无锡地区儿童支气管哮喘流行病学调查及其与空气质量的相关性分析  

Epidemiological survey of childhood asthma in Wuxi and its relation to outdoor environmental factors

作　　者：郭赟 苏维维[1] 冬梅 潘珍珍[1] 王倩 潘姗姗 周琴[1] 徐诗尧 邵思超 王攀 吴晓萍 李羚[1] Guo Yun;Su Weiwei;Dong Mei;Pan Zhenzhen;Wang Qian;Pan Shanshan;Zhou Qin;Xu Shiyao;Shao Sichao;Wang Pan;Wu Xiaoping;Li Ling(Department of Respiration,Wuxi Children′s Hospital,Wuxi 214023,Jiangsu Province,China;Department of Automatic Monitoring,Wuxi Environmental Monitoring Centre,Wuxi 214121,Jiangsu Province,China)

机构地区：[1]无锡市儿童医院呼吸科,江苏无锡214023 [2]无锡市环境监测中心站自动监测室,江苏无锡214121

出　　处：《中华实用儿科临床杂志》2021年第4期271-274,共4页Chinese Journal of Applied Clinical Pediatrics

基　　金：省科教强卫医学创新团队(CXTDB2017016);无锡市卫生局重大项目(Z201606)。

摘　　要：目的调查无锡地区不同行政区3~14岁儿童支气管哮喘(哮喘)的发病情况及急性发作特点,并分析其与空气质量的相关性。方法采用随机抽样的方法于2017年1月至12月从江苏省无锡市5个行政区抽取3~14岁儿童共10175人进行哮喘流行病学调查。结果共回收完整问卷8318份,回收率为81.70%,其中有效问卷6734份。本次调查共筛查出哮喘患儿259例,患病率为3.84%,其中男163例,患病率为4.89%,女96例,患病率为2.82%;男女患病比例为1.70∶1.00,差异有统计学意义(χ^(2)=19.72,P<0.01)。哮喘发作频率以换季时最高(87/259例,33.59%),6-8月份最低(9/259例,3.47%)。患儿急性发作特点为发作时间无明显规律者所占比例最高(88/244例,36.07%),其次为睡前发作(64/244例,26.23%)。无锡地区不同行政区哮喘患病率滨湖区最低(50/1830例,2.73%),新吴区最高(71/1502例,4.72%),不同行政区之间患病率比较差异有统计学意义(χ^(2)=13.19,P<0.05)。无锡市不同行政区空气质量中,滨湖区二氧化氮(NO_(2))、一氧化碳(CO)、PM_(10)、PM_(2.5)均低于其他行政区。不同月份中,无锡市6-8月份二氧化硫(SO_(2))、NO_(2)、CO、PM_(10)、PM_(2.5)均为最优,显著低于其他季节。不同行政区儿童哮喘患病率与SO_(2)浓度及NO_(2)浓度呈弱正相关(r=0.10,P<0.01;r=0.22,P<0.01),哮喘患病率与PM10亦呈弱正相关(r=0.06,P<0.01),臭氧(O3)浓度与哮喘患病率呈弱负相关(r=-0.06,P<0.01)。哮喘急性发作与SO_(2)(r=0.22,P<0.01)、NO_(2)(r=0.28,P<0.01)、CO(r=0.23,P<0.01)、PM_(10)(r=0.18,P<0.01)及PM_(2.5)(r=0.18,P<0.01)均呈弱正相关,与O3呈弱负相关(r=-0.40,P<0.01)。结论无锡地区哮喘患病率男童高于女童,哮喘发作频率与季节有关,SO_(2)、NO_(2)、CO、PM_(10),PM_(2.5)及O3对哮喘患病率及急性发作均有影响。Objective To investigate the incidence of asthma and the characteristics of acute attacks in children aged 3-14 in different administrative areas of Wuxi,and to analyze the correlation of asthma with the outdoor environmental factors.Methods A total of 10175 children aged 3-14 were randomly selected from 5 different administrative regions in Wuxi City,Jiangsu Province for childhood asthma epidemiological survey from January to December in 2017.Results The complete questionnaires were collected from 8318 children with a response rate of 81.70%.There were 6734 valid questionnaires.Asthma occurred to 259 children,and the prevalence rate was 3.84%.The prevalence of asthma in male and female children was 4.89%(163 cases)and 2.82%(96 cases),respectively.The ratio of male patients to female patients was 1.70∶1.00,and the difference was significant(χ^(2)=19.72,P<0.01).Children were most prone to suffer from asthma attacks at the turn of seasons(87/259 cases,33.59%).The frequency of asthma was the lowest from June to August(9/259 cases,3.47%).Among 244 cases attacked by acute asthma,the prevailing time period of acute attacks was irregular in 88 patients(36.07%),bedtime in 64 cases(26.23%).In different regions of the city,the lowest prevalence rate of asthma was found in Binhu District(50/1830 cases,2.73%),the highest prevalence rate of asthma was found in Xinwu District(71/1502 cases,4.72%),the difference between the highest and lowest prevalence rates of asthma was significant(χ^(2)=13.19,P<0.05).In terms of the air quality in different admi-nistrative regions of Wuxi,the nitrogen dioxide(NO_(2))concentration,the carbon monoxide(CO)concentration,PM_(10)and PM_(2.5)in Binhu District were lower than other 4 regions.In different seasons in Wuxi city,the sulfur dioxide(SO_(2))concentration,the NO_(2)concentration,the CO concentration,PM_(10)and PM_(2.5)from June to August were significantly lower than those in other months.The prevalence of asthma in children in different administrative districts of Wuxi was weakly posi

关 键 词：儿童 支气管哮喘 流行病学 空气污染 

分 类 号：R725.6[医药卫生—儿科] R181.3[医药卫生—临床医学]