CAJ | 학술논문

目的了解北京市城区0 ～14岁儿童哮喘患病率、发病规律及其诊治情况.方法采用多阶段分层随机整群抽样方法,2010年10月到2011年3月通过学校或幼儿园老师或社区医生向1995年11月1日至2010年10月31日出生的北京市儿童或外地出生但在北京居住和生活半年以上的儿童家长发放初筛问卷,应用2010年第三次全国儿童哮喘流行病学调查统一问卷,筛查儿童哮喘及过敏疾病.筛查阳性儿童由临床医生通过现场问诊、体检及查阅既往病历记录和辅助检查结果,进行甄别,明确哮喘诊断.对已确诊哮喘患儿做进一步问卷调查,了解其哮喘诊治情况及伴发过敏性疾病情况.所有数据使用Epi-Info3.5.3软件进行双录入,用SPSS 19.0进行统计分析.结果共抽取儿童14085名,完成儿童哮喘与过敏性疾病初筛问卷13513份(95.94％).共诊断哮喘497例3.68％,其中典型哮喘患病率为3.34％(451/13513)、咳嗽变异性哮喘患病率为0.34％(46/13513);40.64％(202/497)的患儿为新诊断病例,59.36％(295/497)为既往已诊断哮喘；男性患病率为4.80％(345/7190),女性患病率为2.40％(152/6323)(x2=54.446,P＜0.01).不同发育阶段儿童以学龄前儿童(3～＜7岁)患病率最高为5.05％(180/3563).69.42％ (345/497)患儿近2年内仍存在哮喘症状,2年现患率为2.55％(345/13513),其中典型哮喘为2.26％ (305/13513),咳嗽变异性哮喘为0.30％(40/13513).在既往已诊断哮喘患儿中,按全球哮喘防治创议(GINA)方案使用过吸入激素的患儿为46.44％ (137/295),而抗生素的使用率高达82.37％ (243/295).结论北京市城区0 ～14岁儿童哮喘总患病率达3.68％,不同性别和不同年龄阶段儿童存在明显差异,仍有相当部分患儿未得到及时诊断,哮喘的治疗和管理水平亦亟待提高.
목적 료해북경시성구0 ～14세인동효천환병솔、발병규률급기진치정황.방법 채용다계단분층수궤정군추양방법,2010년10월도2011년3월통과학교혹유인완로사혹사구의생향1995년11월1일지2010년10월31일출생적북경시인동혹외지출생단재북경거주화생활반년이상적인동가장발방초사문권,응용2010년제삼차전국인동효천류행병학조사통일문권,사사인동효천급과민질병.사사양성인동유림상의생통과현장문진、체검급사열기왕병력기록화보조검사결과,진행견별,명학효천진단.대이학진효천환인주진일보문권조사,료해기효천진치정황급반발과민성질병정황.소유수거사용Epi-Info3.5.3연건진행쌍록입,용SPSS 19.0진행통계분석.결과 공추취인동14085명,완성인동효천여과민성질병초사문권13513빈(95.94％).공진단효천497례3.68％,기중전형효천환병솔위3.34％(451/13513)、해수변이성효천환병솔위0.34％(46/13513);40.64％(202/497)적환인위신진단병례,59.36％(295/497)위기왕이진단효천；남성환병솔위4.80％(345/7190),녀성환병솔위2.40％(152/6323)(x2=54.446,P＜0.01).불동발육계단인동이학령전인동(3～＜7세)환병솔최고위5.05％(180/3563).69.42％ (345/497)환인근2년내잉존재효천증상,2년현환솔위2.55％(345/13513),기중전형효천위2.26％ (305/13513),해수변이성효천위0.30％(40/13513).재기왕이진단효천환인중,안전구효천방치창의(GINA)방안사용과흡입격소적환인위46.44％ (137/295),이항생소적사용솔고체82.37％ (243/295).결론 북경시성구0 ～14세인동효천총환병솔체3.68％,불동성별화불동년령계단인동존재명현차이,잉유상당부분환인미득도급시진단,효천적치료화관리수평역극대제고.
Objective To explore the prevalence,diagnosis and management of childhood asthma in Beijing urban area.Methods Multi-stage,stratified and random cluster sampling was used to recruit children born during November 1,1995 to October 31,2010 from Beijing or other provinces but residing in Beijing for over half a year.The same screening questionnaires for the third national epidemiological survey of children's asthma were distributed to parents of children at schools,kindergartens and communities during October 2010 to March 2011.Asthmatic children were picked among the screening-positive children based on on-the-spot inquiries,physical examinations,medical records and supporting test results.Further survey of asthmatics was carried out to investigate the diagnosis and treatment status of childhood asthma and other associated allergic diseases.All data required double entry by Epi-Info 3.5.3 software and were processed by SPSS 19.0.Results Among a total of 14085 questionnaires,13513 were completed with a response rate of 95.94％.And 497 (3.68％) children were diagnosed with typical (n =451,3.34％) and cough variant (n =46,0.34％) asthma.Among them,40.64％ (202/497) were newly diagnosed and 59.36％(295/497) had been previously diagnosed with asthma.The prevalence of asthma was higher in boys than in girls (4.80％ (345/1790) vs 2.40％ (152/6323),x2 =54.446,P ＜ 0.01).The asthma prevalence of preschoolers (3-＜ 7 years old) was the highest (5.05％ (180/3563)).In the past two years,the symptoms of 69.42％ (345/497) children persisted and the current two-year prevalence of asthma was 2.55％ (345/13513).Among the 295 children with previous asthma,only 46.44％ (137/295) received inhaled corticosteroids according to the Global Initiative for Asthma (GINA) and 82.37％ (243/295) of them used antibiotics.Conclusions The prevalence of asthma is 3.68％ in children under 14 years old in Beijing urban area and it varies in children with different genders and ages.A considerable number of children are not diagnosed or treated properly.And the management of asthma requires further improvement.