江苏宜兴市和新疆阿合奇县儿童支气管哮喘患病率和影响因素调查

Investigation on the prevalence and influencing factors of childhood asthma in Yixing City,Jiangsu and Aheqi County,Xinjiang

目的分析江苏宜兴市和新疆阿合奇县儿童支气管哮喘(哮喘)的患病率和影响因素。方法本研究为横断面研究,采用分层整群随机抽样的方法,将幼儿园、小学、初中分为3层,从每层中随机抽样,对宜兴市7673名儿童和阿合奇县2313名儿童进行调查。制定统一的儿童哮喘电子调查问卷,于2019年1月至2021年10月进行问卷发放填写,问卷内容包括一般资料、围生期情况、家族史、既往史、过敏史、家庭环境和生活习惯等。比较宜兴市和阿合奇县儿童哮喘的患病率和主要特征,通过logistic回归分析两个地区儿童哮喘的影响因素。结果宜兴市儿童哮喘患病率高于阿合奇县,差异有统计学意义[3.4%(264/7673)比2.0%(47/2313),χ^(2)=11.69,P=0.001]。宜兴市儿童父亲或母亲学历为高中及以上者、独生子女、剖宫产娩出者和足月儿占比均高于阿合奇县[73.3%(5624/7673)比37.7%(872/2313)、68.6%(5263/7673)比36.7%(850/2313)、56.1%(4306/7673)比16.6%(384/2313)、46.8%(3593/7673)比17.8%(412/2313)、93.9%(7205/7673)比89.7%(2075/2313)],差异均有统计学意义(均P<0.001)。宜兴市儿童出生体重大于阿合奇县,阿合奇县儿童辅食添加时间早于宜兴市,两地儿童生后6个月内喂养方式的构成不同,差异均有统计学意义(均P<0.001)。宜兴市儿童家中有吸烟亲属、生后补充维生素D、一级亲属有过敏性疾病史、有湿疹史、变应性鼻炎史、食物过敏史和药物过敏史者占比均高于阿合奇县[58.3%(4472/7673)比53.4%(1234/2313)、73.0%(5602/7673)比41.5%(961/2313)、17.8%(1364/7673)比6.5%(151/2313)、13.6%(1043/7673)比4.6%(107/2313)、11.7%(896/7673)比3.2%(73/2313)、14.8%(1132/7673)比1.7%(39/2313)、7.5%(574/7673)比1.3%(30/2313)],而家中饲养动物者占比低于阿合奇县[20.7%(1588/7673)比59.4%(1373/2313)],差异均有统计学意义(均P<0.001)。多因素logistic回归分析显示,男性(OR=1.358,95%CI:1.040~1.775,P=0.025)、早产儿(OR=1.800,95%CI:1.156~2.801,P=0.009)、一级亲属过敏性疾病史(OR=2.195,95%CI:1.665~2.894,P<0.001)、湿疹史(OR=1.838,95%CI:1.362~2.481,P<0.001)、变应性鼻炎史(OR=5.570,95%CI:4.241~7.315,P<0.001)、食物过敏史(OR=2.351,95%CI:1.769~3.125,P<0.001)、药物过敏史(OR=1.659,95%CI:1.157~2.379,P=0.006)是宜兴市儿童哮喘的危险因素。生后6个月内人工喂养相比母乳喂养(OR=2.410,95%CI:1.105~5.253,P=0.027)、湿疹史(OR=4.572,95%CI:2.064~10.128,P<0.001)、变应性鼻炎史(OR=3.929,95%CI:1.568~9.846,P=0.004)是阿合奇县儿童哮喘的危险因素。结论宜兴市儿童哮喘的患病率高于阿合奇县,宜兴市儿童哮喘的危险因素包括男性、早产儿、一级亲属过敏性疾病史、湿疹史、变应性鼻炎史、食物过敏史和药物过敏史,阿合奇县儿童哮喘的危险因素包括生后6个月内人工喂养、湿疹史和变应性鼻炎史。

ObjectiveTo analyze the prevalence and influencing factors of childhood asthma in Yixing City,Jiangsu and Aheqi County,Xinjiang.MethodsThis study was a cross-sectional study using stratified cluster random sampling method.Kindergarten,primary school,and junior high school were divided into three levels,and a random sampling was conducted from each level.A total of 7673 children in Yixing City and 2313 children in Aheqi County were finally enrolled in this study.A unified electronic survey questionnaire for childhood asthma was developed and then distributed from January 2019 to October 2021.The questionnaire included general information,perinatal conditions,family history,past history,allergy history,family environment,living habits,etc.The prevalence and main characteristics of childhood asthma in Yixing City and Aheqi County were compared,and the influencing factors of childhood asthma in the two regions were analyzed through logistic regression.ResultsThe prevalence of childhood asthma in Yixing City was significantly higher than that in Aheqi County(3.4%[264/7673]vs 2.0%[47/2313],χ^(2)=11.69,P=0.001).The proportion of children whose fathers or mothers have a high school education or above,only child,cesarean section delivery,and full-term births in Yixing City were significantly higher than those in Ahqi County(73.3%[5624/7673]vs 37.7%[872/2313],68.6%[5263/7673]vs 36.7%[850/2313],56.1%[4306/7673]vs 16.6%[384/2313],46.8%[3593/7673]vs 17.8%[412/2313],93.9%[7205/7673]vs 89.7%[2075/2313],all P<0.001).The birth weight of children in Yixing City was greater than that in Aheqi County,and the timing of complementary food supplementation in Aheqi County was earlier than that in Yixing City.The composition of feeding methods for children within 6 months after birth was significant different between the two regions(all P<0.001).The proportion of children with family members who smoke,take vitamin D supplements after birth,and first-degree relatives who have a history of allergic diseases,eczema,allergic rhinitis,food allergies and drug allergies in Yixing City was obviously higher than Aheqi County(58.3%[4472/7673]vs 53.4%[1234/2313],73.0%[5602/7673]vs 41.5%[961/2313],17.8%[1364/7673]vs 6.5%[151/2313],13.6%[1043/7673]vs 4.6%[107/2313],11.7%[896/7673]vs 3.2%[73/2313],14.8%[1132/7673]vs 1.7%[39/2313],7.5%[574/7673]vs 1.3%[30/2313],all P<0.001).However,the proportion of children raising animals at home in Yixing City was significantly lower than that in Aheqi County(20.7%[1588/7673]vs 59.4%[1373/2313],P<0.001).Multivariate logistic regression analysis showed that males(OR=1.358,95%CI:1.040-1.775,P=0.025),premature infants(OR=1.800,95%CI:1.156-2.801,P=0.009),first-degree relatives with a history of allergic diseases(OR=2.195,95%CI:1.665-2.894,P<0.001),eczema history(OR=1.838,95%CI:1.362-2.481,P<0.001),allergic rhinitis history(OR=5.570,95%CI:4.241-7.315,P<0.001),food allergy history(OR=2.351,95%CI:1.769-3.125,P<0.001)and drug allergy history(OR=1.659,95%CI:1.157-2.379,P=0.006)were risk factors for childhood asthma in Yixing City.Compared with breastfeeding within 6 months after birth,artificial feeding(OR=2.410,95%CI:1.105-5.253,P=0.027),history of eczema(OR=4.572,95%CI:2.064-10.128,P<0.001),and history of allergic rhinitis(OR=3.929,95%CI:1.568-9.846,P=0.004)were risk factors for childhood asthma in Aheqi County.ConclusionsThe prevalence of childhood asthma in Yixing City is higher than that in Aheqi County.The risk factors for childhood asthma in Yixing City include male,premature infants,history of allergic diseases in first degree relatives,history of eczema,history of allergic rhinitis,history of food allergies,and history of drug allergies.The risk factors for childhood asthma in Aheqi County include artificial feeding within 6 months after birth,history of eczema,and history of allergic rhinitis.