摘要
目的分析中国城市儿童哮喘特征及其危险因素。方法采用成组病例对照研究，以2010年全国43个城市0—14岁儿童哮喘调查中临床确诊的全部哮喘病例为病例组（12450人），与病例年龄、性别匹配者为对照组（14500人），采用全国统一设计、以ISAAC（The International Study of Asthmaand Allergies in Childhood）环境因素问卷为基础的哮喘调查问卷，通过X2检验、广义线性混合效应模型（GLMM）分析阐述儿童哮喘的危险因素。结果纳入调查对象共计26950人（男：女=1．55：1）。经GLMM分析，年龄、民族、性别、过敏史、家族史、母亲职业、抗生素用药史、早产、剖宫产、蛋白辅食添加时间、烹调燃料、使用空调、房屋装修、家人吸烟、居室霉斑及家庭种植花草为中国城市儿童哮喘的主要影响因素（P〈O．05）；部分危险因素对新发病例和现患病例影响程度不同，室内种植花草对新发哮喘（OR=2．09，95％CI：1．30～3．36）和现患哮喘（OR=O．80，95％CI：0．74～0．86）影响的差异有统计学意义。哮喘危险因素因年龄而异，〈3岁组哮喘主要影响因素为过敏、感染、气味刺激和早产（OR=1．72，95％CI：1.42～2．08），3～5岁组的危险因素增加了性别（OR=1．18，95％CI：1．03～1．35）、低出生体重（OR=1．69，95％CI：1．17～2．44）和剖宫产（0R=1．26，95％CI：1．10～2．45）；6-14岁组的危险因素增加了年龄（OR=O．97，95％CI：0．95～0．99）、民族（OR=1．61，95％C／：1．26～2．06）和迁居（OR=1．68，95％CI：1．39～2．03）。结论中国儿童哮喘的危险因素包括遗传、过敏、感染和其他环境因素，其机制有待进一步专题研究。
Objective A case control study was designed to explore the risk factors of asthma for city children residing for more than half a year, in China. Methods All physician-diagnosed asthma children enrolled in the 3rd nationwide survey （2010） in 43 typical cities of China were selected as the cases, and non-asthmatic children in the same survey were selected as control subjects if they were matched with the cases in age and sex. A revised questionnaire on the basis of ISAAC Phase Three Environmental Questionnaire was designed to investigate lhe risks of asthma among city children aged 0-14 years in China. Chi square analysis and generalized linear mixed models were performed to check the exposure difference between the cases and the controls. Results 43 out of the 44 city centers were qualified according to the results after reviewing both data from the survey and management. As a result, 26 950 subjects including 12 450 asthmatic children and 14 500 control subjects were enrolled in the case-control study. Except for the children of Hart ethnicity, another 5 980 children （22.2%） of ethnic minorities and 31 children （0.1%） born in foreign countries were also included as the study subjects. After controlling for city centers as random effect, age, sex, race, problems related to allergy, family history of asthma or allergy, personal medication history of antibiotics, preterm delivery, under caesarean section, baby age for introducing protein-contained foods, environmental tobacco smoking, maternal occupation, indoor plantings, room decorations,dampness, and cooking fuel were proved to be risk factors of childhood asthma. Some differences were seen in the risks of asthma between new cases and current cases. The risk for exposure to indoor plants was different between new cases （OR=2.09,95%CI： 1.30-3.36） and current cases （OR=0.80, 95% Ch 0.74-0.86）. Risks on asthma were varied by age. Allergy, inflection, odor, and preterm delivery （OR= 1.72,95%CI： 1.42-2.08） appeared to be the key risks for asthma in children younger than 3 years. Apart from the risks, specifically for children younger than 3 years, the risks on asthma for children of 3 to 5 years would also include factors as： sex （OR=1.18, 95%C1： 1.03-1.35）, low birth weight （OR= 1.69,95%Cl： 1.17-2.44）, and caesarean section （OR= 1.26,95%CI： 1.10-2.45）. Apart from risks specifically for children younger than 6 years, age （OR=0.97, 95%C1： 0.95-0.99）, race （OR= 1.61,95%CI： 1.26-2.06）, and emigration （OR= 1.68,95%CI： 1.39-2.03 ） were proved to be associated with asthma for children aged 6-14 years. Conclusion Asthma risks for city children in China would include genetic factors, allergy, infection, and other environmental factors but called for further research in the country.
出处
《中华流行病学杂志》
CAS
CSCD
北大核心
2014年第3期237-241,共5页
Chinese Journal of Epidemiology
关键词
儿童哮喘
危险因素
病例对照研究
Childhood astb3na
Risk factors
Case-control study
