儿童变应性鼻炎自然进程的相关因素研究  

Study on factors related to allergic rhinitis natural course in children

作　　者：张杰[1] 陈卉[2] 张星[1] 陈敏[1] 张亚梅[1] 

机构地区：[1]首都医科大学附属北京儿童医院耳鼻咽喉科,100045 [2]首都医科大学生物医学工程学院生物医学信息学系

出　　处：《中华耳鼻咽喉头颈外科杂志》2011年第1期31-35,共5页Chinese Journal of Otorhinolaryngology Head and Neck Surgery

基　　金：首都医学发展科研基金（2009-3125）;北京市优秀人才培养基金（2009A003008000003）

摘　　要：目的 探讨儿童变应性鼻炎（allergic rhinitis,AR）自然进程的变化情况,评估性别、年龄、家族史、环境因素、感染因素对于AR进程变化的影响.方法电话随访2006年9月至2007年9月北京儿童医院通过流行病学调杳的北京城郊地区3～5岁确诊为AR的患儿248例,随访应答188例,失访60例,随访率75.8%.对188例患儿重新进行AR相关问卷调查,对比前后两次的问卷结果;重新评定AR持续或控制的自然进程;采用SPSS 17.0统计软件对性别、年龄、居住地变化、AR严重程度、个人感染史、过敏性疾病家族史、个人过敏史等因素对AR自然进程的影响进行统计学分析.结果 回收完整问卷188份,符合AR持续116例,符合AR控制72例,AR控制率38.3%.在AR持续的116例患儿中,男74例,女42例;25例居住地由郊区迁入城区;Logistic回归分析得出与AR持续相关的因素有：近1年的上呼吸道感染次数大于3次（P=0.006,OR=2.625,95%可信区间为1.317～5.234）、近1年个人湿疹患病史（P=0.028,OR=2.959,95%可信区间为1.124～7.792）以及居住地变化（P=0.017,OR=0.435,95%可信区间为0.220～0.860）.AR严重程度的变化：有26例由原轻度AR进展为中-重度AR.结论 儿童在生长发育过程中,随着年龄增长部分儿童AR有控制趋势.性别、年龄,对于AR进展变化无明显影响;由郊区迁入城区可使AR的发生率降低,而个人近1年湿疹史、个人感染史都不同程度地增加了AR持续存在的风险.持续存在的AR患儿中,其严重程度较前有所加重.Objective To investigate the natural course of allergic rhinitis （AR） in children and to evaluate the effect of following factors including gender, age, family history, environment and infection on AR. Methods Two hundred and forty-eight children aged between 3 and 5 years-old diagnosed as AR by questionnaire and skin prick test were included in this study. These children were selected 3 years ago in Beijing suburb and urban in an epidemiological study by Beijing Children＇s Hospital. One hundred and telephone. The follow-up rate was 75.8%. Two-time questionnaires were compared. Factors related to AR,including gender, age, residence change, degree of AR, upper respiratory tract infectious history, personal or family allergic disease history, and so on, which related with AR, were analyzed by SPSS 17.0. Results One hundred and eighty-eight valid paired questionnaires were acquired. Among this population, 116 cases （boy： girl was 74：42 ） were still consistent with the diagnosis of AR, which were named as AR continuing,and 72 cases （ 38. 3% ） became less serious, which were named as AR controlled. Factors related to AR continuing included residence change [P = 0.017, OR = 0.435, 95% confidence interral （CI） were 0.220 -0.860], personal eczema history in the last year（ P = 0.028, OR = 2.959,95% CI were 1.124 -7.792）, more than 3 times upper respiratory tract infection （URTI） in the last year （ P = 0. 006, OR =2.625, 95% CI were 1. 317 -5. 234）. AR progressed from mild to moderate-severe in 26 children.Conclusions AR in children during growth development became remission. Gender and age were not the decisive factors for AR natural course. Residence change from suburb area to city made the incidence of AR low. Personal eczema history and URTI history in the last year related to AR continuing. In children with AR continuing, the severity of AR became serious with age.

关 键 词：儿童 鼻炎 变应性 问卷调查 疾病严重程度指数 

分 类 号：R765.21[医药卫生—耳鼻咽喉科]