乌鲁木齐市学龄前儿童过敏性鼻炎患病及相关症状影响因素分析

Influencing factors of allergic rhinitis and rhinitis-related symptoms among preschool children in Urumqi city:a cross-sectional survey

目的了解新疆乌鲁木齐市学龄前儿童经医生诊断的过敏性鼻炎患病率及家长报告鼻炎相关症状发生情况,探讨与学龄前儿童过敏性鼻炎及鼻炎相关症状的影响因素,为学龄前儿童过敏性鼻炎及鼻炎相关症状的预防和控制提供理论依据。方法采用横断面研究方法,于2019年8—12月问卷调查乌鲁木齐市60所幼儿园的8153名学龄前儿童经医生诊断的过敏性鼻炎患病情况、家长报告的儿童鼻炎相关症状发生情况、遗传、个体及环境因素,分析儿童过敏性鼻炎及鼻炎相关症状的影响因素。结果调查的8153名学龄前儿童中,有7.6%的儿童曾经医生明确诊断为过敏性鼻炎,有27.4%的儿童既往曾出现过鼻炎相关症状。多因素logistic回归分析结果显示,年龄(5~7岁)(OR=1.36,95%CI=1.04~1.80)、独生子女(OR=1.24,95%CI=1.04~1.48)、出生方式(OR=1.21,95%CI=1.02~1.44)、父亲患鼻炎(OR=2.50,95%CI=2.10~2.98)、母亲患鼻炎(OR=3.29,95%CI=2.76~3.91)、父亲患哮喘(OR=1.95,95%CI=1.02~3.74)、住所的居住面积(OR=1.25,95%CI=1.01~1.56)、母亲怀孕期间住所内购买新家具(OR=1.79,95%CI=1.28~2.51)、孩子0~1岁时住所内新装修(OR=1.82,95%CI=1.19~2.79)是儿童过敏性鼻炎的危险因素;女童(OR=0.79,95%CI=0.67~0.94)、墙壁材料为石灰/水泥(相对于壁纸)(OR=0.39,95%CI=0.16~0.98)是儿童过敏性鼻炎的保护因素。独生子女(OR=1.22,95%CI=1.10~1.36)、出生方式(OR=1.14,95%CI=1.02~1.26)、父亲患鼻炎(OR=2.16,95%CI=1.93~2.42)、母亲患鼻炎(OR=2.38,95%CI=2.13~2.67)、父亲患哮喘(OR=2.22,95%CI=1.34~3.69)、复合地板(OR=1.53,95%CI=1.28~1.84)与瓷砖/石头/水泥地板(OR=1.28,95%CI=1.11~1.49)(相对于实木地板)、母亲怀孕期间住所内购买新家具(OR=1.28,95%CI=1.03~1.60)、在阳光充足时晾晒被褥(OR=1.42,95%CI=1.18~1.71)、孩子0~1岁住所内种植开花植物(OR=1.27,95%CI=1.11~1.46)是儿童鼻炎相关症状的危险因素;女童(OR=0.87,95%CI=0.78~0.96)、纯母乳喂养持续时间(OR=0.86,95%CI=0.77~0.96)、其他墙壁表面材料(相对于壁纸)(OR=0.43,95%CI=0.29~0.64)是儿童鼻炎相关症状的保护因素。结论乌鲁木齐市学龄前儿童过敏性鼻炎及鼻炎相关症状发生风险较高,遗传和室内环境因素是乌鲁木齐市儿童过敏性鼻炎及鼻炎相关症状的主要影响因素。

Objective To examine the prevalence and influencing factors of physician-diagnosed allergic rhinitis and parent-reported rhinitis-related symptoms among preschool children in Urumqi city,Xinjiang Uygur Autonomous Region for providing evidence to the prevention and control of the illness in the children.Methods A self-administered survey was conducted among 10000 children aged 2-7 years in 60 kindergartens selected with stratified random cluster sampling in Urumqi city during August-December 2019.A questionnaire was designed based on the International Study of Asthma and Allergies in Childhood(ISAAC)and Dampness in Buildings and Health(DBH)and the questionnaire was answered by the children's parents or guardians.The data collected were analyzed using SPSS 26.0.Results Of the 8153 preschool children with valid information,7.6%were reported having been diagnosed as allergic rhinitis and 27.4%ever having experienced rhinitis-related symptoms.The results of unconditional multivariate logistic regression analysis showed that the children with following characteristics were more likely to have allergic rhinitis:at elder age(5-7 year vs.2 years:odds ratio[OR]=1.36,95%confidence interval[95%CI]:1.04-1.80),being only child(OR=1.24,95%CI:1.04-1.48),being born by cesarean section(versus vaginal delivery:OR=1.21,95%CI:1.02-1.44),paternal history of rhinitis(OR=2.50,95%CI:2.10-2.98),maternal history of rhinitis(OR=3.29,95%CI:2.76-3.91),paternal history of asthma(OR=1.95,95%CI:1.02-3.74),with larger living space(≥75 m2 vs.<75 m2:OR=1.25,95%CI:1.01-1.56),maternal exposure to new furniture at home during pregnancy(OR=1.79,95%CI:1.28-2.51),and having indoor decoration at home at the age of 0-1 year(OR=1.82,95%CI:1.19-2.79);while the children being girl(OR=0.79,95%CI:0.67-0.94)and living in a house with lime/cement as wallcovering(versus wallpaper:OR=0.39,95%CI:0.16-0.98)were less likely to have allergic rhinitis;the results also revealed significant influencing factors of rhinitisrelated symptoms as following:being only child(OR=1.22,95%CI:1.10-1.36),being born by cesarean section(versus vaginal delivery:OR=1.14,95%CI:1.02-1.26),paternal history of rhinitis(OR=2.16,95%CI:1.93-2.42),maternal history of rhinitis(OR=2.38,95%CI:2.13-2.67),paternal history of asthma(OR=2.22,95%CI:1.34-3.69),living in a house with the floor covered by composite material(versus wood:OR=1.53,95%CI:1.28-1.84)or tile/stone/cement(versus wood:OR=1.28,95%CI:1.11-1.49),maternal exposure to new furniture at home during pregnancy(OR=1.28,95%CI:1.03-1.60),with beddings being aired in sunny day frequently(OR=1.42,95%CI:1.18-1.71),and with indoor cultivation of flowering plant at home at the age of 0-1 year(OR=1.27,95%CI:1.11-1.46)and protective factors including being girl(OR=0.87,95%CI:0.78-0.96),longer duration of exclusive breastfeeding(≥6 months vs.<6 months:OR=0.86,95%CI:0.77-0.96),and living in a house with material other than water based paint/emulsion paint/oily paint/board/lime/cement/seaweed mud as wallcovering(versus wallpaper:OR=0.43,95%CI:0.29-0.64).Conclusion Among preschool children in Urumqi city,the prevalence of allergic rhinitis and rhinitis-related symptoms were relatively high and mainly influenced by genetic factors and residential indoor environment.