贵阳市0～14岁儿童哮喘流行病学初筛调查结果分析
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摘要
目的:分析贵阳市0~14岁儿童哮喘流行病学初筛调查结果。方法:采用随机整群抽样和回顾性询问填表法对贵阳市10 610例儿童进行哮喘筛查和确诊,筛查问卷调查包括Q1~Q8共8项,其中Q7和Q8项含有A、B、C、D共4个亚项;Q1~Q6筛查阳性的患儿,进一步行肺功能检查明确哮喘诊断,以最后确诊哮喘人数为依据,统计Q1~Q6项初筛哮喘阳性分布情况,统计Q7和Q8各亚项初筛阳性人数分别占Q7项、Q8项初筛阳性人数比例情况及与哮喘确诊人数的关系。结果:初筛问卷调查显示,男童哮喘患病率高于女童(P<0.002 5),且3~5岁儿童为哮喘发病高峰年龄段(P<0.001);Q1~Q6各题初筛阳性人数占总调查人数百分比中,Q5的阳性率最高(16.8%);Q7A及Q8B初筛阳性人数分别占Q7、Q8初筛阳性人数的百分比最高,分别为55.94%、57.39%;Q7B和Q8A的哮喘确诊人数分别占Q7B、Q8A初筛阳性人数的百分比最高,分别为13.87%、15.85%(χ~2=81.324,P<0.001;χ~2=17.667,P<0.002 5);单因素分析示Q1~Q8共14个因素与哮喘发病相关,多因素分析示Q1、Q4、Q5、Q7B、Q7D、Q8A是儿童哮喘发病的独立危险因素。结论:贵阳市儿童哮喘其发病可能与有过喘息、慢性咳嗽、反复呼吸道感染、过敏性鼻炎、食物过敏和父母哮喘史有关。
Objective: To analyze the epidemiological screening of asthma in children aged 0 ~ 14 years in Guiyang. Methods: 10610 children in Guiyang were screened and diagnosed by random cluster sampling and retrospective inquiry. The screening questionnaire included 8 items of Q1 ~ Q8,of which Q7 and Q8 contained four subitems of A,B,C and D. Further pulmonary function test determined the diagnosis of asthma in Q1 ~ Q6 screening positive children,based on the number of confirmed asthma. The positive distribution of primary screening asthma in Q1 ~ Q6 items,the proportion of Q7 and Q8 primary screening positive persons in Q7 and Q8 subitems,the relationship between Q7 and Q8 primary screening positive persons,and the number of confirmed asthmatic patients were statistically analyzed. Results: The Preliminary screening questionnaire survey showed the prevalence of asthma in boys was higher than that in girls( P < 0. 002 5),and the children aged 3 to 5 were at the peak age of asthma( P < 0. 001). The positive rate of Q5 was the highest among the total number of people surveyed in Q1 ~ Q6( 16. 8%). Q7 A and Q8 B were the highest percentage of Q7 A and Q8 B primary screening positive persons with 55. 94% and 57. 39%,respectively. Q7 B and Q8 A had the highest percentage of diagnosed asthma in Q7 B and Q8 A with 13. 87% and 15. 85%,respectively( χ~2= 81. 324,P < 0. 001; χ~2= 17. 667,P < 0. 002 5). Univariate analysis showed that 14 factors of Q1 ~Q8 were associated with asthma. Multivariate analysis showed that Q1,Q4,Q5,Q7 B,Q7 D and Q8 A were an independent risk factor for asthma in children. Conclusions: Asthma in children in Guiyang may be associated with wheezing,chronic cough,recurrent respiratory tract infection,allergic rhinitis,food allergy and parental asthma history.
Objective: To analyze the epidemiological screening of asthma in children aged 0 ~ 14 years in Guiyang. Methods: 10610 children in Guiyang were screened and diagnosed by random cluster sampling and retrospective inquiry. The screening questionnaire included 8 items of Q1 ~ Q8,of which Q7 and Q8 contained four subitems of A,B,C and D. Further pulmonary function test determined the diagnosis of asthma in Q1 ~ Q6 screening positive children,based on the number of confirmed asthma. The positive distribution of primary screening asthma in Q1 ~ Q6 items,the proportion of Q7 and Q8 primary screening positive persons in Q7 and Q8 subitems,the relationship between Q7 and Q8 primary screening positive persons,and the number of confirmed asthmatic patients were statistically analyzed. Results: The Preliminary screening questionnaire survey showed the prevalence of asthma in boys was higher than that in girls( P < 0. 002 5),and the children aged 3 to 5 were at the peak age of asthma( P < 0. 001). The positive rate of Q5 was the highest among the total number of people surveyed in Q1 ~ Q6( 16. 8%). Q7 A and Q8 B were the highest percentage of Q7 A and Q8 B primary screening positive persons with 55. 94% and 57. 39%,respectively. Q7 B and Q8 A had the highest percentage of diagnosed asthma in Q7 B and Q8 A with 13. 87% and 15. 85%,respectively( χ~2= 81. 324,P < 0. 001; χ~2= 17. 667,P < 0. 002 5). Univariate analysis showed that 14 factors of Q1 ~Q8 were associated with asthma. Multivariate analysis showed that Q1,Q4,Q5,Q7 B,Q7 D and Q8 A were an independent risk factor for asthma in children. Conclusions: Asthma in children in Guiyang may be associated with wheezing,chronic cough,recurrent respiratory tract infection,allergic rhinitis,food allergy and parental asthma history.
引文
[1]刘传合.儿童支气管哮喘诊断与管理的新观点—2014-2015年全球哮喘防治创议的启示[J].中华实用儿科临床杂志,2015,30(16):1223-1226.
[2]饶路飞,朱晓萍,周志江,等.哮喘患儿血清白细胞介素-17水平测定[J].贵阳医学院学报,2010,35(2):174-179.
[3]刘龙涛.心理、家庭、社会环境因素对儿童支气管哮喘影响的研究进展[J].中华现代护理杂志,2014,20(31):4026-4028.
[4]全国儿童哮喘协作组.2000年与1990年儿童支气管哮喘患病率的调查比较[J].中华结核与呼吸杂志,2004,27(2):112-116.
[5]中华医学会儿科学分会呼吸学组,《中华儿科杂志》编辑委员会.儿童支气管哮喘诊断与防治指南(2016年版)[J].中华儿科杂志,2016,54(3):167-181.
[6]罗新兵,朱晓萍.贵阳地区400例哮喘患儿病情控制状况及影响因素分析[J].中国儿童保健杂志,2017,25(7):711-714.
[7]杨蕾华,成小弟,周缨.兰州市安宁区0~14岁儿童哮喘与过敏性疾病现况调查结果分析[J].西北国防医学杂志,2012,33(1):62-63.
[8]谷加丽,马红玲,郑跃杰.2010-2011年深圳市福田区0~14岁儿童哮喘流行病学调查[J].中国当代儿科杂志,2012,14(12):918-923.
[9]金克,多力坤.木扎帕尔,等.乌鲁木齐市儿童哮喘患病情况调查及相关因素分析[J].临床儿科杂志,2012,30(6):559-561.
[10]林立,李昌崇.儿童反复呼吸道感染判断条件和防治[J].中华实用儿科临床杂志,2017,32(4):249-252.
[11]中华医学会儿科学分会呼吸学组慢性咳嗽协作组,《中华儿科杂志》编辑委员会.中国儿童慢性咳嗽诊断与治疗指南(2013年修订)[J].中华儿科杂志,2014,52(3):184-188.
[12]桂芹,钱桂生,熊洪燕,等.中国重庆汉族哮喘遗传病例对照研究[J].第三军医大学学报,2015,7(13):l394-1396.
[13]代文霞,张英旭,谭志红,等.240例儿童哮喘危险因素分析[J].2015,29(4):214-216.
[14]BURKE W,FESINMEYER M,REED K,et al.Family history as predictor of asthma risk[J].Am J Prev Med,2003,24(2):160-169.
[2]饶路飞,朱晓萍,周志江,等.哮喘患儿血清白细胞介素-17水平测定[J].贵阳医学院学报,2010,35(2):174-179.
[3]刘龙涛.心理、家庭、社会环境因素对儿童支气管哮喘影响的研究进展[J].中华现代护理杂志,2014,20(31):4026-4028.
[4]全国儿童哮喘协作组.2000年与1990年儿童支气管哮喘患病率的调查比较[J].中华结核与呼吸杂志,2004,27(2):112-116.
[5]中华医学会儿科学分会呼吸学组,《中华儿科杂志》编辑委员会.儿童支气管哮喘诊断与防治指南(2016年版)[J].中华儿科杂志,2016,54(3):167-181.
[6]罗新兵,朱晓萍.贵阳地区400例哮喘患儿病情控制状况及影响因素分析[J].中国儿童保健杂志,2017,25(7):711-714.
[7]杨蕾华,成小弟,周缨.兰州市安宁区0~14岁儿童哮喘与过敏性疾病现况调查结果分析[J].西北国防医学杂志,2012,33(1):62-63.
[8]谷加丽,马红玲,郑跃杰.2010-2011年深圳市福田区0~14岁儿童哮喘流行病学调查[J].中国当代儿科杂志,2012,14(12):918-923.
[9]金克,多力坤.木扎帕尔,等.乌鲁木齐市儿童哮喘患病情况调查及相关因素分析[J].临床儿科杂志,2012,30(6):559-561.
[10]林立,李昌崇.儿童反复呼吸道感染判断条件和防治[J].中华实用儿科临床杂志,2017,32(4):249-252.
[11]中华医学会儿科学分会呼吸学组慢性咳嗽协作组,《中华儿科杂志》编辑委员会.中国儿童慢性咳嗽诊断与治疗指南(2013年修订)[J].中华儿科杂志,2014,52(3):184-188.
[12]桂芹,钱桂生,熊洪燕,等.中国重庆汉族哮喘遗传病例对照研究[J].第三军医大学学报,2015,7(13):l394-1396.
[13]代文霞,张英旭,谭志红,等.240例儿童哮喘危险因素分析[J].2015,29(4):214-216.
[14]BURKE W,FESINMEYER M,REED K,et al.Family history as predictor of asthma risk[J].Am J Prev Med,2003,24(2):160-169.