余姚市儿童哮喘诱发因素及规范治疗停药后复发影响因素调查  

Investigation of inducing factors of childhood asthma and influencing factors of recurrence after standardized treatment

作　　者：褚祝飞[1] 褚锋玮 符灵素[1] Chu Zhu-fei;Chu Feng-wei;Fu Ling-su(Yuyao People's Hospital,Yuyao,Zhejiang 315400,China)

机构地区：[1]余姚市人民医院,浙江余姚315400

出　　处：《中国公共卫生管理》2020年第4期524-528,共5页Chinese Journal of Public Health Management

摘　　要：目的分析2016—2017年余姚市人民医院收治患儿哮喘诱发因素,探讨儿童哮喘规范治疗停药后复发的影响因素,为儿童哮喘防治提供依据。方法选择2016年1月—2017年12月余姚市人民医院儿科收治的支气管哮喘急性发作期患儿328例,根据哮喘是否复发分为复发组196例,未复发组132例,应用单因素分析及多因素Logistic回归模型,分析规范治疗停药后复发的影响因素。结果 328例哮喘患儿诱发因素中呼吸道感染、接触冷空气/天气变化、饮食排名前三位,占比分别为83.23%、51.22%和35.37%;116例饮食诱发哮喘的儿童过敏原中虾/蟹/扇贝、牛奶、鳕鱼/鲑鱼/鲈鱼排名前三位,构成比分别为35.34%、30.17%和13.79%。季节交替是哮喘发病的高峰期,发病率为50.91%;其次是冬季,发病率为27.13%。好发时间段以午夜和清晨为主,占比分别为40.24%和26.83%。单因素分析显示,不同发病年龄、糖皮质激素治疗疗程、治疗前哮喘严重程度、治疗后哮喘缓解时间、合并过敏性鼻炎、联合沙美特罗治疗等方面患儿哮喘复发率差异有统计学意义(P<0.05)。多因素Logistic回归分析显示,发病年龄<6岁、糖皮质激素治疗疗程<8个月、治疗前哮喘严重程度为重度、治疗后哮喘缓解时间<4个月、合并过敏性鼻炎是哮喘患儿规范治疗停药后复发的危险因素(P<0.05)。结论儿童哮喘诱发因素及规范治疗停药后复发的影响因素较多,临床应针对诱发因素予以干预,并规避儿童哮喘复发的危险因素。Objective To analyze the inducing factors of childhood asthma in Yuyao People’s Hospital from 2016 to 2017, and to explore the influencing factors of recurrence after standardized treatment, in order to provide the evidence for childhood asthma prevention and treatment.Methods A total of 328 children with acute attack of bronchial asthma in Yuyao People’s Hospital from January 2016 to December 2017 were selected.According to the recurrence of asthma, 196 cases were in recurrence group and 132 cases were in non-recurrence group.The influencing factors of recurrence after standardized treatment were analyzed by single factor and multifactor logistic regression analysis.Results Top three inducing factors were respiratory tract infection,cold air exposure/weather changes and diet among 328 children with asthma, accounting for 83.23%, 51.22% and 35.37% respectively.Top 3 allergens among 116 children with diet-induced asthma were shrimp/crab/scallop, milk, cod/salmon/bass, the constituent ratio was 35.34%, 30.17% and 13.79% respectively.Seasonal alternation was the peak period of asthma,the incidence rate was 50.91%, followed by 27.13% in winter;the predominant periods were midnight and morning, accounting for 40.24% and 26.83% respectively. Single factor analysis showed that there was significant difference in the recurrence rate in the age of onset, course of glucocorticoid therapy, severity of asthma before treatment, remission time of asthma after treatment,allergic rhinitis and salmeterol treatment between recurrence group and non-recurrence group(P<0.05).Multivariate logistic regression analysis showed that age less than 6 years old, duration of glucocorticoid therapy less than 8 months,severity of asthma before treatment,remission time of asthma after treatment less than 4 months and allergic rhinitis were risk factors of childhood asthma recurrence after standardized treatment(P<0.05).Conclusion There are many inducing factors of childhood asthma and influencing factors of recurrence after standardized trea

关 键 词：哮喘 儿童 诱发因素 复发 哮喘危险因素 

分 类 号：R562.2[医药卫生—呼吸系统]