CAJ | 학술논문

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(12 450人),与病例年龄、性别匹配者为对照组(14 500人),采用全国统一设计、以ISAAC (The International Study of Asthma and Allergics 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26 950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＜0.05)；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=0.80,95％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(OR=1.26,95％CI:1.10 ～ 2.45):6～ 14岁组的危险因素增加了年龄(OR=0.97,95％CI:0.95～0.99)、民族(OR=1.61,95％CI: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.
목적 분석중국성시인동효천특정급기위험인소.방법 채용성조병례대조연구,이2010년전국43개성시0～ 14세인동효천조사중림상학진적전부효천병례위병례조(12 450인),여병례년령、성별필배자위대조조(14 500인),채용전국통일설계、이ISAAC (The International Study of Asthma and Allergics in Childhood)배경인소문권위기출적효천조사문권,통과x2검험、엄의선성혼합효응모형(GLMM)분석천술인동효천적위험인소.결과 납입조사대상공계26 950인(남∶녀=1.55∶1).경GLMM분석,년령、민족、성별、과민사、가족사、모친직업、항생소용약사、조산、부궁산、단백보식첨가시간、팽조연료、사용공조、방옥장수、가인흡연、거실매반급가정충식화초위중국성시인동효천적주요영향인소(P＜0.05)；부분위험인소대신발병례화현환병례영향정도불동,실내충식화초대신발효천(OR=2.09,95％CI:1.30 ～ 3.36)화현환효천(OR=0.80,95％CI:0.74 ～ 0.86)영향적차이유통계학의의.효천위험인소인년령이이,＜3세조효천주요영향인소위과민、감염、기미자격화조산(OR=1.72,95％CI:1.42～ 2.08),3～5세조적위험인소증가료성별(OR=1.18,95％CI:1.03～1.35)、저출생체중(OR=1.69,95％CI:1.17 ～ 2.44)화부궁산(OR=1.26,95％CI:1.10 ～ 2.45):6～ 14세조적위험인소증가료년령(OR=0.97,95％CI:0.95～0.99)、민족(OR=1.61,95％CI:1.26～2.06)화천거(OR=1.68,95％CI:1.39～2.03).결론 중국인동효천적위험인소포괄유전、과민、감염화기타배경인소,기궤제유대진일보전제연구.
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 wcre matched with the cases in age and sex.A revised questionnaire on the basis of ISAAC Phase Three Environmental Questionnaire was designed to investigate the 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 Han ethnicity,another 5 980 children (22.2％) of ethnic minorities and 3 1 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％ CI: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％CI:1.03-1.35),low birth weight (OR=1.69,95％ CI: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％CI: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.