2010年包头市城区儿童哮喘流行病学调查研究

Epidemiological survey of childhood asthma in 2010 in urban Baotou, China

摘要:

目的 了解2010 年包头市城区儿童哮喘的患病率、发病规律及诊治情况。方法 2009 年9 月至2010 年8 月采用整群抽样方法对包头市城区0~14 岁儿童进行问卷筛查，对已确诊哮喘患儿做进一步问卷调查。所有数据使用Epi-Info 软件进行录入，并对数据进行统计分析。结果 共接受调查儿童11 323 人，诊断哮喘127 例，患病率1.12%，男童哮喘患病率（1.51%）明显高于女童（0.72%，P<0.01）；2010 年患病率较1990年（0.55%）和2000 年（0.88%）显著上升（P<0.05）；与2000 年相比，2010 年哮喘患儿全身糖皮质激素使用率从60.2% 降至25.9%，吸入激素使用率从13.6% 上升至85.8%，抗生素使用率也从98.1% 降至66.9%，差异均有统计学意义（均P<0.01）；多因素logistic 回归分析显示，影响儿童哮喘发生的独立危险因素为家族过敏史、过敏性鼻炎、慢性咳嗽和反复呼吸道感染。结论 包头市城区儿童哮喘患病率呈上升趋势；吸入激素已经得到广泛应用。

Abstract:

Objective To investigate the prevalence rate of childhood asthma in 2010 in urban Baotou, China, as well as the characteristics of attacks and the status of diagnosis and treatment of childhood asthma. Methods More than 10 000 children (0-14 years) were selected from 3 secondary schools, 3 primary schools, 6 kindergartens, and 4 community vaccination sites in urban Baotou by cluster random sampling between September 2009 and August 2010. A standardized preliminary questionnaire was used for screening out suspected cases, which were then confirmed or excluded by a clinician; the confirmed cases underwent further questionnaire survey. Double entry and validation was adopted for all data using Epi-Info software, and analysis was performed using SPSS 13.0. Results A total of 11 323 children were surveyed. Asthma was diagnosed in 127 cases (including 121 children with typical asthma and 6 children with cough variant asthma), with a prevalence rate of 1.12%. The prevalence rate of asthma in male children was significantly higher than that in female children (1.51% vs 0.72%; P<0.01). The prevalence rate of asthma in 2010 was significantly increased compared with that in 1990 (0.55%) and 2000 (0.88%) (P<0.05). Systemic glucocorticoid use decreased significantly from 60.2% in 2000 to 25.9% in 2010 (P<0.01); inhaled corticosteroid use increased significantly from 13.6% in 2000 to 85.8% in 2010 (P<0.01); antibiotic use decreased from 98.1% in 2000 to 66.9% in 2010 (P<0.01). The multivariate logistic regression analysis showed that family history of allergy, allergic rhinitis, chronic cough, and recurrent respiratory tract infection were independent risk factors for childhood asthma. Conclusions The prevalence rate of childhood asthma in urban Baotou shows an increasing trend. Inhaled corticosteroids have been widely used.