Prevalence and risk factors for asthma among children aged 0-14 years in Hangzhou: a cross-sectional survey.
Prevalence and risk factors for asthma among children aged 0-14 years in Hangzhou: a cross-sectional survey.
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DOI：
10.1186/s12931-016-0439-z
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发表时间：
2016-09-27
影响因子：
5.8
通讯作者：
Zhao L
中科院分区：
文献类型：
--
作者：
Xu D;Wang Y;Chen Z;Li S;Cheng Y;Zhang L;Zhao L
哮喘是一个全球性的问题。不同国家和城市的患病率有所不同。本研究旨在了解杭州市哮喘的患病率，描述其特点，发现可能与哮喘相关的因素。这项横断面研究是在杭州进行的。受试者为14岁及以下的儿童。与每个哮喘患者在年龄和性别上匹配的非哮喘儿童的对照组也被随机选择和采访。本次调查采用国际儿童哮喘与变态反应研究和全国哮喘与变态反应流行病学中国问卷调查。我们对13,877名儿童进行了问卷调查，其中665名儿童(4.8%)被诊断为哮喘。监护人认为哮喘治疗费用可承受的占49.4%，可耐受的占46.9%，不可耐受的占3.7%。由于儿童哮喘，监护人和儿童都缺席了工作或学校。呼吸道感染是哮喘发作最常见的触发因素(85.1%)。其他常见原因包括冷空气、室内灰尘、运动、鱼虾、花粉等。有趣的是，我们还发现，在6岁及以上的儿童中，一些触发因素比5岁及以下的儿童发生得更多。这些因素包括锻炼、情绪变化、室内灰尘、花粉、室内装修、蚊香和宠物(p值均为0.05)。我们比较了一些可能与哮喘发生有关的因素。哮喘组有哮喘家族史、个人过敏史(特应性皮炎、药物过敏和食物过敏)、合并症(过敏性鼻炎、鼻窦炎、腺样体肥大、荨麻疹)、剖宫产和孕期并发症的比例高于非哮喘组(P均<0.05)。非哮喘组在前6个月内纯母乳喂养和饲养动物的比例高于哮喘组(p值均为0.05)。46.2%的患者应用吸入糖皮质激素/吸入糖皮质激素 + 长效β2激动剂。44.2%的哮喘儿童使用中药，36.4%的儿童使用白三烯受体拮抗剂(LTRA)。中医组依从性评分高于 + 组(P<0.003)和LTRA组(P<0.05)。总之，我们在杭州进行了一项流行病学研究。儿童哮喘患病率为4.8%。哮喘是儿童和监护人的经济和社会负担。哮喘发生的危险因素可能包括剖腹产、个人过敏史和伴随的过敏性疾病。前6个月内纯母乳喂养和饲养动物可能是保护因素。中医药学在中国中的流行程度仅次于ICS/ICS、 + 、LABA和LTRA。
Asthma is a global problem. Prevalence varies among different countries and cities. We aimed to obtain the prevalence, describe the characteristics, and discover factors that may relate to asthma in Hangzhou. This cross-sectional study was conducted in Hangzhou. The subjects were children aged 14 years and younger. A control group of non-asthma children that matched in age and sex with each asthmatic patient was also randomly selected and interviewed. International Study of Asthma and Allergies in Childhood and National Epidemiology study of Asthma and Allergies in China questionnaires were used in this survey. We have questionnaired 13,877 children, and 665 (4.8 %) children were diagnosed asthma. The guardians regarded the cost of asthma management affordable in 49.4 %, tolerable in 46.9 %, and intolerable in 3.7 %. Both guardians and children have been absent from work or school due to children’s asthma. Respiratory tract infection was the most common trigger of asthma attacks (85.1 %). Other common causes included cold air, house dust, exercise, fish and shrimp, pollen, and et al. Interestingly, we also found in children 6 years and older, some triggers happened more than that in children 5 years and younger. Those factors included exercise, emotional changes, house dust, pollen, renovation works in the home, mosquito–repellent incense and pets (all the p values were <0.05). We compared some factors may relate to asthma development. Higher percentage of family history of asthma, personal history of allergy (atopic dermatitis, drug allergy and food allergy), comorbidities (allergic rhinitis, sinusitis, adenoidal hypertrophy, and urticaria), caesarean birth and complications ever happened during pregnancy were discovered in asthma children than in non-asthma children (all the p values were <0.05). Exclusive breastfeeding within first 6 months and keeping animals had higher percentage in non-asthma children than in asthma (both the p values were <0.05). Inhaled corticosteroid (ICS)/ICS + long-acting beta2 agonists (LABA) was applied to 46.2 % of patients. Traditional Chinese medicine (TCM) was used in 44.2 % of asthma children, while leukotriene receptor antagonist (LTRA) was used in 36.4 % of them. The adherence scored higher in TCM than in ICS/ICS + LABA (P = 0.003) and LTRA. In conclusion, we conducted an epidemiology study in Hangzhou. The prevalence of childhood asthma was 4.8 %. Asthma was an economic and social burden to both children and guardians. Risk factors of asthma development may include caesarean birth, personal history of allergy and concomitant allergic diseases. Exclusive breastfeeding within first 6 months and keeping animals might be protecting factors. TCM was really popular in China besides ICS/ICS + LABA and LTRA.