学龄前儿童哮喘分布特征及母乳喂养保护作用  

Distribution characteristics of asthma in preschool children and the protective effect of breastfeeding

作　　者：刘蒙 伍晓艳[1] 耿梦龙 陶舒曼[1] 丁鹏 陶芳标[1] LIU Meng;WU Xiaoyan;GENG Menglong;TAO Shuman;DING Peng;TAO Fangbiao(Department of Maternal,Child and Adolescent Health,School of Public Health,Anhui Medical University/MOE Key Laboratory of Population Health Across Life Cycle,Hefei 230032,China)

机构地区：[1]安徽医科大学公共卫生学院儿少卫生与妇幼保健学系/出生人口健康教育部重点实验室,合肥230032

出　　处：《中国学校卫生》2020年第9期1379-1383,共5页Chinese Journal of School Health

基　　金：国家自然科学基金项目(81573168)。

摘　　要：目的阐明中国长江中下游三省3~6岁学龄前儿童哮喘的分布及母乳喂养对哮喘的保护作用,为降低学龄前儿童过敏性疾病的发病率提供参考。方法 2017年10—11月,以幼儿园为单位对湖北、安徽和江苏三省共11座城市的27 200名学龄前儿童家长进行问卷调查,描述儿童哮喘和母乳喂养情况。结果调查地区学龄前儿童哮喘检出率为4.0%,男女童分别为5.0%,2.9%;3,4,5,6岁分别为3.2%,3.7%,4.4%,4.9%。从未母乳喂养3 448名,占12.7%;主要母乳喂养7 630名,占28.1%;纯母乳喂养1~5个月比例为50.0%,≥6个月仅为10.2%。纯母乳喂养1~5个月对哮喘(OR=0.88,95%CI=0.77~0.89)具有保护作用,调整混杂因素后仍具有统计学意义。调整混杂因素后,以过敏性结膜炎分层,对于无过敏性结膜炎史的4岁学龄前儿童,纯母乳喂养≥6个月对哮喘具有保护作用(OR=0.63,95%CI=0.40~0.99);以湿疹分层,对有湿疹史的4岁学龄前儿童,纯母乳喂养≥6个月对哮喘具有保护作用(OR=0.52,95%CI=0.27~0.99)。结论纯母乳喂养对学龄前儿童哮喘具有保护作用。对无过敏性结膜炎和有湿疹史的4岁儿童,纯母乳喂养≥6个月对哮喘保护性更好。Objective To clarify the distribution of asthma in preschool children aged 3-6 years old and the protective effect of breastfeeding on asthma in three provinces in the middle and lower reaches of the Yangtze river in China.Methods The parents of 27 200 preschoolers chosen from kindergartens in 11 cities of Hubei,Jiangsu and Anhui Province were investigated with children’s asthma and breastfeeding during October to November in 2017.Results The asthma detection rate for preschoolers was4.0%,5.0% for boys and 2.9% for girls.The asthma detection rate for children aged 3,4,5,and 6 years old was 3.2%,3.7%,4.4%,and 4.9%.3 448( 12.7%) and 7 630( 28.1%) preschoolers were never breastfed or mainly breastfed.The rate of exclusive breastfeeding was 50.0% for 1 to 5 months and only 10.2% over 6 months.Meanwhile,there was a significant protective effect on asthma( OR = 0.88,95%CI = 0.77-0.89) by exclusive breastfeeding for 1-5 months,which was still statistically significant after adjusting for confounding factors.After adjusting for confounding factors,exclusive breastfeeding over 6 month have significant effected on preschool children aged 4 years old without allergic conjunctivitis history( OR = 0.63,95%CI = 0.40-0.99).Furthermore,exclusive breastfeeding over 6 month had important effect on preschool children aged 4 years old with eczema history( OR = 0.52,95%CI= 0.27-0.99).Conclusion Exclusive breastfeeding has protective effect on asthma in preschool children.Exclusive breastfeeding over 6 months even has better protective effect on asthma for the 4-years-old children without the history of allergic conjunctivitis and eczema.

关 键 词：哮喘 母乳哺养 回归分析 患病率 儿童 学龄前 

分 类 号：R725.6[医药卫生—儿科] R193[医药卫生—临床医学]