哮喘儿童主观生活质量研究

目的 探讨哮喘对儿童主观生活质量的影响,以及生活质量测评在哮喘儿童健康评估中的意义.方法 抽取9～12岁健康儿童189例,哮喘儿童128例,其中病情已控组60例,未控组68例,应用儿少主观生活质量问卷进行对照评估研究.结果 哮喘未控组儿童主观生活质量在认知、情感水平及总体满意度显著低于哮喘已控组及健康组(P均<0.05),哮喘已控组情感水平满意度高于健康组(P<0.05).结论 哮喘末控制影响患儿主观生活质量满意度,提高哮喘儿童主观生活质量关键是控制疾病.     

父母管理与支气管哮喘儿童的生活质量

目的评估父母对哮喘的认知、态度、健康理念、自我效能、自控能力及外部资源与父母管理策略应用的相关性;分析父母管理行为中,不同程度自控能力与哮喘疗效间的关系。方法采取横断面研究设计,共纳入151份哮喘患儿及其家长的有效调查问卷。结果父母的外部资源、自我效能、自控能力是父母坚持日常预防及哮喘规范化治疗的重要影响因素。父母管理行为与患儿哮喘治疗的疗效呈中度相关。患儿父母的管理策略越多元化,其子女拥有的体能、学习能力及生活质量就越好。家庭不同阶段自控能力与患儿肺功能及生活质量呈显著的线性关系。结论对父母自我效能及自控能力的干预,可有效提高学龄期哮喘儿童的生活质量。     

运动康复训练对支气管哮喘儿童运动能力和生活质量干预效果的系统评价

目的 系统评价运动康复训练对支气管哮喘儿童运动能力和生活质量的干预效果。 方法 检索PubMed、Cochrane Library、Web of Science、EBSCO、中国知网、维普数据库、万方数据库等数据库从建库至2021年2月关于运动康复训练对支气管哮喘儿童影响的随机对照试验。采用RevMan 5.3软件进行Meta分析。 结果 共纳入14项研究,共计990例受试者。Meta分析结果显示：（1）运动康复组运动能力优于常规治疗组：6 min步行试验的步行距离（MD=108.13,P<0.01）、自我疲劳感觉值（MD=-2.16,P<0.001）、峰值功率（MD=0.94,P=0.001）均显著优于常规治疗组;（2）在儿科哮喘生活质量问卷中,运动康复组生活质量总评分（SMD=1.28,P=0.0002）显著高于常规治疗组,活动受限评分（SMD=1.38,P=0.0002）、症状评分（SMD=1.02,P<0.001）、情感功能评分（SMD=0.86,P<0.001）均显著高于常规治疗组。 结论 运动康复训练对支气管哮喘儿童运动能力和生活质量具有一定的改善作用,但受纳入研究数量和质量的限制,作为指导临床应用还需进一步研究和验证。     

儿童支气管哮喘的心理治疗

支气管哮喘是儿童期较常见的一种变态反应性疾病。是一种以嗜酸粒细胞、肥大细胞和T淋巴细胞反应为主的气道变应性炎症和气道高反应性为特征的疾病。临床表现为反复发作伴有哮鸣音的呼气性呼吸困难。是儿童期常见的慢性疾病,严重威胁儿童健康。近几年其发病率和死亡率均呈上升趋势。许多研究已证实儿童哮喘与心理因素存在一定关系,社会心理因素对患儿的哮喘促发起直接或间接作用。免疫学研究也发现支气管哮喘变态反应的启动与心理因素有很大关系。1心理因素与哮喘发作的关系随着医学模式的转变,有关行为、精神及心理因素与哮喘的关系逐渐受…     

哮喘儿童吸入糖皮质激素治疗回顾性分析

对哮喘患儿进行长期、持续、规范化治疗是提高哮喘综合管理水平的关键。我科哮喘学组自1996年1月起 ,遵循《全球哮喘防治创议》(GlobalInitiativeforAsthma,GINA)[1]及1993年、1998年中华医学会儿科呼吸学组制定的哮喘防治指南 [2 ,3],进行以糖皮质激素 (glucosecorticosteroid,GCS)吸入为主的治疗措施 ,现总结如下。对象与方法一、对象1996年1月～2000年12月接受糖皮质激素吸入治疗的支气管哮喘患儿326例 ,男178例 ,女148例 ,男女之比为1∶2。首次就诊时的年龄范围为2个月～16岁 ,其中2个月～3岁91例(占27.9 % ) ,～6岁137例 (占42.0 %…     

上海嘉定地区支气管哮喘儿童常见过敏原分析

目的 探讨上海嘉定地区儿童哮喘的致敏原以及哮喘患儿年龄与过敏原的相关性.方法 351例哮喘儿童按年龄分组,用15种标准化的吸入性过敏原和食物性过敏原点刺液对所有患儿进行皮肤点刺试验,观察阳性率及不同年龄组过敏原情况.结果 (1)哮喘患儿吸入性过敏原阳性率为71.2%,其排序依次为粉尘螨(49.6%)、屋尘螨(49.0%...     

内皮素与儿童支气管哮喘的相关性

支气管哮喘(简称哮喘)严重影响儿童、青少年的生长发育。内皮素(ET)是哮喘发病过程中的重要因子。ET在哮喘患儿血浆中高水平表达,可减少呼吸道上皮细胞的繁殖、移植和呼吸道平滑肌细胞异常增殖和呼吸道重塑;ET是哮喘的启动因子,刺激肺组织分泌炎性介质,加重哮喘;通过对染色体基因片段影响,导致哮喘家族性遗传。动物实验中发现ET抗体能抑制哮喘发生发展,在人类是否有效有待进一步探讨。     

哮喘儿童体外过敏原抗体280例调查研究

目的了解东莞市哮喘儿童过敏原分布情况。方法（1）问卷调查；（2）用UniCAP100全自动检测仪、荧光免疫检测法、体外检测哮喘组及肺炎组（对照组）患儿血清过敏原抗体。吸人性过敏原筛查包括：螨及屋尘螨、粉尘螨等。食人性过敏原筛查（FX5E）：主要为牛奶、鸡蛋、虾、螃蟹、鱼等。结果吸人性过敏原筛查：肺炎组受检296例患儿中，阳性为75例（25．33％）；哮喘组受检280例患儿中，阳性为230例（82．14％）。食人性过敏原筛查：肺炎组受检296例患儿中，阳性为45例（15．20％）；哮喘组受检280例中，阳性为142例（50．71％）。哮喘组与肺炎组间吸人性过敏原、食人性过敏原差异均有统计学意义（P〈0．05）。哮喘组对尘螨呈高敏感趋势，而且阳性率随年龄增长而增长，呈正相关关系。哮喘组对食人性过敏原较为敏感者，主要是对海鲜类过敏，其次为常见蔬果过敏。结论本组受检哮喘儿童吸人性过敏原中，主要过敏原为尘螨。而且阳性率及过敏反应程度随年龄的增长而增长，呈正相关关系。部分哮喘儿童对海鲜类食物过敏，其次是对常见蔬果类过敏。     

剖宫产与儿童支气管哮喘的Meta分析

目的探讨剖宫产与支气管哮喘(哮喘)发生的关系。方法检索Pubmed、中国知网、万方数据库和重庆维普数据库中剖宫产与哮喘发生的相关文献,并应用RevMan 5.0软件对符合入选标准的文献进行异质性检验和效应值合并,同时进行敏感性分析和偏倚评估。结果纳入符合条件的相关文献共8篇,其中哮喘组32 622例,对照组890 876例。剖宫产与哮喘发生关系的研究间有异质性(P=0.000 4),故采用随机效应模型进行分析。剖宫产与哮喘的各研究的合并OR值(95%CI)为1.22(1.10～1.36),Z=3.76,P=0.000 2。各研究的敏感性分析结果稳定且无发表偏倚。结论剖宫产与哮喘的发生密切相关。     

癫痫儿童生活质量的研究

目的研究癫痫儿童的生活质量。方法应用美国癫痫生活质量量表，对１９２例癫痫儿童进行生活质量的评估，探讨影响因素并与正常儿童进行比较。结果癫痫儿童的生活质量明显低于正常儿童，主要表现在对发作的恐惧、长期用药的担忧、认知功能的障碍及社会交往的困难。即使发作已被控制，其生活质量并无明显改善。生活质量高低因发作类型不同而各异。结论对癫痫儿童应加强综合治疗，特别要进行心理干预，才能提高其生活质量。     

中文版儿童生命质量哮喘特异性量表的信度和效度评价

目的：评价简体中文版儿童生命质量（PedsQLTM）哮喘特异性量表家长报告的信度和效度。方法：采用 PedsQLTM 哮喘特异性量表家长报告量表及自设一般情况问卷,对重庆医科大学附属儿童医院哮喘中心就诊的 233 例哮喘患儿及其家长进行问卷调查。用克朗巴赫α系数考核其信度,分别用探索性因子分析、相关分析考核其效度。结果：中文版 PedsQLTM 哮喘特异性量表家长报告全量表、症状相关问题、治疗相关问题、担心相关问题、沟通相关问题的α系数分别为0.86、0.80、0.78、0.89和0.93,表明量表有较好的内部一致性。通过因子分析共提取7个公因子,与量表基本结构一致,主成分累积贡献率接近 66%。4个维度得分与所含条目得分间均有较强的相关关系(r=0.41~0.92, P＜0.01)。结论：中文版PedsQLTM 哮喘特异性量表家长报告有良好的信度和效度,与原语言版本一致,可适用于中国哮喘患儿健康相关生命质量评价。［中国当代儿科杂志,2010,12(12)：943-946］     

先天性神经管缺陷患儿生活质量评价

目的对种经管缺陷患儿生活质量作一评价。方法1983年1月至1997年12月随访105例神经管缺陷患儿,年龄1天～11岁,采取门诊随访及信访方式,时间3个月～14年,平均（3．89±3．53）年。结果77．22％的患儿生活质量下降,主要表现在运动功能、括约肌功能、性功能及智力方面。病变部位越高,生活质量越低下;伴有脑积水的患儿智商较易受影响。结论神经管缺陷患儿多数留有后遗症,其严重程度主要与病变部位、病变类型及脑积水有关。     

自我管理教育对哮喘患儿生命质量的影响

目的通过对哮喘患儿及其家长的自我管理教育,使患儿的临床症状、药物需求量、肺功能和呼吸道反应性等方面产生明显改善同时,再采用哮喘儿童生命质量调查问卷（PAQLQ）,评估自我管理教育对哮喘患儿生命质量的影响,以期通过哮喘自我管理教育有效提高哮喘患儿的生命质量。方法将确诊为支气管哮喘的75例6～14岁的门诊及住院患儿随机分为教育组38例,对照组37例,采用中国版的PAQLQ,二组初诊时、0.5年后均作生命质量评估,并将二组教育前后问卷结果及二组间问卷结果进行比较。结果0.5年后教育组及对照组二组生命质量症状、活动、情感各方面得分及总得分均有显著提高,但教育组生命质量症状、活动、情感各方面得分及总得分均显著高于对照组（Pa〈0.01）。结论对哮喘患儿及其家长进行自我管理教育及生命质量评估能显著提高哮喘患儿的生命质量。     

Health-Related Quality of Life in Children Attending a Cardiology Clinic

Our purpose was to evaluate the impact of suspicion or confirmation of heart disease on the physical and psychosocial health of children. We utilized the Child Health Questionnaire (CHQ PF-50). Children ages 5 to 18 years attending a general cardiology clinic were eligible. Those with primary noncardiac diagnoses unrelated to heart disease were excluded. Children with similar conditions were grouped together for analysis. Group and subgroup means were compared to a U.S. population normative sample using the two-sample t test. The CHQ was administered to 321 patients (median age, 10.6 years). Overall, parents reported mean Physical and Psychosocial Summary Scores comparable to those for the normative sample (mean, 51.5 vs 53.0, p = 0.04; mean, 52.3 vs 51.2, p = 0.10). There was a trend toward worse physical health in most subgroups, especially those with cardiomyopathy (CM) (46.5; p = 0.01), and a comparable trend toward better psychosocial health except in those requiring major interventions. In subscale analyses, most subgroups reported worse Physical Functioning than the normative sample, especially CM (85.1 vs 96.1; p = 0.02). Parents of children with CM (53.2 vs 73.0; p = 0.002) and the intervention subgroups (except minor) reported worse General Health Perceptions. Parents experienced increased Parental Impact—Emotional, especially parents of children undergoing evaluations for chest pain (62.5 vs 80.3; p = 0.007). Most parents reported comparable or better health for the Family Cohesion and Bodily Pain subscales. Generally, parents of children attending a cardiology clinic report physical and psychosocial health comparable to that for the general U.S. population. However, diagnosis or confirmation of heart disease resulted in worse physical functioning and health perceptions and a significant negative emotional impact on parents.     

The Paediatric Asthma Caregiver's Quality of Life Questionnaire in Swedish parents

With the Paediatric Asthma Caregiver's Quality of Life Questionnaire (PACQLQ), parents grade impaired activities (5 items) and emotional concern (8 items) from 1 to 7 regarding how much their own quality of life (QoL) has been affected by the disease of their child during the last week. The questionnaire was translated into Swedish. To test the feasibility and validity of the Swedish version, 71 asthmatic children and their families were approached. Sixty-one families (86%) participated. The mean age of the children was 8.7 y. Parental grading of symptoms (Spearman's rho = 0.637, p < 0.001), the asthma-specific QoL of the child (rho = 0.359, p = 0.002) and gradings of asthma from medical records (mild asthma median score 6.69, moderate 6.27 and severe 5.12, p = 0.001) were all related to overall PACQLQ scores. The sex of the child, the presence of other diseases related to allergy, peak flow rate (PEFR) and socio-economic level did not affect the scores. Lower scores in the emotional domain were seen in parents of children on steroids (p = 0.049). The distribution of scores was heavily skewed towards the positive end of the scale, leading to limited power to discriminate among parents of children with mild asthma. The instrument had good internal consistency and was well accepted by the parents.     

PPD反应与发作期哮喘患儿ECP IgE及细胞因子表达的关系

目的：探讨PPD反应与发作期哮喘患儿ECP,IgE及细胞因子表达的关系。方法：实验分健康对照组和哮喘发作组,均进行结核菌素纯蛋白衍化物(PPD)试验。观察PPD反应与哮喘临床症状、肺通气功能测定。血清ECP、IgE等的关系以及PPD试验后哮喘患儿外周血IFN-γ,IL-4,IL-12P40 mRNA的表达。结果：哮喘患儿PPD阴性者(24/32例)明显多于阳性者(8/32例),且PPD反应阴性患儿哮喘中/重度发作(16/24例)较PPD阳性患儿(2/8例)多,P<0.05。PPD阴性的哮喘患儿血嗜酸性细胞阳离子蛋白(ECP)及IgE较PPD阳性的哮喘患儿明显增高(P<0.05)。哮喘患儿PPD试验后IL-12 P40 mRNA,IFN-γ mRNA无明显变化,而IL-4 mRNA升高较对照组明显(P<0.05),致IFN-γ/IL-4 mRNA比值下降。结论：PPD反应阴性的哮喘患儿可能存在着细胞免疫功能低下。PPD正向免疫刺激作用在哮喘患儿中受到抑制。[中国当代儿科杂志,2003,5(1):20-22]     

支气管哮喘儿童的心理行为评价

目的分析支气管哮喘儿童的心理行为。方法采用儿童行为量表（CBCL）分别对支气管哮喘和健康儿童各100名进行问卷调查，并计算总分和行为因子，用SPSS12．0统计软件进行对比分析。结果哮喘儿童行为问题发生率显著高于健康儿童组，两组比较有显著差异（P〈0．05）；哮喘与同性别健康儿童的行为问题因子比较有显著差异（P〈0．05）。结论支气管哮喘儿童易发生心理行为异常。     

Quality of life in children with undiagnosed and diagnosed asthma

This study describes the impact of undiagnosed and diagnosed asthma on quality of life in schoolchildren aged 7–10 years and their caregivers in a cross-sectional community-based study. Diagnosed asthma was defined as the parents’ confirmation of a physician’s diagnosis of asthma. Undiagnosed asthma was defined by asthma symptoms combined with airway reversibility or bronchial hyperresponsiveness. Quality of life was evaluated in all children with asthma and a sample of healthy controls by the Pediatric Asthma Quality of Life Questionnaire, and by the Paediatric Asthma Caregiver’s Quality of Life Questionnaire. We studied the impact of breathing problems on school absence. Compared with healthy controls, quality of life scores among children and their caregivers were lower if the child had asthma (P < 0.05), with lowest scores in diagnosed asthma (P < 0.05 compared with undiagnosed asthma). Children with asthma reported more school absence (P < 0.05), with highest absence rate in those with diagnosed asthma. In conclusion, both undiagnosed and diagnosed asthma have a significant impact on the quality of life of both children and their caregivers.     

Perceived Quality of Life and Health of Hospitalized Children

Objective  The purpose of the current study was to examine the impact of disease and hospitalization on children’s quality of life. Method  Three measures were administered to 105 participants ranging in age from 6 to 15 years, from public hospitals in Castilla y Leon (Spain). Data were collected throughout 9 months. Measures were the Survey on Subjective Perception of Hospitalization and Hospital (CPSH), the quality of life survey KINDL, and the health survey SF-36. Internal consistency coefficients were acceptable for most of scales and subscales. Results indicated that children experience a decrease in their quality of life, mainly in daily living activities and psychological well being; that emotional states impact their quality of life, and that hospitals need to make some changes to better meet the needs of hospitalized children. Conclusions  Interventions, at an organizational and individual level, may help improve the well-being of hospitalized children.