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过敏性鼻炎儿童发生支气管哮喘的影响因素分析

叶茂鑫 刘传合 沙莉 谷庆隆 赵京

叶茂鑫, 刘传合, 沙莉, 谷庆隆, 赵京. 过敏性鼻炎儿童发生支气管哮喘的影响因素分析[J]. 中国学校卫生, 2021, 42(9): 1302-1305,1310. doi: 10.16835/j.cnki.1000-9817.2021.09.007
引用本文: 叶茂鑫, 刘传合, 沙莉, 谷庆隆, 赵京. 过敏性鼻炎儿童发生支气管哮喘的影响因素分析[J]. 中国学校卫生, 2021, 42(9): 1302-1305,1310. doi: 10.16835/j.cnki.1000-9817.2021.09.007
YE Maoxin, LIU Chuanhe, SHA Li, GU Qinglong, ZHAO Jing. Risk factors for bronchial asthma in children with allergic rhinitis[J]. CHINESE JOURNAL OF SCHOOL HEALTH, 2021, 42(9): 1302-1305,1310. doi: 10.16835/j.cnki.1000-9817.2021.09.007
Citation: YE Maoxin, LIU Chuanhe, SHA Li, GU Qinglong, ZHAO Jing. Risk factors for bronchial asthma in children with allergic rhinitis[J]. CHINESE JOURNAL OF SCHOOL HEALTH, 2021, 42(9): 1302-1305,1310. doi: 10.16835/j.cnki.1000-9817.2021.09.007

过敏性鼻炎儿童发生支气管哮喘的影响因素分析

doi: 10.16835/j.cnki.1000-9817.2021.09.007
基金项目: 

国家重点研发计划"精准医学研究"专项 2016YFC0901103

北京市医院管理局儿科学科协同发展中心专项 XTZD20180102

北京市医院管理局重点医学专业发展计划 ZYLX201829

详细信息
    作者简介:

    叶茂鑫(1995-), 女, 重庆綦江人, 在读硕士, 主要研究方向为儿童变态反应性疾病

    通讯作者:

    刘传合, E-mail: liuchcip@126.com

  • 中图分类号: R 725.6 R 446

Risk factors for bronchial asthma in children with allergic rhinitis

  • 摘要:   目的  探讨过敏性鼻炎患儿发生支气管哮喘的危险因素,为鼻炎患儿发生哮喘的早期诊断、治疗和预防提供依据。  方法  纳入2019年11月至2020年10月在首都儿科研究所变态反应科门诊就诊的单纯过敏性鼻炎患儿(117例)和过敏性鼻炎继发哮喘患儿(111例),采集病史,检测过敏原,对其临床特征、过敏原种类及危险因素等进行统计分析。  结果  单因素分析显示,鼻炎病程、鼻炎严重度、鼻炎类型、季节特征、宠物接触史、过敏性疾病家族史、霉菌、豚草、粉尘螨和户尘螨致敏与过敏性鼻炎患儿哮喘的发生相关(χ2值分别为6.15,8.79,3.99,9.44,5.17,4.43,8.48,10.38,6.18,5.31,P值均 < 0.05)。多因素Logistic回归分析显示,鼻炎严重度(OR=7.03)、过敏性疾病家族史(OR=8.24)、霉菌(OR=5.19)、粉尘螨(OR=25.25)与过敏性鼻炎患儿哮喘的发生呈正相关(P值均 < 0.05),粉尘螨致敏患儿的风险最高。  结论  儿童过敏性鼻炎继发哮喘受多种因素影响,其中鼻炎严重度、过敏性疾病家族史、尘螨致敏是最主要的因素。
  • 表  1  单纯AR和AR继发哮喘患儿间各特征分布情况

    Table  1.   Comparison between children with AR and AR secondary asthma in different groups

    组别 单纯AR
    (n=117)
    AR继发哮喘
    (n=111)
    χ2 P
    性别
        男 64(54.7) 68(61.3) 1.01 0.32
        女 53(45.3) 43(38.7)
    年龄/岁
        3~5 31(26.5) 13(11.7) 7.99 0.05
        6~14 86(73.5) 98(88.3)
    鼻炎病程/年
         < 3 100(85.5) 80(72.1) 6.15 0.01
        ≥3 17(14.5) 31(27.9)
    鼻炎严重度
        轻度间歇 17(14.5) 7 (6.3) 8.79 0.03
        轻度持续 26(22.2) 15(13.5)
        中重度间歇 3(2.6) 2 (1.8)
        中重度持续 71(60.7) 87(78.4)
    鼻炎类型
        鼻塞型 89(76.1) 71(64.0) 3.99 0.05
        流涕型 28(23.9) 40(36.0)
    季节特征
        季节性 67(57.3) 41(36.9) 9.44 0.00
        常年性 50(42.7) 70(63.1)
    宠物接触史
        有 89(76.1) 69(62.2) 5.17 0.02
        无 28(23.9) 42(37.8)
    湿疹史
        有 38(32.5) 24(21.6) 3.39 0.07
        无 79(67.5) 87(78.4)
    被动吸烟史
        有 68(58.1) 54(48.6) 2.05 0.15
        无 49(41.9) 57(51.4)
    过敏性疾病家族史
        有 48(41.0) 61(55.0) 4.43 0.04
        无 69(59.0) 50(45.0)
    注: ()内数字为构成比/%。
    下载: 导出CSV

    表  2  不同过敏性鼻炎患儿常见吸入性过敏原致敏情况比较

    Table  2.   Common inhaled allergen sensitization in childen patients

    组别 人数 春季花粉 艾蒿 豚草 霉菌 粉尘螨 户尘螨 猫毛 狗毛
    单纯AR 117 65(55.6) 78(66.7) 66(56.4) 47(40.2) 40(34.2) 18(15.4) 16(13.7) 11(9.4)
    AR继发哮喘 111 53(47.7) 72(64.9) 39(35.1) 66(59.5) 56(50.1) 31(27.9) 23(20.7) 13(11.7)
    χ2 1.39 0.08 10.38 8.48 6.18 5.31 1.99 0.32
    P 0.24 0.77 0.00 0.00 0.01 0.02 0.16 0.57
    注: ()内数字为报告率/%。
    下载: 导出CSV

    表  3  AR患儿继发哮喘影响因素的Logistic回归分析(n=228)

    Table  3.   Multivariate Logistic regression of risk factors for asthma in children with AR(n=228)

    自变量 β 标准误 Wald χ2 P OR值(OR值95%CI)
    鼻炎病程 -0.72 0.59 1.47 0.23 0.49(0.15~1.56)
    鼻炎严重度 1.95 0.39 24.20 < 0.01 7.03(3.23~15.28)
    鼻炎类型 -0.65 0.39 2.74 0.09 0.52(0.24~1.13)
    季节特征 -0.29 0.36 0.66 0.42 0.75(0.37~1.51)
    宠物接触史 -1.55 0.63 6.02 0.01 0.21(0.06~0.73)
    过敏性疾病家族史 2.11 0.90 5.50 0.02 8.24(1.41~48.03)
    霉菌 1.65 0.42 15.65 < 0.01 5.19(2.29~11.74)
    豚草 -1.52 0.41 13.85 < 0.01 0.22(0.09~0.49)
    粉尘螨 3.23 1.05 9.47 < 0.01 25.25(3.23~197.50)
    屋尘螨 0.54 0.45 1.45 0.23 1.71(0.71~4.09)
    下载: 导出CSV
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  • 收稿日期:  2021-01-05
  • 修回日期:  2021-03-30
  • 网络出版日期:  2021-09-24
  • 刊出日期:  2021-09-24

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