苏州市中小学生腺样体肥大及并发分泌性中耳炎分析

方琴; 陶朵朵

doi:10.16835/j.cnki.1000-9817.2021.11.029

苏州市中小学生腺样体肥大及并发分泌性中耳炎分析

doi: 10.16835/j.cnki.1000-9817.2021.11.029

方琴,
陶朵朵

苏州大学附属第一医院耳鼻咽喉科，江苏 215006

基金项目:

国家自然科学基金项目 81600796

江苏省科技项目 BK20160344

详细信息

作者简介:
方琴(1988-), 女, 江苏苏州人，大学本科, 主管护师，主要研究方向为耳鼻咽喉疾病及护理

中图分类号: R181.3 R179 R764.21
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- 被引次数: 0
出版历程
- 收稿日期: 2021-06-23
- 修回日期: 2021-08-31
- 网络出版日期: 2021-12-01
- 刊出日期: 2021-11-25

Analysis of adenoid hypertrophy and secretory otitis media in primary and middle school students in Suzhou

Department of Otorhinolaryngology, the First Affliated Hospital of Soochow University, Suzhou (215006), Jiangsu Province, China

摘要

摘要: 目的分析苏州市7~16岁中小学生腺样体肥大发病情况及并发分泌性中耳炎危险因素，为临床诊断治疗及预后评估提供参考。方法整群分层抽取苏州市2015年1月—2019年12月2 986名7~16岁中小学生为研究对象，采用整群分层抽样调查腺样体肥大疑似病例、磁共振检查确诊的方法，分析7~16岁中小学生腺样体肥大流行病学及并发分泌性中耳炎相关危险因素。结果中小学生发生腺样体肥大327例，检出率10.95%。2015—2019年中小学生腺样体肥大检出率呈逐年上升趋势，2019年检出率10.95%高于2015年9.20%、2016年9.95%。男生腺样体肥大检出率(12.29%)高于女生(9.48%)(χ²=6.04, P < 0.05)。7~10岁腺样体肥大检出率(15.08%)高于11~16岁中小学生(6.36%)(χ²=57.93, P < 0.05)。327例腺样体肥大中小学生中，合并分泌性中耳炎20例，合并率为6.12%。合并分泌性中耳炎组年龄低于未合并组，腺样体肥大严重程度高于未合并组，血清IL-4、TNF-α、IgA、IgG、IgM高于未合并组(P值均 < 0.05)。腺样体肥大并发分泌性中耳炎与年龄、严重程度、IL-4、IgG、IgM相关(P值均 < 0.05)。结论苏州市7~16岁中小学生腺样体肥大发病率较高，与性别、年龄、发病时间及季节有关，且易并发分泌性中耳炎，应引起全社会足够的重视。
- 中耳炎 /
- 流行病学研究 /
- 患病率 /
- 回归分析 /
- 学生
Abstract: Objective To analyze the incidence of adenoid hypertrophy and risk factors for secretory otitis media among primary and middle school students aged 7-16 years in Suzhou, and to provide a reference for its clinical disagnosis, treatment and prognosis. Methods The primary and secondary school students aged from 7 to 16 in Suzhou from January 2015 to December 2019 were selected by using cluster stratified sampling, adenoid hypertrophy cases were screened and diagnosed by MR, the epidemiology of adenoid hypertrophy and related risk factors of complicated secretory otitis media were analyzed among participants. Results Among 327 cases of adenoid hypertrophy were screened, with a prevalence rate of 10.95%. From 2015 to 2019, the prevalence rate of adenoid hypertrophy among primary and middle school students increased by year. The prevalence rate in 2019 was 10.95% higher than 9.20% in 2015 and 9.95% in 2016. The prevalence rate of adenoid hypertrophy in boys was 12.29%, which was higher than 9.48% in girls(χ²=6.04, P < 0.05). The prevalence rate of adenoid hypertrophy between 7-10 years old was 15.08% and higher than 6.36%(χ²=57.93, P < 0.05) for primary and middle school students aged 11-16. Among the 327 primary and middle school students with adenoid hypertrophy, a total of 20 had secretory otitis media, and the combined rate was 6.12%. The age of the combined secretory otitis media group was younger than that of the non-combined group, the severity of adenoid hypertrophy was higher than that of the non-combined group, and serum IL-4, TNF-α, IgA, IgG, and IgM were higher than those of the non-combined group (P < 0.05). Adenoid hypertrophy complicated with secretory otitis media was associated with age, severity, IL-4, IgG, and IgM (P < 0.05). Conclusion The prevalence of adenoid hypertrophy among primary and secondary school students aged 7-16 years in Suzhou is relatively high, which is related to gender, age, time of onset and season. Secretory otitis media in adenoids hypertrophy children and adolescents should attract sufficient attention from the whole society.
- Otitis media /
- Epidemiologic studies /
- Prevalence /
- Regression analysis /
- Students

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表 1 苏州市不同特征中小学生腺样体肥大检出率比较

Table 1. Comparison of the detection rate of adenoid hypertrophy among primary and middle school students with different characteristics in Suzhou City

人口统计学指标	选项	人数	腺样体肥大人数	χ²值	P值
性别	男	1 562	192(12.29)	6.04	0.01
	女	1 424	135(9.48)
年龄/岁	7	390	64(16.41)	66.90	＜0.01
	8	394	60(15.23)
	9	382	57(14.92)
	10	406	56(13.79)
	11	342	28(8.19)
	12	332	26(7.83)
	13	176	14(7.95)
	14	168	10(5.95)
	15	181	8(4.42)
	16	215	4(1.86)
年份/年	2015	587	49(8.35)	12.98	0.01
	2016	583	56(9.61)
	2017	594	59(9.93)
	2018	605	77(12.73)
	2019	617	86(13.94)
注：()内数字为检出率/%。

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表 2 不同组别中小学生腺样体肥大合并分泌性中耳炎检出率比较

Table 2. Comparison of the detection rate of adenoid hypertrophy with secretory otitis media among different groups of primary and middle school students

组别	选项	人数	检出人数	χ²值	P值
性别	男	192	14(7.29)	1.12	0.29
	女	135	6(4.44)
严重程度	轻度	89	1(1.12)	5.66	0.06
	中度	114	8(7.02)
	重度	124	11(8.87)
肥胖程度	正常	131	6(4.58)	1.74	0.42
	超重	119	7(5.88)
	肥胖	77	7(9.09)
注：()内数字为检出率/%。

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表 3 中小学生腺样体肥大并发分泌性中耳炎多因素Logistic回归分析(n=2 986)

Table 3. Multivariate Logistics regression analysis of adenoid hypertrophy complicated by secretory otitis media(n=2 986)

自变量	β值	Wald χ²值	P值	OR值(OR值95%CI)
年龄	0.53	12.78	＜0.01	0.21(0.09~0.50)
严重程度
中度	0.07	1.34	0.25	22.26(0.12~4 273.25)
重度	0.06	0.58	0.45	7.56(0.04~1 364.93)
IL-4	0.31	5.54	0.02	1.07(1.01~1.16)
TNF	0.13	2.92	0.09	1.05(0.99~1.12)
IGA	0.09	1.90	0.17	1.00(1.00~1.01)
IGG	0.35	6.12	0.01	3.20(1.27~8.04)
IGM	0.24	4.00	0.05	1.00(1.00~1.01)

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