空气污染物对支气管哮喘的影响及健康管理防治措施  

Influence of air pollutants on bronchial asthma and preventive measures of health management

作　　者：刘源[1] 刘倩[2] 王萍[1] 刘永全[1] 高福生[1] LIU Yuan;LIU Qian;WANG Ping;LIU Yongquan;GAO Fusheng(Department of Pneumology,the Affiliated Hospital of Weifang Medical University,Weifang 261053,China;Health Management Center,the Afiliated Hospital of Weifang Medical University)

机构地区：[1]潍坊医学院附属医院呼吸内科,山东潍坊261053 [2]潍坊医学院附属医院健康管理中心

出　　处：《潍坊医学院学报》2023年第1期10-12,共3页Acta Academiae Medicinae Weifang

基　　金：潍坊市卫生健康委课题(项目编号:WFWSJK-2022-256)。

摘　　要：目的探讨空气污染物和支气管哮喘的危险因素以及对成人哮喘急性发作的影响,分析空气中可吸入颗粒物(PM10)的浓度与哮喘的相关性,评价健康管理方案对哮喘的防治作用。方法选取就诊于潍坊医学院附属医院门诊和住院哮喘急性发作的112例和106例患者。通过Pearson相关分析和Logistic回归分析哮喘急性发作与PM10、细颗粒物(PM2.5)、二氧化硫(SO2)、二氧化氮(NO2)、氮氧化物(NOx)、一氧化氮(NO)、一氧化碳(CO)、臭氧(O3)等因素的关系。哮喘急性发作期全部规范使用普米克都保加奥克斯都保吸入治疗,缓解期将所有哮喘患者随机分为两组,实验组102例和对照组95例,对其进行支气管哮喘控制测试表(ACT)评分及肺功能监测,并定期调查和随访。结果Pearson相关分析表明:哮喘急性发作与空气中的PM10,PM2.5,NO2,SO2,CO的浓度有关,与PM2.5的相关性较强,与NO2关系较弱。逐步回归分析表明PM2.5是引起哮喘急性发作的主要因素。单因素Logistic回归分析:哮喘家族史、过敏性鼻炎、体质指数增加、儿童期患喘息性支气管炎、吸烟等为主要因素。缓解期观察组哮喘控制情况ACT评分高于对照组,发作次数和住院次数少于对照组。肺功能检测的FEV1和PEF预计值%变化在治疗前、治疗3个月及6个月有统计学意义。结论哮喘急性发作与空气中的PM10,PM2.5,NO2,SO2,CO的浓度有关,PM2.5是引起该病急性发作的主要影响因素;哮喘急性发作与哮喘家族史、过敏性鼻炎、体质指数增加、儿童期患喘息性支气管炎、吸烟等有关。Objective To explore the risk factors of air pollutants and bronchial asthma and their effects on the acute attack of adult asthma,analyze the correlation between the concentration of inhalable particles in the air and asthma,and evaluate the preventive and therapeutic effects of health management programs on asthma.Methods A total of 218 asthma patients with acute attack were selected from the affiliated hospital of Weifang Medical University.Of the 218 patients,112 were outpatients and 106 were hospitalized patients.The air quality was monitored as the air quality index(AQI),inhalable particulate matter(PM_(10)),fine particulate matterPM_(2.5),sulfur dioxideSO_(2),nitrogen dioxide(NO_(2)),nitrogen oxides(NOx),nitric oxide(NO),carbon monoxide(CO)and ozoneO_(3)in the same year.The risk factors of asthma were analyzed by Pearson correlation analysis and Logistic regression analysis.All patients with acute asthma were treated with pulmicort dubao plus oxdubao inhalation.In remission stage,all asthma patients were randomly divided into two groups,102 cases in the experimental group and 95 cases in the control group.They were assessed by bronchial asthma control test score and monitored by peak current meter at home.Results Pearson correlation analysis shows that the acute attack of asthma is related to the concentrations of PM_(10),PM_(2.5),NO_(2),SO_(2)and CO in the air,with a strong correlation with PM_(2.5)and a weak relationship with NO_(2).Stepwise regression analysis showed that PM_(2.5)was the main cause of acute asthma attack.Univariate Logistic regression analysis showed that family history of asthma,allergic rhinitis,increased body mass index,asthmatic bronchitis in childhood and smoking were the main factors.Establish health management files,improve follow-up visits and regular follow-up for discharged patients.The ACT score of asthma control in remission observation group was higher than that in control group,and the number of attacks and hospitalizations was less than that in control group.After 6 month

关 键 词：支气管哮喘 LOGISTIC回归 空气质量监测 PM2.5 健康管理 

分 类 号：R562.25[医药卫生—呼吸系统]