单餐大份量进食是儿童单纯性肥胖的饮食危险因素

目的了解儿童单餐摄食量与肥胖的关系,探索儿童单纯性肥胖的饮食危险因素。方法设计问卷,对202名超重肥胖儿童和209名正常体重儿童进行图片法食量评估、24h膳食回顾、饮食行为及家庭环境等调查。采用logistic回归方法分析儿童单纯性肥胖的饮食危险因素。结果肥胖儿童在单餐进食份量(P<0.05)、每日总能量(P<0.05)及供能营养素摄入量(P<0.05)上明显高于对照组,蔬菜摄入量则低于对照组(P<0.05)。食物图片法分析儿童食量的结果与24h膳食调查结果一致。多因素校正后的回归分析显示儿童肥胖与单餐进食份量(午餐OR=1.003,P<0.05、晚餐OR=1.002,P<0.05)、晚餐能量密度(OR=2.260,P<0.05)、蛋白质摄入量(OR=1.027,P<0.05)密切相关,与总能量及脂肪摄入量无关(P>0.05)。结论单餐大份量、高能量密度进食是儿童肥胖的饮食危险因素,食物图片法可以对儿童日常食量作出良好评价,结合食量及食物能量密度分析的方法能更全面地反映儿童肥胖发生的风险。     

海口市学龄前儿童特应性皮炎流行病学调查

目的 调查海口市学龄前儿童特应性皮炎(atopic dermatitis, AD)流行病学特征及患病危险因素。 方法 2020年10—11月采用问卷与体检相结合的方式调查海口市3~6岁学龄前儿童AD的流行病学特征,并采用logistic回归分析确定患病危险因素。 结果 海口市学龄前儿童AD总患病率为4.79%,其中男性为5.20%,女性为4.33%,3~4岁儿童为5.65%,5~6岁儿童为4.10%,男女及各年龄段患病率差异无统计学意义(P>0.05)。AD患儿病情以轻中度为主,64.95%的患儿在1岁内首次发病,45.36%的患儿合并其他过敏性疾病。经logistic回归分析显示父母过敏史、居住城市、儿童被动吸烟、居住环境潮湿、母亲孕期及儿童出生后居住新装修半年内房屋是学龄前儿童AD患病的独立危险因素。 结论 海口市3~6岁学龄前儿童AD患病率较高,父母过敏史、居住城市、儿童被动吸烟、居住环境潮湿、儿童出生后及母亲孕期居住新装修半年内房屋是学龄前儿童AD患病的独立危险因素。     

我国三省7～13岁儿童血压升高影响因素的初步分析

目的探讨儿童血压升高的影响因素,为制定儿童高血压预防控制措施提供参考依据。方法数据来源于中国疾病预防控制中心青年科研基金我国6~13岁学龄儿童主要慢性病干预模式及适宜技术研究项目,选取江苏、山东、广西3省的调查资料,包括血压测量与相关因素调查,分析儿童血压升高的影响因素。结果共收集2 774名7~13岁儿童的资料,该人群血压升高检出率为28.6%,男、女儿童检出率分别为29.8%、27.1%;城市、乡村儿童血压升高检出率分别为31.5%、24.8%。单因素分析显示,居住地类型(城市或乡村)、居住地区、高血压家族史、超重肥胖、中心型肥胖、身高、出生体重以及早餐、蔬菜、奶制品的食用频率、早餐包括咸菜与儿童血压升高有统计学关联(均有P<0.05);多因素非条件Logistic回归分析显示,居住地类型、超重肥胖、身高、居住地区、早餐包括咸菜是儿童高血压升高的危险因素。结论超重肥胖、常食用咸菜是儿童血压升高的危险因素,控制肥胖是减少儿童高血压的重要措施。     

儿童过敏性鼻炎过敏原调查和相关危险因素分析

目的探讨儿童过敏性鼻炎相关危险因素,为预防儿童过敏性鼻炎提供参考。方法选取2017年2月-2019年1月该院收治的115例过敏性鼻炎患儿为观察组,所有患儿均行过敏原检测,总结过敏原临床特点,选取同期年龄、性别可比行健康体检的非过敏性鼻炎儿童115例为对照组。收集整理两组个体资料,采用单因素分析过敏性鼻炎发病相关影响因素,对其进行多因素Logistic危险因素分析。根据危险因素,探讨儿童过敏性鼻炎防范措施。结果 (1)115例儿童过敏性鼻炎患儿检测明确过敏原108例,检出率93.91%。其中21例患儿的过敏原超过两种。过敏原构成以吸入性过敏原为主,吸入性过敏性原以粉尘螨、屋尘螨、花粉及蟑螂为主,食物性过敏原以牛奶、鸡蛋及海鲜为主;(2)性别、遗传因素、季节、过敏史、合并哮喘、家养宠物、家养花草、居住环境、吸二手烟、居住环境空气质量达标、居住房屋装修情况、空调使用史、家庭人数面积比及居住环境尘螨浓度(P0.05);(3)儿童过敏性鼻炎发病危险因素有:家族过敏性鼻炎史、既往有过敏史、合并哮喘、家养宠物、吸二手烟、近2年居住环境装修及居住环境尘螨浓度≥0.35个/m~2是儿童发生过敏性鼻炎的高危因素,母乳喂养是儿童过敏性鼻炎的保护因素。结论儿童过敏性鼻炎过敏原构成复杂,重视儿童居住环境及避免环境出现常见过敏原,降低儿童过敏性鼻炎发病率,提高儿童健康水平。     

父母居室内吸烟对儿童呼吸系统疾病和症状的影响研究

目的探讨居室内烟草烟雾暴露对儿童呼吸系统疾病和症状的影响,为呼吸系统疾病的预防和控制提供依据。方法于2014年5—7月采用随机整群抽样方法,调查上海市某区8所小学和4所幼儿园4 101名4~12岁儿童持续咳嗽、喘息、哮喘现患、支气管炎患病情况,及儿童性别年龄、家庭社会经济因素、父母哮喘与过敏性疾病史、居室内外环境因素、家人在室内吸烟情况,分析二手烟暴露对儿童呼吸系统疾病和症状的影响。结果 47.11%(1 932/4 101)的被调查儿童暴露于二手烟。在调整了个体、家庭社会经济、遗传及居室内外环境等混杂因素后,多因素二分类非条件logistic回归分析结果显示,父亲吸烟、父母均吸烟是儿童持续咳嗽、喘息、支气管炎的危险因素(OR值分别为2.06,1.81,1.87和4.02,5.62,3.74,P0.05),母亲吸烟是儿童喘息、支气管炎的危险因素(OR值分别为2.36,1.95,P0.05),父母均吸烟时对呼吸系统疾病和症状的影响(OR值)均高于父母一方吸烟者,其他家庭成员吸烟的影响未见统计学意义(P0.05)。室内吸烟量与儿童呼吸系统疾病和症状有关联,随着吸烟量的增加,OR值逐渐升高(在1.62~2.80之间)。结论父母居室内吸烟是儿童呼吸系统疾病与症状的危险因素,室内二手烟暴露量趆高,发生呼吸系统疾病与症状的风险越高。     

母孕期及新生儿期危险因素与儿童支气管哮喘的关系探讨

目的:探讨儿童支气管哮喘和孕母期及新生儿期危险因素的关系,给临床治疗该类疾病提供理论依据。方法:选取2014年2月-2016年2月在医院收治的148例支气管儿童患者作为观察者,并选取同期的148例来我院体检的正常儿童作为对照组,回顾性分析患儿的临床资料以及患儿母亲在孕期的情况、出生时的情况。结果:孕母中过敏家族史、妊娠呕吐、吸烟或二手烟和新生儿早产、病理性黄疸、频繁呼吸道感染、机械通气均是婴儿童支气管哮喘的危险因素,观察者和对照组见发生率差异明显,具有统计学意义。另外母乳喂养是儿童支气管哮喘的保护因素。结论:过敏家族、病理性黄疸、吸烟或二手烟、机械通气是儿童支气管哮喘的独立危险因素,母乳喂养是保护因子。     

江苏海安地区40岁以上人群支气管哮喘患病率及影响因素

目的探究海安地区40岁以上人群支气管哮喘患病率及其发病的流行病学特征。方法采用分层随机抽样法对江苏海安地区40岁以上常住居民进行问卷调查及肺功能测定,分析哮喘患病情况及流行病学特征。结果研究共收集有效问卷2237份,发现支气管哮喘患者116例,发病率为5.19%;哮喘患病率与性别、年龄、家族史、主被动吸烟、职业暴露、幼年存在肺部疾病史、存在呼吸道过敏史、接触烹饪油烟有关(P<0.05);多因素logistic回归分析显示,男性(OR=0.637,95%CI:0.499~0.691)是哮喘患病的保护因素,高龄(OR=1.438,95%CI:1.207~1.972)、主动吸烟(OR=1.795,95%CI:1.423~2.399)、被动吸烟(OR=2.098,95%CI:1.423~2.399)、职业暴露(OR=3.446,95%CI:2.175~6.290)、幼年存在肺部疾病史(OR=2.228,95%CI:1.337~4.491)、存在呼吸道过敏史(OR=2.287,95%CI:1.535~5.219)是影响哮喘患病的危险因素(P<0.05)。结论海安地区40岁以上人群支气管哮喘患病率偏高,高龄、主被动吸烟、职业暴露、幼年存在肺部疾病史、存在呼吸道过敏史与哮喘患病有关。临床需加强高危人群哮喘防治工作,从而降低哮喘的发病。     

毛细支气管炎后患儿发生哮喘的相关危险及保护因素筛查

目的 对毛细支气管炎后患儿发生哮喘的危险因素进行筛查.方法 收集毛细支气管炎患儿220例的临床及随访资料,对性别、治疗方法、免疫接种、特异性体质、喂养方式、哮喘家族史等进行调查统计,筛选毛细支气管炎后发生哮喘的危险因素.结果 单因素分析显示不同性别的毛细支气管炎患儿哮喘发生率比较差异无统计学意义(P＞0.05),按时接种卡介苗、使用大剂量免疫球蛋白治疗的患儿哮喘发生率低于未按时接种卡介苗及未使用大剂量免疫球蛋白治疗者(P＜0.01),有特异性体质、有哮喘家族史的患儿哮喘发生率高于无特异性体质及无哮喘家族史者(P＜0.01),肥胖患儿哮喘发生率高于非肥胖者(P＜0.05),母乳喂养＞4个月患儿哮喘发生率低于非母乳喂养＞4个月者(P＜0.05).多因素回归分析显示有哮喘家族史、肥胖、有特异性体质是毛细支气管炎患儿发生哮喘的危险因素,使用大剂量免疫球蛋白治疗、按时接种卡介苗、母乳喂养＞4个月是毛细支气管炎患儿发生哮喘的保护因素.结论 有哮喘家族史、有特异性体质、肥胖是毛细支气管炎患儿发生哮喘的危险因素,免疫球蛋白治疗及按时接种卡介苗是减少哮喘发生的保护因素,尤其值得应用在有上述危险因素的患儿中.     

富阳区学龄期儿童肥胖现状调查及影响因素分析

目的探讨富阳区学龄期儿童肥胖现状调查及影响因素,为控制和预防儿童肥胖提供参考。方法选择富阳区2017年1月-2017年12月部分小学就读的学龄期儿童1 640人作为研究对象,发放问卷调查表,包括性别、年龄、肥胖家族史、食欲、吃甜食、油炸食品、周末锻炼时间、上网看电视时间。结果 820例学龄期儿童发放问卷调查1 640份,收回1 640份,回收率为100%。共检出肥胖儿童162例,肥胖率为9. 88%。经单因素分析,肥胖组与非肥胖组性别和年龄比较差异无统计学意义(P0. 05);肥胖组肥胖家族史多于非肥胖组,食欲欠佳多于非肥胖组,喜欢吃甜食非肥胖组,喜欢吃油炸食品多于非肥胖组,周末锻炼时间2 h多于非肥胖组,上网看电视时间≥2 h多于非肥胖组,两组比较差异具有统计学意义(P0. 05)。将上述单因素分析差异具有统计学意义的纳入多因素Logistic回归分析,肥胖家族史、喜欢吃甜食、喜欢吃油炸食品、周末锻炼时间2 h和上网看电视时间≥2 h为影响学龄期儿童肥胖独立危险因素。结论富阳区学龄期儿童肥胖发病率较高,肥胖家族史、吃甜食、吃油炸食品、周末锻炼时间和上网看电视时间为影响其独立危险因素。     

台州、大理农村5岁以下儿童家庭二手烟暴露情况与影响因素分析

目的了解台州、大理农村地区5岁以下儿童家庭二手烟的暴露情况并探索其影响因素,为制定减少儿童家庭二手烟暴露的干预措施提供科学依据。方法 2018年4—6月期间采用多阶段随机抽样的方法,对台州与大理所属农村地区与5岁以下儿童共同居住的吸烟者进行一对一问卷调查,最终获得658份有效问卷。结果与吸烟者共同居住的农村儿童家庭二手烟暴露率为59.4%;多因素分析显示,与无吸烟规定相比,家庭室内完全禁止吸烟(OR=0.62,95%CI:0.39～0.99)可降低儿童家庭二手烟暴露风险;吸烟者年龄在30岁以下(OR=3.74,95%CI:1.99～7.04)、家庭月收入3000元以下(OR=1.91,95%CI:1.33～2.73)、吸烟者对尼古丁的依赖在中度及以上时(OR=2.06,95%CI:1.46～2.92)可增加儿童家庭二手烟暴露风险;此外,其他家人吸烟(OR=1.53,95%CI:1.09～2.15)与访客吸烟(OR=1.75,95%CI:1.19～2.58)也可使儿童家庭二手烟暴露风险增加。结论台州、大理农村地区5岁以下儿童家庭二手烟暴露情况较严重,帮助吸烟者戒烟、建立家庭室内吸烟规定是保护儿童免遭家庭二手烟暴露的有效手段。     

Effects of environmental tobacco smoke on lower respiratory system of children under 5 years of age

OBJECTIVE: To determine the effects of second-hand smoke in the respiratory system of children under 5 years old. METHODS: A cross sectional study of a total of 1,104 children under 5 years old. Information about respiratory symptoms and illness, family history of respiratory diseases, smoking habits of household members and housing conditions were assessed by home interviews with the children's parents. RESULTS: We studied 546 boys and 558 girls. Among 611 children exposed to second-hand smoke, 82% had respiratory problems (odds ratio = 1.64; 95% confidence interval: 1.21-2.20). Children whose parents were smokers at the time of the survey were more likely to experience wheezing than children of nonsmoking parents (odds ratio = 1.66; 95% confidence interval: 1.21-2.27), shortness of breath (odds ratio = 1.91; 95% confidence interval: 1. 36-2.67), morning and day time or night coughs (odds ratio = 1.58; 95% confidence interval: 1.09-2.28). The odds ratio for asthma, bronchitis and pneumonia was greater for children exposed to second-hand smoke (odds ratio = 1.60; 95% confidence interval: 1. 11-2.31). CONCLUSIONS: Maternal smoking, paternal smoking, family history of respiratory diseases, and housing conditions are considered risk factors for respiratory diseases in children.     

Effect of television advertisements for foods on food consumption in children

The impact of television (TV) advertisements (commercials) on children's eating behaviour and health is of critical interest. In a preliminary study we examined lean, over weight and obese children's ability to recognise eight food and eight non-food related adverts in a repeated measures design. Their consumption of sweet and savoury, high and low fat snack foods were measured after both sessions. Whilst there was no significant difference in the number of non-food adverts recognised between the lean and obese children, the obese children did recognise significantly more of the food adverts. The ability to recognise the food adverts significantly correlated with the amount of food eaten after exposure to them. The overall snack food intake of the obese and overweight children was significantly higher than the lean children in the control (non-food advert) condition. The consumption of all the food offered increased post food advert with the exception of the low-fat savoury snack. These data demonstrate obese children's heightened alertness to food related cues. Moreover, exposure to such cues induce increased food intake in all children. As suggested the relationship between TV viewing and childhood obesity appears not merely a matter of excessive sedentary activity. Exposure to food adverts promotes consumption.     

Obesity and its association with diets and sedentary life style among school children in Seoul, Korea: Compliance with Dietary References Intakes for Koreans food guides

This study compared obese children''s food group intakes with the new Dietary References Intakes for Koreans (KDRIs) food guides for 5th-6th grade school children. This study also determined the extent of sedentary life styles related with obesity in this area of children. This is a cross-sectional study of 799 school children. The dietitian sent a survey form describing the project and a questionnaire to the subject''s family. The questionnaire included child demographics, family history of chronic diseases, the daily servings of five food groups, such as grains, meat and beans, dairy products, fruits, and vegetables. The daily or weekly hours of physical activity, television viewing, and computer usage were also surveyed. Obesity index (%) of the subjects was calculated, and children with an obesity index (%) equal to or greater than 20 were classified as the obese. Among the 799 participants, 50.7% were female. The percentages of the normal and the obese were 691 (86.5%) and 108 (13.5%) respectively. Obese children reported eating less vegetables (p<0.05), more high sugar snacks (p<0.05), and high fat snacks (p<0.05) than normal children. No significant differences in food servings of grains, meats and beans, and fruits, and dairy products between the normal and the obese were shown. Obese children reported fewer hours of physical activities (p<0.05) and more hours of computer usage (p<0.05) than normal children. Girls showed less likelihood of being obese (odds ratio, 0.575, CI (0.38, 0.87), p<0.05). More hours of physical activity significantly decreased the likelihood of being obese (odds ratio, 0.572, CI (0.35, 0.92), p<0.05). Family history of obesity almost doubled the likelihood of obesity in children (odds ratio, 2.653, CI (1.660, 4.241), p<0.05). In conclusion, frequent snacking, inadequate vegetable consumption, and sedentary lifestyle increased significantly the likelihood of obesity in children, which suggest that obesity intervention in this age group should focuse more on those variables.     

郑州市6~14岁儿童支气管哮喘影响因素分析

目的 探析6~14岁儿童支气管哮喘发生相关因素。方法 对2019年郑州市某医院全年收治的6~14岁儿童支气管哮喘患者（观察组）和健康儿童（对照组）及其家长进行调查,对2组儿童的体质指数（BMI）、家族哮喘史、饲养宠物、家中使用地毯、家人吸烟、室内居住环境、个人食物过敏史、上呼吸道感染史等因素进行比较分析。结果 本研究共对支气管哮喘儿童（观察组）176例、健康儿童473人进行调查。观察组男、女童分别占54.55%、45.45%,对照组分别占59.41%、40.59%,2组儿童年龄、性别构成分布差异均无统计学意义（均P>0.05）。多因素非条件Logistic回归分析结果显示,超重、肥胖（OR=3.537,2.956）、家族哮喘史（OR=4.536）、家人吸烟（OR=3.764）、室内居住环境有霉斑（OR=3.679）、个人食物过敏史（OR=4.403）、上呼吸道感染史（OR=7.043）的6~14岁儿童发生支气管哮喘的风险更高。结论 家族哮喘史、肥胖与支气管哮喘发病密切相关,个人食物过敏史、上呼吸道感染史为儿童支气管哮喘高危因素,家人吸烟、居住环境有霉斑等均与此年龄段儿童支气管哮喘发生相关,因此家庭及社会应加强危险因素的防控,远离哮喘过敏源与诱因,预防儿童呼吸系统疾病的发生。     

Beyond-brand effect of television (TV) food advertisements/commercials on caloric intake and food choice of 5-7-year-old children

Food advert exposure has been shown to influence calorie intake and food choice in 9-11 year olds. However, little is known about the effect of food advertisements on feeding behaviour in younger children. Therefore, we conducted a study with 93 children aged 5-7 years, 28 of whom were over weight or obese. The children were exposed to 10 non-food adverts and 10 food adverts in a repeated measures design. Their consumption of sweet and savoury, high and low fat snack foods, and fruit were measured following both sessions. Food advert exposure produced a significant increase in total food intake in young children. The collection of recognition data was incomplete. These data replicate previous findings in that exposure to food adverts increases food intake in all children, but recognition of food adverts is related to body mass index (BMI). Beyond their effects on brand choice, exposure to food advertisements (commercials) promotes over-consumption in younger children.     

儿童单纯性肥胖症发生危险因素的Meta分析

目的：综合评价我国儿童单纯性肥胖症发生的危险因素。方法：应用Meta分析方法对国内21篇有关儿童单纯性肥胖危险因素的病例对照研究进行定量综合分析。统计处理采用Meta分析的效应模型和随机效应模型。结果：父母至少一方肥胖，出生时体重过大、食欲好、食量大、常吃油腻食物、喜爱甜食、过多吃零食、进食速度快、偏／挑食、每天看电视时间过长以及不爱参加体育活动等因素的合并OR值分别为2．35、1．64、2．44、10．52、3．33、2．39、2．23、1．93、5．09、0．40、2．09和3．29。结论：父母肥胖史、高出生体重、活动少和不良饮食习惯包括常吃油腻食物、喜欢甜食、过多吃零食、食欲好、食量大、进食速度快等与儿童单纯性肥胖症发生有关。     

广州、佛山两地学龄期儿童家庭二手烟暴露及自我保护行为调查研究

目的 了解广州、佛山地区学龄期儿童家庭二手烟暴露情况及其面对暴露时的自我保护行为。方法 采用自行编制的学龄期儿童二手烟暴露及自我保护行为问卷,对广州、佛山两地共385名三年级以上的小学生进行问卷调查。结果 9.2%的小学生曾经尝试过吸烟,且男童显著高于女童(χ²=9.269,P=0.002);46.8%的学龄期儿童与1个或以上的吸烟者同住,且42.6%的吸烟者每天吸烟;学龄期儿童家庭二手烟暴露的来源除了家庭成员,还有客人,其中29.3%学龄期儿童在调查前一个月内曾暴露在客人的二手烟中,42.6%的家人会主动提供香烟给客人;暴露的场所除了家庭室内还有私家车;但90%以上的学龄期儿童不认可吸烟行为,且认为二手烟对自身有害;面对二手烟暴露,98.8%学龄期儿童会采取主动或者被动的自我保护行为,并且其中大部分会尝试劝家人戒烟,而女童更倾向于劝解家人戒烟(χ²=7.161,P= 0.012)。66.7%的吸烟家长被儿童劝解戒烟后会有积极的改变,其中有8.8%学龄期儿童报告吸烟者戒烟了。结论 广州、佛山地区学龄期儿童家庭二手烟暴露情况不容乐观,儿童对被动吸烟有一定的自我保护能力,在性别方面需要针对性的指导。控烟工作应注意将儿童与家长结合起来,共同创建无烟家庭。     

海口市学龄前儿童哮喘的影响因素分析

目的 调查和分析海南省海口市儿童哮喘发病的危险因素,以期为儿童哮喘预防提供参考。方法 通过整群抽样调查法对2016年1月-12月海口市城区13所幼儿园、社区保健机构单位7 256例3～6岁的儿童进行儿童哮喘流行病学问卷调查,通过Logistic回归分析法了解哮喘儿童发病的高危因素。结果 对海口市的学龄前儿童调查发现,哮喘预测指数阳性率为6.74%;影响哮喘发病的因素十分复杂,其中最主要的独立危险因素为个人药物过敏史(OR＝8.437,95%CI:1.538~22.643)、食物过敏史(OR＝5.463,95%CI:1.578~21.727)、过敏性鼻炎(OR＝7.847,95%CI:1.584~25.684)以及家族过敏史(OR＝7.443,95%CI:1.843~13.614)。结论 海南省海口市儿童哮喘发病率较高,和多种因素有关,其中个人药物过敏史、食物过敏史、过敏性鼻炎以及家族过敏史是造成儿童哮喘发病的独立危险因素,必须引起重视,进一步规范治疗。     

Gender-specific differences in effects of prenatal and postnatal environmental tobacco smoke exposure on respiratory symptoms in 23,474 children with and without allergic predisposition: results from 25 districts of northeast China

To assess the interaction of environmental tobacco smoke (ETS) exposure and allergic predisposition regarding respiratory health among Chinese children, a sample of 23,474 children (6-13 years old) was studied from 25 districts in Liaoning province, China. The results showed that children without allergic predisposition were more susceptible to ETS than children with allergic predisposition. Among children without allergic predisposition, ETS exposure was associated with more respiratory symptoms and diseases in boys than in girls; In utero ETS exposure was associated with history of asthma (OR, 1.86; 95% CI, 1.44-2.40) and current asthma (OR, 2.25; 95% CI, 1.48-3.44) only among boys without allergic predisposition. Among children with allergic predisposition, more associations between ETS exposure and respiratory symptoms and diseases were detected in girls. In conclusion, ETS exposure was more evident in boys without family atopy history and more associations were detected in girls with family atopy history.