CAJ | 학술논문

目的探讨母乳喂养与儿童哮喘及哮喘样症状的相关性.方法采用整群随机抽样法,在沈阳市5个行政区各抽取1所幼儿园和2所小学,共5所幼儿园和10所小学,共调查儿童8733名.采用国际统一标准问卷,收集所选学校儿童出生时喂养方式、居住环境及呼吸系统疾病与症状信息.采用x2检验、多因素非条件logistic回归分析不同喂养方式对儿童哮喘及哮喘样症状(哮喘现患、喘鸣现患、持续咳嗽、持续咳痰、过敏性鼻炎)的影响.结果在调查的8733名儿童中,年龄为(8.00±2.88)岁,母乳喂养的儿童有6830名,母乳喂养率为78.21％.在母乳喂养的儿童中,哮喘阳性率为6.12％(418/6830),持续咳痰阳性率为3.97％ (271/6830),过敏性鼻炎阳性率为4.17％(285/6830),均低于非母乳喂养儿童[哮喘阳性率为7.41％ (141/1903),持续咳痰阳性率为6.04％(115/1903),过敏性鼻炎阳性率为5.89％ (112/1903)](P值均＜0.05).在302名母亲是过敏体质的儿童中,母乳喂养的儿童哮喘阳性率为14.69％(36/245),持续咳痰阳性率为4.08％( 10/245),过敏性鼻炎阳性率为7.35％(18/245),均低于非母乳喂养儿童[哮喘阳性率为33.33％(19/57),持续咳痰阳性率为14.04％ (8/57),过敏性鼻炎阳性率为17.54％( 10/57)](P值均＜0.05).logistic分析结果显示,母乳喂养可降低儿童哮喘(OR =0.78,95％ CI:0.64 ～0.96)、过敏性鼻炎(OR =0.72,95％ CI:0.57 ～0.90)、持续咳嗽(OR =0.81,95％CI:0.69 ～ 0.96)和持续咳痰(OR =0.61,95％CI:0.48～0.76)的发生风险.结论母乳喂养儿童哮喘及哮喘样症状的发生率明显低于非母乳喂养儿童.
목적 탐토모유위양여인동효천급효천양증상적상관성.방법 채용정군수궤추양법,재침양시5개행정구각추취1소유인완화2소소학,공5소유인완화10소소학,공조사인동8733명.채용국제통일표준문권,수집소선학교인동출생시위양방식、거주배경급호흡계통질병여증상신식.채용x2검험、다인소비조건logistic회귀분석불동위양방식대인동효천급효천양증상(효천현환、천명현환、지속해수、지속해담、과민성비염)적영향.결과 재조사적8733명인동중,년령위(8.00±2.88)세,모유위양적인동유6830명,모유위양솔위78.21％.재모유위양적인동중,효천양성솔위6.12％(418/6830),지속해담양성솔위3.97％ (271/6830),과민성비염양성솔위4.17％(285/6830),균저우비모유위양인동[효천양성솔위7.41％ (141/1903),지속해담양성솔위6.04％(115/1903),과민성비염양성솔위5.89％ (112/1903)](P치균＜0.05).재302명모친시과민체질적인동중,모유위양적인동효천양성솔위14.69％(36/245),지속해담양성솔위4.08％( 10/245),과민성비염양성솔위7.35％(18/245),균저우비모유위양인동[효천양성솔위33.33％(19/57),지속해담양성솔위14.04％ (8/57),과민성비염양성솔위17.54％( 10/57)](P치균＜0.05).logistic분석결과현시,모유위양가강저인동효천(OR =0.78,95％ CI:0.64 ～0.96)、과민성비염(OR =0.72,95％ CI:0.57 ～0.90)、지속해수(OR =0.81,95％CI:0.69 ～ 0.96)화지속해담(OR =0.61,95％CI:0.48～0.76)적발생풍험.결론 모유위양인동효천급효천양증상적발생솔명현저우비모유위양인동.
Objective To evaluate the effect of breastfeeding on asthma and asthma related symptoms among children.Methods Using a cluster random sampling method,2 elementary schools and 1 kindergarten were randomly selected from each of the 5 districts of Shenyang,and a total of 10 elementary schools and 5 kindergartens were included,and 8733 children from the selected schools were recruited in this survey.The information about the type of feeding,living environment and respiratory diseases of the selected children from the time they were born was collected by an international standard questionnaire.Evaluating the effect of breastfeeding on asthma and asthma related symptoms( asthma,current asthma,current wheeze,persistent cough,persistent phlegm,and allergic rhinitis ) by x2 test and logistic regression.Results There were 8733 children involved in this study.The age was ( 8.00 ± 2.88 ) years old.There were 6830 breastfed children.The percentage of breastfed children was 78.21％.In breastfed children,the prevalence of asthma,persistent phlegm and allergic rhinitis were 6.12％ (418/6830),3.97％ (271/6830),4.17％ (285/6830),respectively.In non-breastfed children,the prevalence of asthma,persistent phlegm and allergic rhinitis were 7.41％ ( 141/1903 ),6.04％ ( 115/1903 ),5.89％(112/1903 ),respectively.Compared to the non-breastfed children,the breastfed children had significantly lower prevalence( all P values ＜0.05 ).After adjustment for 302 cases of atopy history of children's mother,the results showed that in breastfed children,the prevalence of asthma,persistent phlegm and allergic rhinitis were 14.69％ ( 36/245 ),4.08％ ( 10/245 ),7.35％ ( 18/245 ), respectively.In non-breastfed children,the prevalence of asthma,persistent phlegm and allergic rhinitis were 33.33％ ( 19/57 ),14.04％ (8/57),17.54％ (10/57),respectively.The breastfed children had statistically lower prevalence( all P values ＜ 0.05 ).Multivariate analysis showed that breastfeeding was significantly associated with lower prevalence of asthma( OR =0.78,95％ CI:0.64 - 0.96),allergic rhinitis ( OR =0.72,95％ CI:0.57 -0.90),persistent cough ( OR =0.81,95％ CI:0.69 - 0.96 ) and persistent expectoration ( OR =0.61,95％ CI:0.48 -0.76).Conclusion Breastfed children had lower prevalence of asthma and asthma related symptoms compared with non-breastfed children.