中华预防医学杂志
中華預防醫學雜誌
중화예방의학잡지
CHINESE JOURNAL OF
2013年
6期
523-528
,共6页
刘玉芹%赵洋%刘苗苗%王达%马亚楠%任万辉%高峰%董光辉
劉玉芹%趙洋%劉苗苗%王達%馬亞楠%任萬輝%高峰%董光輝
류옥근%조양%류묘묘%왕체%마아남%임만휘%고봉%동광휘
儿童%母乳喂养%被动吸烟%哮喘%哮喘样症状
兒童%母乳餵養%被動吸煙%哮喘%哮喘樣癥狀
인동%모유위양%피동흡연%효천%효천양증상
Child%Breast feeding%Passive smoking%Asthma%Asthma related symptoms
目的 探讨母乳喂养与被动吸烟的交互作用对儿童哮喘及哮喘样症状的影响.方法 采用整群随机抽样法在辽宁省7个城市各抽取1所小学和2所幼儿园,共25所小学和50所幼儿园,对所选学校所有在此居住满2年的31 049名儿童的喂养方式、居住环境、被动吸烟等情况及呼吸系统疾病与症状的信息进行收集.采用Glimmix回归模型分析母乳喂养与被动吸烟的交互作用对儿童哮喘及哮喘样症状(持续咳嗽、持续咳痰、喘鸣现患、过敏性鼻炎)的影响.结果 在调查的31 049名儿童中,年龄为(8.32±2.75)岁,母乳喂养的儿童有23 987名,母乳喂养率为77.26％；被动吸烟的儿童有11 820名,被动吸烟率为38.07％.母乳喂养的儿童哮喘、过敏性鼻炎阳性率分别为6.22％(1491/23 987)、4.67％(1120/23 987),非母乳喂养的儿童分别为7.70％(544/7062)、5.48％(387/7062).母乳喂养儿童发生哮喘(OR=0.79,95％ CI:0.72～0.88)、过敏性鼻炎(OR =0.85,95％CI:0.75～0.95)的风险较低.父亲吸烟的儿童喘鸣现患阳性率为7.89％(929/11 770),父亲未吸烟的儿童为5.37％(1036/19 279),父亲吸烟的儿童发生喘鸣现患(OR=1.51,95％CI:1.38 ～1.65)的风险较高.母亲吸烟的儿童持续咳嗽阳性率为18.96％(51/269),母亲未吸烟的儿童为9.51％(2926/30 780),母亲吸烟的儿童发生持续咳嗽(OR =2.23,95％ CI:1.64～3.03)的风险较高.家中其他任何人吸烟的儿童持续咳痰阳性率为5.69％(871/15 316),家中无人吸烟的儿童为3.50％(550/15 733),家中其他任何人吸烟的儿童发生持续咳痰(OR=1.67,95％CI:1.49～ 1.86)的风险较高.Glimmix回归模型分析显示,母乳喂养与被动吸烟对儿童哮喘及哮喘样症状存在交互影响:在父亲吸烟暴露下,母乳喂养的儿童发生哮喘的风险低于非母乳喂养儿童；在母亲吸烟暴露下,母乳喂养的儿童发生过敏性鼻炎的风险低于非母乳喂养儿童；在家中其他任何人吸烟暴露下,母乳喂养的儿童发生哮喘、过敏性鼻炎的风险低于非母乳喂养儿童(P值均＜0.05).结论 母乳喂养使被动吸烟的儿童发生哮喘及哮喘样症状的风险降低.
目的 探討母乳餵養與被動吸煙的交互作用對兒童哮喘及哮喘樣癥狀的影響.方法 採用整群隨機抽樣法在遼寧省7箇城市各抽取1所小學和2所幼兒園,共25所小學和50所幼兒園,對所選學校所有在此居住滿2年的31 049名兒童的餵養方式、居住環境、被動吸煙等情況及呼吸繫統疾病與癥狀的信息進行收集.採用Glimmix迴歸模型分析母乳餵養與被動吸煙的交互作用對兒童哮喘及哮喘樣癥狀(持續咳嗽、持續咳痰、喘鳴現患、過敏性鼻炎)的影響.結果 在調查的31 049名兒童中,年齡為(8.32±2.75)歲,母乳餵養的兒童有23 987名,母乳餵養率為77.26％；被動吸煙的兒童有11 820名,被動吸煙率為38.07％.母乳餵養的兒童哮喘、過敏性鼻炎暘性率分彆為6.22％(1491/23 987)、4.67％(1120/23 987),非母乳餵養的兒童分彆為7.70％(544/7062)、5.48％(387/7062).母乳餵養兒童髮生哮喘(OR=0.79,95％ CI:0.72～0.88)、過敏性鼻炎(OR =0.85,95％CI:0.75～0.95)的風險較低.父親吸煙的兒童喘鳴現患暘性率為7.89％(929/11 770),父親未吸煙的兒童為5.37％(1036/19 279),父親吸煙的兒童髮生喘鳴現患(OR=1.51,95％CI:1.38 ～1.65)的風險較高.母親吸煙的兒童持續咳嗽暘性率為18.96％(51/269),母親未吸煙的兒童為9.51％(2926/30 780),母親吸煙的兒童髮生持續咳嗽(OR =2.23,95％ CI:1.64～3.03)的風險較高.傢中其他任何人吸煙的兒童持續咳痰暘性率為5.69％(871/15 316),傢中無人吸煙的兒童為3.50％(550/15 733),傢中其他任何人吸煙的兒童髮生持續咳痰(OR=1.67,95％CI:1.49～ 1.86)的風險較高.Glimmix迴歸模型分析顯示,母乳餵養與被動吸煙對兒童哮喘及哮喘樣癥狀存在交互影響:在父親吸煙暴露下,母乳餵養的兒童髮生哮喘的風險低于非母乳餵養兒童；在母親吸煙暴露下,母乳餵養的兒童髮生過敏性鼻炎的風險低于非母乳餵養兒童；在傢中其他任何人吸煙暴露下,母乳餵養的兒童髮生哮喘、過敏性鼻炎的風險低于非母乳餵養兒童(P值均＜0.05).結論 母乳餵養使被動吸煙的兒童髮生哮喘及哮喘樣癥狀的風險降低.
목적 탐토모유위양여피동흡연적교호작용대인동효천급효천양증상적영향.방법 채용정군수궤추양법재요녕성7개성시각추취1소소학화2소유인완,공25소소학화50소유인완,대소선학교소유재차거주만2년적31 049명인동적위양방식、거주배경、피동흡연등정황급호흡계통질병여증상적신식진행수집.채용Glimmix회귀모형분석모유위양여피동흡연적교호작용대인동효천급효천양증상(지속해수、지속해담、천명현환、과민성비염)적영향.결과 재조사적31 049명인동중,년령위(8.32±2.75)세,모유위양적인동유23 987명,모유위양솔위77.26％；피동흡연적인동유11 820명,피동흡연솔위38.07％.모유위양적인동효천、과민성비염양성솔분별위6.22％(1491/23 987)、4.67％(1120/23 987),비모유위양적인동분별위7.70％(544/7062)、5.48％(387/7062).모유위양인동발생효천(OR=0.79,95％ CI:0.72～0.88)、과민성비염(OR =0.85,95％CI:0.75～0.95)적풍험교저.부친흡연적인동천명현환양성솔위7.89％(929/11 770),부친미흡연적인동위5.37％(1036/19 279),부친흡연적인동발생천명현환(OR=1.51,95％CI:1.38 ～1.65)적풍험교고.모친흡연적인동지속해수양성솔위18.96％(51/269),모친미흡연적인동위9.51％(2926/30 780),모친흡연적인동발생지속해수(OR =2.23,95％ CI:1.64～3.03)적풍험교고.가중기타임하인흡연적인동지속해담양성솔위5.69％(871/15 316),가중무인흡연적인동위3.50％(550/15 733),가중기타임하인흡연적인동발생지속해담(OR=1.67,95％CI:1.49～ 1.86)적풍험교고.Glimmix회귀모형분석현시,모유위양여피동흡연대인동효천급효천양증상존재교호영향:재부친흡연폭로하,모유위양적인동발생효천적풍험저우비모유위양인동；재모친흡연폭로하,모유위양적인동발생과민성비염적풍험저우비모유위양인동；재가중기타임하인흡연폭로하,모유위양적인동발생효천、과민성비염적풍험저우비모유위양인동(P치균＜0.05).결론 모유위양사피동흡연적인동발생효천급효천양증상적풍험강저.
Objective To evaluate the interaction effects of breastfeeding and passive smoking 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 7 cities of Liaoning province.The resulting 25 elementary schools and 50 kindergartens were included,and 31 049 children from the selected schools living up to 2 years were recruited in this survey.The information about the children's type of feeding up,living environment,passive smoking exposure,respiratory diseases and symtoms were collected.The interaction effects of breastfeeding and passive smoking on asthma and asthma related symptoms (persistent cough,persistent phlegm,current wheeze and allergic rhinitis) were evaluated with Glimmix procedure.Results There were 31 049 children involved in this investigation.The age was (8.32 ± 2.75) years old.There were 23 987 (77.26％) children with breastfeeding and 11 820 (38.07％) children with passive smoking.The prevalence of asthma and allergic rhinitis were 6.22％ (1491/23 987),4.67％ (1120/23 987)in children with breastfeeding,and were 7.70％ (544/7062),5.48％ (387/7062) in children without breasffeeding,compared to the children without breasffeeding,the children with breastfeeding had lower risk of asthma(OR =0.79,95％ CI:0.72-0.88) and allergic rhinitis (OR =0.85,95％ CI:0.75-0.95) ; The prevalence of current wheeze was 7.89％ (929/11 770) in children with father smoking,and was 5.37％ (1036/19 279) in children without father smoking,compared to the children without father smoking,the children with father smoking increased the risk of current wheeze (OR =1.51,95％ CI:1.38-1.65).The prevalence of persistent cough was 18.96％ (51/269) in children with mother smoking,and was 9.51％ (2926/30 780) in children without mother smoking,compared to the children without mother smoking,the children with mother smoking increased the risk of persistent cough(OR =2.23,95％ CI:1.64-3.03).The prevalence of persistent phlegm was 5.69％ (871/5316) in children with anyone smoking,and was 3.50％ (550/15 733) in children without anyone smoking,compared to the children without anyone smoking,the children with anyone smoking increased the risk of persistent phlegm (OR =1.67,95％ CI:1.49-1.86).Glimmix procedure analysis showed there was a significant interaction effects between breastfeeding and passive smoking.The estimated OR for father smoking among breastfeeding children were consistently lower than those among non-breastfeeding children for asthma.The estimated OR for mother smoking among breastfeeding children were consistently lower than those among non-breastfeeding children for allergic rhinitis.The estimated OR for anyone smoking among breasffeeding children were consistently lower than those among non-breastfeeding children for asthma and allergic rhinitis (all P values ＜ 0.05).Conclusion Breasffeeding decreases the detrimental effects of passive smoking on asthma and asthma related symptoms in children.
