气象因素对儿童和青少年哮喘的影响

Influence of meteorological factors on children and adolescents with asthma

目的分析气象因素对不同特征哮喘儿童和青少年的影响。方法该研究为回顾性研究,以2021年6月至2022年6月期间使用电子版中国儿童哮喘行动计划(China Children's Asthma Action Plan,CCAAP)的2600例哮喘儿童和青少年为研究对象,收集患儿的基本信息、症状及同期环境监测数据。分析空气质量指数(air quality index,AQI)、温度、湿度对哮喘患儿的影响。结果2021年6月至2022年6月哮喘患儿共记录日常症状49107次,其中“黄区”及“红区”症状共3274次。多因素Logistic回归分析显示与AQI等级为优相比等级为良(OR=1.270,95%CI:1.162~1.389,P<0.05)、污染(OR=1.640,95%CI:1.436~1.873,P<0.05)时出现哮喘症状的风险增加;与日温为21~30℃相比日温为11~20℃(OR=1.545,95%CI:1.400~1.706,P<0.05)、1~10℃(OR=1.583,95%CI:1.415~1.770,P<0.05)及大于30℃(OR=1.393,95%CI:1.122~1.730,P<0.05)时出现哮喘症状的风险增加;与空气湿度为41%~60%相比湿度为0~20%(OR=1.767,95%CI:1.381~2.259,P<0.05)、21%~40%(OR=1.456,95%CI:1.273~1.665,P<0.05)时出现哮喘症状的风险增加。出现哮喘症状的风险随着哮喘儿童和青少年的年龄增长而降低(OR=0.916,95%CI:0.903~0.930,P<0.05),随使用电子版CCAAP依从性升高而降低(OR=0.930,95%CI:0.927~0.933,P<0.05)。哮喘儿童和青少年自我报告的单一诱发因素中最常见的为呼吸道感染占56.03%,气候变化占23.99%,空气污染占5.08%。组间比较显示青春期、居住在华北地区、肥胖的哮喘患儿更容易受空气污染影响,居住在华东、华南及华中地区的哮喘患儿更容易受气候变化影响。结论空气质量差、低温、高温、空气湿度低、患儿年龄较小及使用电子版CCAAP依从性降低为出现哮喘症状的危险因素。

Objective To analyze the influence of meteorological factors on children and adolescents with asthma of different characteristics.Methods This study was a retrospective study.A total of 2600 children and adolescents with asthma who used the electronic version of the China Children's Asthma Action Plan(CCAAP)from June 2021 to June 2022 were enrolled.This study collected the basic information,symptoms and environmental monitoring data of children and adolescents with asthma.The influence of air quality index(AQI),temperature and humidity on children and adolescents with asthma were analyzed.Results From June 2021 to June 2022,a total of 49107 daily symptoms were recorded.Among them,the symptoms of"yellow zone"and"red zone"were 3274 times.Multivariate Logistic regression analysis showed that compared with excellent AQI grade,the occurrence of asthma symptoms increased when the AQI grade was good(OR=1.270,95%CI:1.162-1.389,P<0.05)and polluted(OR=1.640,95%CI:1.436-1.873,P<0.05);compared with the daily temperature of 21-30℃,the occurrence of asthma symptoms increased when the daily temperature was 11-20℃(OR=1.545,95%CI:1.400-1.706,P<0.05),1-10℃(OR=1.583,95%CI:1.415-1.770,P<0.05)and more than 30℃(OR=1.393,95%CI:1.122-1.730,P<0.05);compared with the air humidity of 41%-60%,the occurrence of asthma symptoms increased when the air humidity was 0-20%(OR=1.767,95%CI:1.381-2.259,P<0.05)and 21%-40%(OR=1.456,95%CI:1.273-1.665,P<0.05).The occurrence of asthma symptoms decreased with increasing age(OR=0.916,95%CI:0.903-0.930,P<0.05)and adherence of using the electronic version of CCAAP(OR=0.930,95%CI:0.927-0.933,P<0.05).Among the single self-reported triggers in children and adolescents with asthma,the most common trigger was respiratory infection accounting for 56.03%,climate change accounted for 23.99%,and air pollution accounted for 5.08%.The comparison between groups showed that children and adolescents with asthma who were adolescent,living in North China,and obese were more susceptible to air pollution.Children and adolescents with asthma living in East China,Southern China and Central China were more susceptible to climate change.Conclusion Poor air quality,low temperature,high temperature,low air humidity,younger age and decreased compliance with electronic CCAAP were risk factors for the occurrence of asthma symptoms.