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    徐州市婴幼儿喘息6岁后发生哮喘的危险因素分析

    Analysis of the risk factors for asthma in infants and young children after wheezing at six years old in Xuzhou

    • 摘要: 目的 探讨徐州市婴幼儿喘息6岁后支气管哮喘的发生率及其危险因素。方法 回顾性分析2013年11月-2014年1月在徐州市儿童医院呼吸科和中国人民解放军陆军第71集团军医院儿科住院的0~3岁喘息患儿的临床资料,并以电话、门诊随访及问卷调查的方式进一步收集资料。6岁后诊断为支气管哮喘的患儿作为哮喘组,其余患儿作为非哮喘组,统计支气管哮喘的发生率,并先采用单因素分析,再采用多因素Logistic回归分析其危险因素。结果 徐州市婴幼儿喘息6岁后支气管哮喘的发生率为27.2%。单因素分析显示,与3岁内喘息发作次数>3次、活动诱发(无发热症状)的喘息、喘息症状持续至3岁后、一级亲属过敏史、剖宫产出生、幼时有湿疹和(或)特应性皮炎、过敏性鼻炎、临近马路、血液嗜酸性粒细胞百分比≥4%、吸入性过敏原阳性、食物性过敏原阳性、父母文化程度初中以下和不遵医嘱治疗喘息共13个因素有关,差异有统计学意义(P<0.05)。多因素Logistic回归分析显示,其中3岁内喘息发作次数>3次、活动诱发(无发热症状)的喘息、喘息症状持续至3岁后、一级亲属过敏史、幼时有湿疹和(或)特应性皮炎、过敏性鼻炎、血液嗜酸性粒细胞百分比≥4%、吸入性过敏原阳性和不遵医嘱治疗喘息共9个因素是独立危险因素,差异有统计学意义(P<0.05)。结论 徐州市婴幼儿喘息6岁后支气管哮喘发生率为27.2%,独立危险因素为:3岁内喘息发作次数>3次、活动诱发(无发热症状)的喘息、喘息症状持续至3岁后、一级亲属过敏史、幼时有湿疹和(或)特应性皮炎、过敏性鼻炎、血液嗜酸性粒细胞百分比≥4%、吸入性过敏原阳性和不遵医嘱治疗喘息。

       

      Abstract: Objective To investigate the incidence and risk factors of bronchial asthma in infants and young children after wheezing at six years old in Xuzhou. Methods Retrospective analysis was performed using clinical data from 0-3 year-old wheezing children who were admitted to Department of Respiratory Diseases, Xuzhou Children’s Hospital and Department of Pediatrics, the 71st Army Hospital of PLA from November 2013 to January 2014. Moreover, they were followed-up by telephone, outpatient service or questionnaire survey to collect further information. Children were diagnosed with bronchial asthma after six years old were set as an asthma group, and the remaining children were regarded as a non-asthma group. Their incidence of bronchial asthma was calculated, and univariate analysis was conducted followed by multivariate logistic regression to analyze its risk factors. Results The incidence of bronchial asthma in infants and young children after wheezing at six years old in Xuzhou was 27.2%. According to univariate analysis, there were 13 factors associated with the condition, namely the number of wheezing episodes>3 times within 3 years old, activity induced wheezing without fever, wheezing after 3 years old, an allergy history of first-degree relatives, cesarean section birth, childhood eczema and/or atopic dermatitis, allergic rhinitis, living close to the road, blood eosinophil percentage≥4%, inhaled allergen positive, food allergen positive, parents with junior high school education and below, and treatment of wheezing without medical advice, with statistical difference (P<0.05). Multivariate logistic regression analysis showed nice dependent risk factors, namely the number of wheezing episodes>3 times within 3 years old, activity induced wheezing without fever,wheezing after 3 years old, an allergy history of first-degree relatives, childhood eczema and/or atopic dermatitis, allergic rhinitis, blood eosinophil percentage≥4%, inhaled allergen positive, food allergen positive, and treatment of wheezing without medical advice, with statistical difference (P<0.05). Conclusions The incidence of bronchial asthma in infants and young children after wheezing at six years old in Xuzhou is 27.2%. The independent risk factors are the number of wheezing episodes>3 times within 3 years old, activity induced wheezing without fever, wheezing after 3 years old, an allergy history of first-degree relatives, childhood eczema and/or atopic dermatitis, allergic rhinitis, blood eosinophil percentage≥4%, inhaled allergen positive, food allergen positive, and treatment of wheezing without medical advice.

       

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