摘要
目的·探讨学龄前儿童反复喘息的相关危险因素。方法·选取2019年12月—2020年12月因喘息在上海市某儿童专科医院呼吸科住院诊治的学龄前儿童(年龄3~6岁)作为研究对象,随访12个月。根据喘息发作次数分偶发喘息组(1~2次/年)和反复喘息组(≥3次/年)。采用面对面问卷形式向患儿父母询问患儿基本情况、相关病史及潜在的危险因素,包括儿童的年龄、性别、胎龄、低出生体质量史、湿疹史、变应性鼻炎史、食物过敏史、吸入花粉过敏史、毛细支气管炎病史、母亲生产年龄、生产方式、喂养方式、父母哮喘病史、生活区域(城市/农村)、被动吸烟史、宠物接触史、季节因素等。单因素分析比较2组学龄前儿童喘息发作的相关因素,Logistic回归分析反复喘息的独立危险因素。结果·共纳入370例,其中偶发喘息组204例(55.14%),反复喘息组166例(44.86%)。与反复喘息显著相关的危险因素包括年龄(χ^(2)=36.608,P=0.000)、性别(χ^(2)=4.290,P=0.038)、湿疹史(χ^(2)=6.250,P=0.012)、变应性鼻炎史(χ^(2)=10.787,P=0.001)、吸入花粉过敏史(χ^(2)=8.868,P=0.003)、毛细支气管炎病史(χ^(2)=27.898,P=0.000)、胎龄(χ^(2)=5.141,P=0.023)、喂养方式(χ^(2)=4.316,P=0.038)、父母哮喘病史(χ^(2)=5.050,P=0.025)和生活区域(χ^(2)=31.013,P=0.000)。Logistic回归分析结果显示:变应性鼻炎史(OR=4.759,95%CI 1.665~13.603)、毛细支气管炎史(OR=12.113,95%CI 5.686~25.802)、早产(OR=3.092,95%CI 1.120~8.539)和居住在城市(OR=2.395,95%CI 1.326~4.324)是反复喘息的独立危险因素。结论·学龄前儿童反复喘息的独立危险因素包括变应性鼻炎史、毛细支气管炎史、早产和居住于城市。
Objective·To investigate the potential risk factors of recurrent wheezing in preschool children.Methods·A case-control study was conducted in 370 children with wheezing admitted to the Department of Respiratory Medicine in a specialized hospital for children in Shanghai from December 2019 to December 2020.The children were preschool children aged 3?6 years.According to the frequency of wheezing,pediatric patients were divided into occasional wheezing group(1?2 attacks per year)and recurrent wheezing group(≥3 attacks per year).The face-to-face questionnaire was performed to the parents responding for basic information and recurrent wheezing risk factors including the children age,gender,gestational age,birth weight,history of eczema,history of allergic rhinitis,history of food allergy,history of inhalational pollen allergy,history of bronchiolitis,maternal age,production mode,feeding pattern,history of parental asthma,resident area(city/village),passive smoking,history of pet contact,seasonal factors,etc.Univariate analysis was used to compare risk factors of recurrent wheezing between the two groups.Logistic regression analysis was used to analyze the independent risk factors associated with recurrent wheezing.Results·Three hundred and seventy cases were enrolled,including 204 cases(55.14%)in the occasional wheezing group and 166 cases(44.86%)in the recurrent wheezing group.A total of 10 risk factors were determined for recurrent wheezing,which included children's age(χ^(2)=36.608,P=0.000),gender(χ^(2)=4.290,P=0.038),eczema(χ^(2)=6.250,P=0.012),allergic rhinitis(χ^(2)=10.787,P=0.001),inhaling pollen(χ^(2)=8.868,P=0.003),history of bronchiolitis(χ^(2)=27.898,P=0.000),gestational age(χ^(2)=5.141,P=0.023),feeding pattern(χ^(2)=4.316,P=0.038),parental asthma history(χ^(2)=5.050,P=0.025)and resident area(χ^(2)=31.013,P=0.000).The Logistic regression showed that allergic rhinitis(OR=4.759,95%CI 1.665?13.603),bronchiolitis(OR=12.113,95%CI 5.686?25.802),premature birth(OR=3.092,95%CI 1.120?8.539)and living in city(OR=2.395,95%CI 1.326?4.324)were the independent risk factors of recurrent wheezing.Conclusion·The independent risk factors for recurrent wheezing in preschoolers include allergic rhinitis,bronchiolitis,premature birth and living in city.
作者
李爱求
张潇潇
姜允丽
肖艳赏
丁国栋
吴蓓蓉
董晓艳
LI Aiqiu;ZHANG Xiaoxiao;JIANG Yunli;XIAO Yanshang;DING Guodong;WU Beirong;DONG Xiaoyan(Nursing Department,Shanghai Children's Hospital,Shanghai Jiao Tong University School of Medicine,Shanghai 200040,China;Department of Respiratory Medicine,Shanghai Children's Hospital,Shanghai Jiao Tong University School of Medicine,Shanghai 200040,China)
出处
《上海交通大学学报（医学版）》
CAS
CSCD
北大核心
2022年第10期1435-1440,共6页
Journal of Shanghai Jiao tong University:Medical Science
基金
上海申康医院发展中心临床科技创新项目(SHDC12016215)。
关键词
喘息
反复
危险因素
学龄前儿童
wheezing
recurrent
risk factor
preschool child
