摘要 目的:调查2010~2011年深圳市福田区0~14岁儿童哮喘患病情况及哮喘发病的危险因素,为今后儿童哮喘的防治工作提供科学依据。方法:首先通过多阶段分层随机整群抽样方法,采用2010年第三次全国儿童哮喘流行病学调查问卷,调查深圳市福田区7168名0~14岁儿童哮喘患病情况;其次采用1∶1病例对照研究方法和logistic回归分析法对哮喘患儿的发病危险因素进行调查。结果:在调查的7168人中,哮喘患儿169人,总患病率为2.36%。男性患病率高于女性(3.06% vs 1.55%,P<0.01)。哮喘患儿中,首次发病以3岁内居多(115人,68.1%);经常发作强度以中度最常见(95人,56.2%);发作类型以突然发作最多(159人,94.1%);好发季节为换季(86人,50.9%);好发时辰为睡前(97人,57.4%);发作诱因最常见的为呼吸道感染(157人,92.9%);发作先兆最常见的为打喷嚏(159人,94.1%)。通过对169例哮喘患儿及169例非哮喘儿童的病例对照研究并且经logistic回归分析显示,哮喘发病的独立危险因素包括:个人药物过敏史(OR=3.645,95%CI:1.316,10.094,P=0.013)、食物过敏史(OR=4.720,95%CI:1.987,11.212,P<0.001)、过敏性鼻炎(OR=10.273,95%CI:5.485,19.241,P<0.001)、家族过敏史(OR=4.221,95%CI:2.147,8.298,P<0.001)。结论:深圳市福田区0~14岁儿童哮喘患病率为2.36%,与10年前该地区儿童哮喘患病率2.39%比较无明显增加。男性哮喘患病率高于女性。个人药物过敏史、食物过敏史、过敏性鼻炎及家族过敏史是该地区儿童哮喘发病的独立危险因素。
Abstract:OBJECTIVE: To investigate the prevalence rate and risk factors for asthma in children from the Futian District of Shenzhen, China who were aged from 0-14 years between 2010 and 2011, and to provide scientific evidence for the prevention and treatment of childhood asthma. METHODS: A multistage stratified cluster sampling survey of 7168 children aged 0-14 years from the Futian District of Shenzhen was conducted using the Third National Childhood Asthma Epidemiological Questionnaire 2010, to investigate the prevalence rate of childhood asthma. A case-control study (1∶1) and logistic regression analysis were used to investigate the risk factors for childhood asthma. RESULTS: Of the 7168 children surveyed, 169 were diagnosed with asthma, with a total prevalence rate of 2.36%. The prevalence rate was higher in males than in females (3.06% vs 1.55%, P<0.01). Of the 169 cases, 115 (68.1%) had their first asthma attack before the age of 3 years, 95 (56.2%) had moderate attacks, 159 (94.1%) had sudden attacks, 86 (50.9%) suffered from asthma during periods of seasonal change, 97 (57.4%) had attacks before going to bed, 157 (92.9%) suffered from asthma caused by respiratory infection, and 159 (94.1%) had sneezing as the sign of oncoming attack. The case-control study (including the 169 asthma cases and 169 healthy children) and logistic regression analysis both showed that the independent risk factors for asthma in children were a personal history of drug allergy (OR=3.645, 95%CI: 1.316, 10.094, P=0.013), a history of food allergy (OR=4.720, 95%CI: 1.987, 11.212, P<0.001), allergic rhinitis (OR=10.273, 95%CI: 5.485, 19.241, P<0.001), and a family history of allergy (OR=4.221, 95%CI: 2.147, 8.298, P<0.001). CONCLUSIONS: The prevalence rate of asthma was 2.36% in children aged 0-14 years in the Futian District of Shenzhen between 2010 and 2011. The prevalence rate had not increased when compared with the rate in this region 10 years earlier (2.39%). The prevalence rate of childhood asthma is higher in males than in females. Personal history of drug allergy, food allergy, allergic rhinitis and a family history of allergy are the independent risk factors for childhood asthma in this region.
GU Jia-Li,MA Hong-Ling,ZHENG Yue-Jie. Epidemiological survey of asthma in children aged 0-14 years in the Futian District of Shenzhen, China between 2010 and 2011[J]. CJCP, 2012, 14(12): 918-923.
[1]Masali M, Fabian D, Holt S, Beasley R. The global burden of asthma: Execu-rive summary of the GINA Dissemination Committee report[J]. Allergy, 2004, 59(5): 469-478.
[2]Akinbami LJ, Schoendorf KC. Trends in childhood asthma: prevalence, health care utilization, and mortality[J]. Pediatrics, 2002, 110(2 Pt 1): 315-322.
[3]Anandan C, Nurmatov U, Van Schayck OC, Sheikh A. Is the prevalence of asthma declining? Systematic review of epidemiological studies[J]. Allergy, 2010, 65(2): 152-167.
[4]Cserhati E. Current view on the etiology of childhood bronchial asthma[J]. Orv Hetil, 1999, 140(48): 2675-2683.
[6]Basagana X, Sunyer J, Kogevinas M, Zock JP, Duran-Tauleria E, Jarvis D, et al. Socioeconomic status and asthma prevalence in young adults: the European Community Respiratory Health Survey [J]. Am J Epidemiol, 2004, 160(2): 178-188.
[7]The International Study of Asthma and Allergies in Childhood (ISAAC) Steering Committee. Worldwide variation in prevalence of symptoms of asthma, allergic rhinoconjunctivitis, and atopic eczema: ISAAC. The International Study of Asthma and Allergies in Childhood (ISAAC) Steering Committee[J]. Lancet, 1998, 351(9111): 1225-1232.
[8]Wong GW, Hui DS, Chan HH, Fok TF, Leung R, Zhong NS, et al. Prevalence of respiratory and atopic disorders in Chinese schoolchildren[J].Clin Exp Allergy, 2001, 31(8): 1125-1231.
[9]National Heart, Lung, and Blood Institute. Global burden of asthma [EB/OL]. (2004-05)[2010-06-20].
[18]Sly RM.Decreases in asthma mortality in the United States[J]. Ann Allergy Asthma Immunol, 2000, 85(2): 121-127.
[19]Jonasson G, Lodrup Carlsen KC, Leegaard J, Carlsen KH, Mowinckel P, Halvorsen KS. Trends in hospital admissions for childhood asthma in Oslo, Norway 1980-95[J]. Allergy, 2000, 55(3): 232-239.
[20]Ramadour M, Burel C, Lanteaume A, Vervloet D, Charpin D, Brisse F, et al. Prevalence of asthma and rhinitis in relation to long-term exposure to gaseous air pollutants[J]. Allergy, 2000, 55(12): 1163-1169.
[21]Behbehani NA, Abal A, Syabbalo NC, Abd Azeem A, Shareef E, Al-Momen J. Prevalence of asthma, allergic rhinitis, and eczema in 13-to 14-year-old children in Kuwait: an ISAAC study. International Study of Asthema and Allergies in Childhood[J]. Ann Allergy Asthma Immunol, 2000, 85(1): 58-63.
[22]Shohat T, Golan G, Tamir R, Green MS, Livne L, Davidson Y, et al. Prevalence of asthma in 13-14 yr-old schoolchildren across Israel[J]. Eur Respir J, 2000, 15(4): 725-729.
[23]Leung R, Wong G, Lau J, Ho A, Chan JK, Choy D, et al. Prevalence of asthma and allergy in Hong Kong schoolchildren: an ISAAC study[J]. Eur Respir J, 1997, 10(2): 354-360.
[27]Gdalevich M, Mimouni D, Mimouni M. Breast-feeding and the risk of bronchial asthma in childhood: a systematic review with meta-analysis of prospective studies[J].J Pediatr, 2001, 139(2): 261-266.