学龄期支气管哮喘发作患儿哮喘控制水平调查及相关影响因素分析  

Investigation of asthma control level and related influencing factors in school-age children with bronchial asthma attack

作　　者：邵艳艳 蔡海轮 余伟豪 吴洋洋[1] 缪大宏[1] 夏小娇[1] Shao Yanyan;Cai Hailun;Yu Weihao;Wu Yangyang;Miao Dahong;Xia Xiaojiao(Department of Children's Integrative Medicine,the Second Affiliated Hospital of Wenzhou Medical University,Wenzhou 325000,Zhejiang,China)

机构地区：[1]温州医科大学附属第二医院儿童中西医结合病区,浙江温州325000

出　　处：《中国中西医结合急救杂志》2023年第3期338-342,共5页Chinese Journal of Integrated Traditional and Western Medicine in Intensive and Critical Care

基　　金：浙江省温州市科技计划项目(Y20210299)。

摘　　要：目的调查学龄期支气管哮喘患儿的哮喘控制水平,分析影响支气管哮喘患儿哮喘控制水平的因素,为临床制定哮喘防治措施提供参考。方法选取2021年1月至2023年1月温州医科大学附属第二医院儿科接诊的148例学龄期支气管哮喘患儿作为研究对象,采用哮喘控制测试(ACT)量表评估患儿的哮喘症状控制水平,根据ACT结果将患儿分为哮喘控制组(66例)和哮喘未控制组(82例),通过调查问卷收集患儿性别、年龄、体质量指数(BMI)、父母月收入、患儿哮喘家族史、是否存在焦虑和抑郁等消极情绪、居住处是否有空气污染、哮喘病程、用药依从性、是否使用吸入性糖皮质激素治疗等临床资料。比较哮喘是否控制两组患儿临床资料的差异。采用多因素Logistic回归法分析影响学龄期支气管哮喘患儿哮喘控制水平的因素,同时绘制受试者工作特征曲线(ROC)曲线,分析各危险因素对哮喘控制水平的预测价值。结果支气管哮喘患儿中,平均ACT为(21.24±2.33)分,其中ACT>19分患儿66例,支气管哮喘控制水平良率为44.59%。与哮喘控制组比较,哮喘未控制组有哮喘家族史、合并焦虑和抑郁情绪、居住处空气污染、病程≥12个月的患者比例更高,哮喘用药依从性更差,使用吸入性糖皮质激素治疗比例更低(均P<0.05)。多因素Logistic回归分析显示,有哮喘家族史、合并焦虑和抑郁情绪、居住处空气污染、病程≥12个月、哮喘用药依从性差和未使用吸入性糖皮质激素治疗是影响支气管哮喘患儿哮喘控制水平的独立危险因素〔优势比(OR)和95%可信区间(95%CI)分别为7.647(1.098~20.168)、3.706(1.742~7.885)、7.411(3.623~15.160)、4.734(1.342~9.566)、3.497(1.659~11.364)、2.656(1.145~6.157)、3.948(1.493~10.436),均P<0.05〕。ROC曲线分析显示:各危险因素对哮喘控制水平均有一定预测价值〔ROC曲线下面积(AUC)和95%CI分别为0.704(1.908~20.168)、0.701(1.742~7Objective To investigate the asthma control level of school-age children with bronchial asthma,analyze the factors affecting the asthma control level of children with bronchial asthma,and provide reference for the clinical development of asthma prevention and treatment measures.Methods A total of 148 school-age children with bronchial asthma admitted to the department of pediatrics of the Second Affiliated Hospital of Wenzhou Medical University from January 2021 to January 2023 were selected as the study objects.Asthma control test(ACT)was used to assess the asthma symptom control level of the children.According to the ACT results,the children were divided into asthma control group(66 cases)and asthma uncontrolled group(82 cases).Clinical data such as gender,age,body mass index(BMI),monthly income of parents,family history of asthma,negative emotions such as anxiety and depression,air pollution in residence,asthma course,medication compliance,and use of inhaled glucocorticoids were collected through questionnaires.The clinical data were compared between the two groups with or without asthma control.Multivariate Logistic regression was used to analyze the influence factors of asthma control in school-age children with bronchial asthma.Receiver operator characteristic curves(ROC curves)were plotted to analyze the predictive value of risk factors for asthma control.Results Among the children with bronchial asthma,the mean ACT score was(21.24±2.33),among which 66 children with ACT score>19,and the level of bronchial asthma control was good,rate 44.59%.Compared with asthma control group,the proportion of family history of asthma,combined anxiety and depression,residential air pollution,duration of disease≥12 months in the asthma uncontrolled group were higher,the asthma uncontrolled group had poorer compliance with asthma medication,and the proportion of inhaled glucocorticoids treated was lower in asthma uncontrolled group(all P<0.05).Multivariate Logistic regression analysis showed that family history of asthma,c

关 键 词：学龄期 支气管哮喘 哮喘控制水平 影响因素 防治措施 

分 类 号：R562.25[医药卫生—呼吸系统]