上海某区4~15岁儿童少年哮喘环境影响因素分析
A Case-control Study on Risk Factors of Asthma among 4-15 Years School-aged Children in a District of Shanghai
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摘要:
目的 探讨儿童哮喘患病的危险因素, 为哮喘的预防和控制提供依据。 方法 应用病例 -对照研究方法,调查上海某区 4~15岁经医生诊断的哮喘病例 202例和 368名对照的个体特征及家庭社会经济、遗传、室内环境因素, 用Logistic回归方法分析哮喘患病潜在危险因素。 结果 在调整了混杂因素后, 该区儿童青少年哮喘患病的各种危险因素的OR值及 95%可信区间分别为:母亲文化程度本科及以上(1.76, 1.15~2.71), 出生低体重(1.89, 1.03~3.47), 母亲哮喘(4.27, 1.59~11.42),父亲过敏病史(2.94, 1.79~4.80),母亲过敏病史(2.21, 1.34~3.64),与父母或家人共用卧室(1.66,1.10~2.51), 出生至 2岁家养毛皮动物(2.24, 1.02~4.90), 室内环境烟草烟雾(ETS)暴露量(1~10支/d:1.57, 1.01~2.43; ≥ 11支/d:2.36, 1.06~2.58), 使用燃气炉烹调的时间 ≥ 45 min/d(1.89, 1.22~2.83), 居室内有霉斑(2.59, 1.08~8.06), 住宅附近 50 m内有车辆繁忙的街道(1.70, 1.11~2.62)。 结论 遗传因素对哮喘患病的影响最大, 减少 ETS暴露、避免室内潮湿和霉菌繁殖可能会降低儿童哮喘患病的风险。婴幼儿期免于宠物暴露也可能降低哮喘患病风险。 Abstract:Objective To explore the risk factors for asthma in school-age children, and to provide the data for asthma control and prevention. Methods Asthma cases aged 4-15 years(n=202)from schools were recruited and matched for year of birth, sex, and living area with randomly selected schoolchildren controls(n=391). Cases and controls were surveyed by questionnaire to ascertain the asthma and various proposed risk factors for asthma. Asthma was defined as ever having been diagnosed as asthma by doctors. Results After adjusting the confounder variables, factors which increased the risk of asthma were:mother education > 13 years(OR:1.76; 95%CI:1.15-2.71), low weight birth(OR:1.89; 95%CI:1.03-3.47), maternal history of asthma(OR:4.27; 95%CI:1.59-11.42), paternal history of allergy(OR:2.94; 95%CI:1.79-4.80), maternal history of allergy(OR:2.21; 95%CI:1.34-3.64), sharing bedroom with parents or others(OR:1.66; 95%CI:1.10-2.51), breeding furry pets while less than 2 years old(OR:2.24; 95%CI:1.02-4.90), indoor environmental tobacco smoke exposure (1-10/d:1.57; 95%CI:1.01-2.43; ≥ 11/d:2.36; 95%CI:1.06-2.58), using gas stove cooking more than 45 minutes per day (OR:1.89; 95%CI:1.22-2.83), visible moulds in rooms(OR:2.59; 95%CI:1.08-8.06), and having a busy traffic within 50 meters to home(OR:1.70; 95%CI:1.11-2.62). Conclusion Genetic factors are most important to increase asthma risk. Of the environmental factors tested, those having the greatest potential if modified to reduce the risk of asthma are environmental tobacco smoke exposure, furry pet exposure in early life, and indoor visible moulds.
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