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

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

叶茂鑫^{1, 2},
刘传合^2, ,,
沙莉²,
谷庆隆²,
赵京²

1.
潍坊医学院临床学院, 山东 261000
2.
首都儿科研究所附属儿童医院变态反应科

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
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- 被引次数: 0
出版历程
- 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

Risk factors for bronchial asthma in children with allergic rhinitis

YE Maoxin^{1, 2},
LIU Chuanhe^{2
, ,},
SHA Li²,
GU Qinglong²,
ZHAO Jing²

1.
Clinical College of Weifang Medical University, Weifang(261000), Shandong Province, China

摘要

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。
- 鼻炎 /
- 哮喘 /
- 变应原 /
- 回归分析 /
- 儿童
Abstract: Objective To explore the risk factors of bronchial asthma in children with allergic rhinitis, and to provide evidence for the early diagnosis, treatment and prevention of asthma in children with allergic rhinitis. Methods Children with allergic rhinitis and children with allergic rhinitis and asthma, who attended the Allergy Clinic of the Capital Institute of Pediatrics from November 2019 to October 2020, were recruited for the study. Medical history, clinical characteristics, allergen types and risk factors were collected and analyzed. Results A total of 117 children with allergic rhinitis and 111 children with allergic rhinitis that subsequently developed into asthma were included. The results of the univariate analysis showed that the occurrence of asthma in children with allergic rhinitis was associated with the course of rhinitis, severity of rhinitis, type of rhinitis, seasonal onset, history of pet contact, family history of allergic diseases, mold, ragweed, dermatophagoides culinae and dust mite sensitization(χ²=6.15, 8.79, 3.99, 9.44, 5.17, 4.43, 8.48, 10.38, 6.18, 5.31, P < 0.05). The Logistic regression analysis showed that rhinitis severity(OR=7.03), family history of allergic diseases(OR=8.24), mold(OR=5.19), and household dust mite sensitization (OR=25.25) were positively correlated with the occurrence of asthma in children with allergic rhinitis(P < 0.05), and dust mite sensitization was the strongest risk factor. Conclusion The development of asthma in children with allergic rhinitis is affected by many factors, among which the severity of rhinitis, family history of allergic diseases and dust mite sensitization are the most important factors.
- Rhinitis /
- Asthma /
- Allergens /
- Regression analysis /
- Child

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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值	P值
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/%。

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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值		1.39	0.08	10.38	8.48	6.18	5.31	1.99	0.32
P值		0.24	0.77	0.00	0.00	0.01	0.02	0.16	0.57
注： ()内数字为报告率/%。

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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值	标准误	Wald χ²值	P值	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)

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