浙江省丽水市学龄儿童变应性鼻炎流行病学特征及影响因素分析

Epidemiological characteristics and related influencing factors of allergic rhinitis among school-age children in Lishui,Zhejiang Province

目的调查浙江省丽水东部及中部地区小学儿童变应性鼻炎(AR)流行病学特征,并对相关影响因素进行分析。方法2022年1—7月以浙江省丽水市东部莲都区、青田县、缙云县和中部云和县小学儿童为研究对象,对其家长或监护人发放儿童AR调查问卷,了解丽水东部及中部地区儿童AR的患病现状,分析儿童AR相关影响因素。结果浙江省丽水市东部及中部地区学龄儿童AR平均患病率为15.4%,莲都区、青田县、缙云县、云和县患病率分别22%、19.8%、7.5%、7.9%。鼻痒(48.4%)、鼻塞(34.5%)、喷嚏(28%)、眼痒(23.9%)是儿童最常见的鼻部症状。最常见的AR伴随疾病为湿疹(20.1%)、鼻窦炎(28.6%)、腺样体肥大(20.1%)。多因素logistics分析显示相较于居住的住宅建成时间5~10年,居住在建成时间>10年(OR=1.447,95%CI:1.047~2.002)儿童的患病风险更高。男孩(OR=1.966,95%CI:1.530~2.528)、有变应性疾病家族史暴露(OR=6.341,95%CI:4.873~8.251)均是丽水地区儿童患病的危险因素;相较于家用空调制冷,家用风扇制冷(OR=0.485,95%CI:0.310~0.758)、家养绿植(OR=0.559,95%CI:0.407~0.769)、平均感冒次数<5次/年(OR=0.678,95%CI:0.520~0.885)是保护因素。结论浙江省丽水市儿童AR的患病率存在区域性差异,莲都区、青田县儿童患病率高于缙云县、云和县。相比于遗传因素,环境因素对于AR的影响更加复杂,应更深入研究环境因素的影响并进行必要的干预,有助于减少儿童AR的发病。

Objective To investigate the epidemiological characteristics of allergic rhinitis(AR)in primary school children in the eastern and central regions of Lishui,Zhejiang Province,and to analyze the relevant influencing factors.Methods From January to July 2022,elementary school children in Liandu District,Qingtian County,Jinyun County and Yunhe County in the eastern and central areas of Lishui City,Zhejiang Province were studied.Their parents or guardians were given questionnaires on childhood AR to understand the current situation of childhood AR prevalence in eastern and central Lishui,City,Zhejiang Province and to analyze the influencing factors related to childhood AR.Results The average prevalence of AR in school-aged children in the eastern and central areas of Lishui City,Zhejiang Province was 15.4%,and the prevalence rates in Liandu District,Qingtian County,Jinyun County,and Yunhe County were 22%,19.8%,7.5%,and 7.9%,respectively.Nasal itching(48.4%),nasal congestion(34.5%),sneezing(28%),and itchy eyes(23.9%)were the most common nasal symptoms in children.The most common AR concomitant diseases were eczema(20.1%),sinusitis(28.6%),and adenoid hypertrophy(20.1%).Multifactorial logistic analysis showed that children living in a built-up home(>10 years)(OR=1.447,95%CI:1.047-2.002)had a higher risk of the disease compared to those living in a built-up home(5-10 years).Boys(OR=1.966,95%CI:1.530-2.528)and family history of allergic disease exposure(OR=6.341,95%CI:4.873-8.251)were all risk factors for the disease in children in the Lishui area.Compared with home air conditioning for cooling,house hold fan cooling(OR=0.485,95%CI:0.310-0.758),home greenery(OR=0.559,95%CI:0.407-0.769),and average number of colds<5 times/year(OR=0.678,95%CI:0.520-0.885)were protective factors.Conclusions There are regional differences in the prevalence of AR among children in Lishui,Zhejiang Province and the prevalence of children in Liandu District and Qingtian County is higher than that in Jinyun County and Yunhe County.Compared with genetic factors,the impact of environmental factors on AR is more complex.Therefore,the impact of environmental factors should be studied in a greater depth and necessary interventions should be carried out to help reduce the incidence of AR in children.