成都地区0~14岁城乡儿童哮喘流行病学调查对比分析

Epidemiological survey and analysis of asthma in children aged 0-14 years old in urban and rural areas of Chengdu region

摘要:

目的：探讨成都地区不同生活环境、不同经济水平和不同卫生条件下0~14岁城乡儿童哮喘的患病率、发病规律及影响因素。方法：首先确定调查对象为中心城区、城镇及农村3个层面的0~14岁儿童，采取随机、整群和不等比抽样方法抽出所需调查的学校、幼儿园及社区的全部0~14岁儿童为调查对象，向家长发放问卷初筛表，然后筛选出相关疾病的可疑患者，再经呼吸专科医师问诊和体查以明确诊断。所有数据经SPSS统计软件分析。结果：中心城区、城镇及农村3个层面实际调查人数分别12082例、5677例及5590例，确诊哮喘、咳嗽变异性哮喘患儿分别为551例、150例及142例，累计患病率分别为4.56%、2.64%及2.54%，中心城区累计患病率明显高于城镇和农村。至调查时中心城区准确诊断率最高，城镇其次，农村诊断率最低。在哮喘的治疗中，从中心城区到城镇到农村，抗生素的使用率逐级增加、吸入激素及白三烯调节剂的使用率呈逐级减少的趋势。3层面显示患儿的性别、年龄、首次发作年龄、呼吸道感染和遗传因素等均与哮喘发病有关。结论：人口密度和生活环境的差异、医疗卫生资源和经济收入的不同可影响哮喘的患病率和治疗。

Abstract:

OBJECTIVE: To investigate the prevalence and incidence of asthma among children aged 0-14 years, with different living environments, economic levels, and sanitary conditions, in the urban and rural areas of Chengdu, China, and their influential factors. METHODS: Children aged 0-14 years who were selected from urban, suburban and rural areas of Chengdu, were included in the study. The subjects were selected from all children aged 0-14 years in schools, kindergartens and communities by random, cluster and non-proportional sampling. Parents were surveyed by questionnaire to find out suspected cases, which were then confirmed by inquiry and physical examination in the department of respiratory medicine. All the obtained data were analyzed using SPSS/PC statistical software. RESULTS: A total of 12082 children from the urban areas, 5677 from suburban areas and 5590 from the rural areas were included in the study. Of all the subjects, 551 (4.56%) had confirmed asthma, 150 (2.64%) had cough variant asthma (CVA), and 142 (2.54%) had suspected asthma. The prevalence rate of asthma was significantly higher in the urban areas than in the suburban and rural areas. The correct rate of diagnosis of asthma and CVA was highest in the urban areas, followed by the suburban and rural areas. Use of antibiotics and systemic corticosteroids was most common in the rural areas, followed by the suburban and urban areas, but this pattern was reversed for use of inhaled corticosteroids and leukotriene modifier. All the results in the three areas demonstrated that sex, age, age at which the first attack occurred, respiratory tract infection, inhalation/intake of allergens and genetic factors were significantly associated with asthmatic attack. CONCLUSIONS: Population density, living environment, medical and health resources and economic level are associated with the prevalence and treatment of asthma