儿童哮喘吸入糖皮质激素治疗依从性影响因素分析  

Influencing factors for compliance with inhaled glucocorticoid therapy in children with asthma

作　　者：常瑜 仇丽华 金蓉[3] 管仁政[3] 林荣军[3] CHANG Yu;CHOU Lihua;JIN Rong;GUAN Renzheng;LIN Rongjun(Neonatology Department,YEDA Hospital,Yantai 264000,China)

机构地区：[1]烟台业达医院新生儿科,山东烟台264000 [2]青岛市妇女儿童医院新生儿科 [3]青岛大学附属医院综合儿科

出　　处：《青岛大学学报（医学版）》2024年第2期195-198,共4页Journal of Qingdao University(Medical Sciences)

基　　金：国家自然科学基金青年基金项目(81701587)。

摘　　要：目的调查儿童支气管哮喘(简称哮喘)吸入糖皮质激素治疗依从性的现状,分析其原因和影响因素,以促进对哮喘病儿的长期规范化管理。方法通过问卷调查的方式,共收集296例哮喘病儿的临床资料,了解病儿糖皮质激素吸入治疗的依从性现状,分析相关原因,判断各种因素对依从性的影响强度。结果病儿的年龄、家庭月收入、居住地、使用峰流速仪监测、对疾病及药物的认知与病儿治疗依从性有关(χ^(2)=6.190~15.842,P<0.05)。年龄<6岁、居住在城市、家庭月收入高、使用峰流速仪监测、了解疾病及药物均为独立保护因素,提高吸入糖皮质激素治疗的依从性(OR=1.800~3.980,P<0.05)。有168例(56.8%)病儿存在不同程度的自行停药或减量等不遵医嘱行为,主要原因为担心糖皮质激素副作用(33.3%)及日常生活繁忙所致漏用(33.3%)。结论儿童哮喘吸入糖皮质激素治疗未按医嘱用药的主要原因为担心副作用和漏用,家长对于疾病的认识、是否坚持使用峰流速仪监测、病儿年龄、家庭经济条件及居住地都是相关影响因素。Objective To investigate the current status of compliance with inhaled glucocorticoid therapy in children with bronchial asthma and related causes and influencing factors,and to facilitate long-term standardized management of children with asthma.Methods A questionnaire survey was conducted to collect the clinical data of 296 children with asthma.The current status of compliance with inhaled glucocorticoid therapy and related causes were analyzed,and the influence intensity of various factors on compliance was determined.Results The age of the child,monthly family income,place of residence,monitoring with a peak flow meter,and awareness of the disease and drugs were associated with treatment compliance(χ^(2)=6.190-15.842,P<0.05).Age<6 years,living in the city,high monthly family income,monitoring with a peak flow meter,and awareness of the di-sease and drugs were independent protective factors that could improve the compliance with inhaled glucocorticoid therapy(OR=1.800-3.980,P<0.05).Among all children,168(56.8%)had varying degrees of non-adherent behaviors including spontaneous drug withdrawal or dose reduction,and the main reasons included worry about the side effects of glucocorticoids(33.3%)and missed use due to busy daily work(33.3%).ConclusionThe main reasons for not taking the medicine according to the doctor’s advice are worry about side effects and misseduse,parents’awareness of the disease,adherence to peak flow meter monitoring,age of the child,family economic condition,and place of residence arerelated factors.

关 键 词：哮喘 糖皮质激素类 投药 吸入 病人依从 儿童 

分 类 号：R725.622[医药卫生—儿科]