母乳喂养与被动吸烟对儿童哮喘及哮喘样症状的交互作用  

Interaction effects of breastfeeding and passive smoking on asthma and asthma related symptoms among children

作　　者：刘玉芹[1] 赵洋[1] 刘苗苗[1] 王达[1] 马亚楠[1] 任万辉[2] 高峰[2] 董光辉[1] 

机构地区：[1]中国医科大学公共卫生学院卫生统计教研室,沈阳110001 [2]沈阳市环境监测中心站

出　　处：《中华预防医学杂志》2013年第6期523-528,共6页Chinese Journal of Preventive Medicine

基　　金：中华环境保护基金项目（CEPF2008-123-1-5）

摘　　要：目的探讨母乳喂养与被动吸烟的交互作用对儿童哮喘及哮喘样症状的影响。方法采用整群随机抽样法在辽宁省7个城市各抽取1所小学和2所幼儿园，共25所小学和50所幼儿园，对所选学校所有在此居住满2年的31049名儿童的喂养方式、居住环境、被动吸烟等情况及呼吸系统疾病与症状的信息进行收集。采用Glimmix回归模型分析母乳喂养与被动吸烟的交互作用对儿童哮喘及哮喘样症状（持续咳嗽、持续咳痰、喘鸣现患、过敏性鼻炎）的影响。结果在调查的31049名儿童中，年龄为（8．32±2．75）岁，母乳喂养的儿童有23987名，母乳喂养率为77．26％；被动吸烟的儿童有11820名，被动吸烟率为38．07％。母乳喂养的儿童哮喘、过敏性鼻炎阳性率分别为6．22％（1491／23987）、4．67％（1120／23987），非母乳喂养的儿童分别为7．70％（544／7062）、5．48％（387／7062）。母乳喂养儿童发生哮喘（OR=0．79，95％CI：0．72～0．88）、过敏性鼻炎（OR=0．85，95％CI：0．75～0．95）的风险较低。父亲吸烟的儿童喘鸣现患阳性率为7．89％（929／11770），父亲未吸烟的儿童为5．37％（1036／19279），父亲吸烟的儿童发生喘鸣现患（OR=1．51，95％CI：1．38～1．65）的风险较高。母亲吸烟的儿童持续咳嗽阳性率为18．96％（51／269），母亲未吸烟的儿童为9．51％（2926／30780），母亲吸烟的儿童发生持续咳嗽（OR=2．23，95％CI：1．64—3．03）的风险较高。家中其他任何人吸烟的儿童持续咳痰阳性率为5．69％（871／15316），家中无人吸烟的儿童为3．50％（550／15733），家中其他任何人吸烟的儿童发生持续咳痰（OR=1．67，95％CI：1．49～1．86）的风险较高。Glimmix回归模型分析显示，母乳喂养与被动吸烟对儿童哮喘及哮喘样症状存在交互影响：在父亲吸烟暴露下，母乳喂养的儿童发生哮喘的风± Objective To evaluate the interaction effects of breastfeeding and passive smoking on asthma and asthma related symptoms among children. Methods Using a cluster random sampling method, 2 elementary schools and 1 kindergarten were randomly selected from 7 cities of Liaoning province. The resulting 25 elementary schools and 50 kindergartens were included, and 31 049 children from the selected schools living up to 2 years were recruited in this survey. The information about the children＇s type of feeding up, living environment, passive smoking exposure, respiratory diseases and symtoms were collected. The interaction effects of breastfeeding and passive smoking on asthma and asthma related symptoms （ persistent cough, persistent phlegm, current wheeze and allergic rhinitis ） were evaluated with Glimmix procedure. Results There were 31 049 children involved in this investigation. The age was （8.32 ± 2. 75 ） years old. There were 23 987（77.26% ） children with breastfeeding and 11 820 （38.07%） children with passive smoking. The prevalence of asthma and allergic rhinitis were 6. 22% （ 1491/23 987 ） ,4. 67% （ 1120/23 987 ） in children with breastfeeding, and were 7. 70% （544/7062）, 5.48% （387/7062） in children without breastfeeding, compared to the children without breastfeeding, the children with breastfeeding had lower risk of asthma （ OR = 0. 79,95 % CI： 0. 72 - 0. 88 ） and allergic rhinitis （ OR = 0. 85,95 % CI： 0. 75 - 0. 95 ） ; The prevalence of current wheeze was 7.89% （929/11 770） in children with father smoking, and was 5.37% （1036/19 279） in children without father smoking, compared to the children without father smoking, the children with father smoking increased the risk of current wheeze （ OR = 1.51,95% CI： 1.38 - 1.65 ）. The prevalence of persistent cough was 18.96% （51/269） in children with mother smoking, and was 9. 51% （2926/30 780） in children without mother smoking, compared to the children without mother smoking, the children wit

关 键 词：儿童 母乳喂养 被动吸烟 哮喘 哮喘样症状 

分 类 号：R72[医药卫生—儿科]