-up,and finally 154 cases were included and divided into recurrence group(91 cases)and non-recurrence group(63 cases)according to the presence or absence of recurrence.The data of these children were collected and recorded,and logistic regression analysis was used to explore the influencing factors of asthma recurrence in children,and to explore the corresponding intervention strategies.Results The results of univariate analysis showed that the differences in guardian′s education level,asthma family history,asthma severity,coexisting allergic rhinitis,coexisting sinusitis,standardized medication course,combined medication,drug withdrawal season,adherence to regular follow-up visits,etc.were statistically significant between the two groups of asthmatic children(all P<0.05).Multivariate Logistic regression analysis showed that the children′s guardians had low educational level(junior high school and below)(OR=1.960,95%CI:1.714-2.206),family history of asthma(OR=2.277,95%CI:1.850-2.705),coexisting allergic rhinitis(OR=2.034,95%CI:1.520-2.548),severe asthma(OR=1.866,95%CI:1.026-2.707),drug withdrawal in spring or winter(OR=1.861,95%CI:1.704-2.018)were risk factors for asthma recurrence,while standard medication duration>12 months(OR=0.465,95%CI:0.304-0.712),combined medication(OR=0.458,95%CI:0.297-0.705),adherence to regular follow-up visits(OR=0.559,95%CI:0.389-0.803)were protective factors for asthma recurrence in children(all P<0.05).Conclusion Family history of asthma,coexistence of allergic rhinitis,severity of asthma,adherence to regular follow-up visits,and standardized and combined medication are the main factors affecting asthma recurrence in preschool children,and clinical intervention strategies can be formulated accordingly.