武汉市4～14岁儿童过敏性鼻炎的危险因素分析

目的 回顾性分析武汉地区4～14岁儿童过敏性鼻炎的相关因素,以期为儿童过敏性鼻炎的防治提供指导。方法 选取2016年1月-2017年12月间因过敏性鼻炎症状在湖北大学医院和解放军武汉总医院门诊或住院治疗并采用敏筛过敏原体外半定量免疫试验检测方法而确诊的236名儿童纳入病例组进行回顾性分析,选择同期门诊体检健康的儿童60例为对照组;采用单因素分析及Logistic回归分析明确儿童过敏性鼻炎的危险因素。结果 2016年来院就诊儿童过敏性鼻炎排名前五位的过敏原依次为:粉尘螨135例(57.2%)、屋尘螨92例(38.9%)、霉菌混合65例(27.5%)、狗猫毛皮屑59例(25%)、牛奶45例(19%)。多因素Logistic分析结果显示,家族史(OR=2.87, 95%CI: 1.47～3.02)、过敏史(OR=2.67, 95%CI:1.72～8.37 )、剖宫产(OR=3.51, 95%CI:1.39～6.7 )、合并哮喘(OR=2.93, 95%CI:1.52～4.08 )、饲养宠物(OR=1.67, 95%CI:1.39～4.70 )、病程≥24个月(OR=1.09, 95%CI: 1.03～1.15)、食用海鲜(OR=1.78, 95%CI:1.06～4.81 )、处于吸烟环境(OR=2.23,95%CI:1.64～3.03 )等可能会增加儿童过敏性鼻炎的发病风险,而母乳喂养史为过敏性鼻炎的保护因素(OR=0.68,95%CI: 0.53～0.89)。结论 明确过敏原,减少或避免过敏原的接触,对儿童过敏性鼻炎的防治具有重要临床意义和指导作用。

Analysis of risk factors for allergic rhinitis in 4 to 14-year-old children in Wuhan

Objective To analyze the related factors of allergic rhinitis in 4 to 14-year-old children in Wuhan retrospectively,in order to provide guidance for the prevention and treatment of allergic rhinitis in children. Methods A total of 236 children with allergic rhinitis diagnosed by vitro semi quantitative immunoassay for sensitive screening allergen and receiving treatment in the school hospital of Hubei University and Wuhan General Hospital of the PLA were enrolled in the case group from January 2016 to December 2017. And 60 healthy children in the same period were selected as control group. Single factor analysis and Logistic regression analysis were used to determine risk factors for allergic rhinitis. Results The top five anaphylaxis in children′s allergic rhinitis were as the following order: dermatophagoides (135, 57.2%), house dust mites (92, 38.9%), mold mixture (65,27.5%), dog/cat fur chips (59,25%) and milk (45,19%). Multifactor Logistic analysis showed that family history(OR=2.87, 95%CI: 1.47～3.02), allergy history(OR=2.67, 95%CI:1.72～8.37 ), cesarean section(OR=3.51, 95%CI:1.39～6.70), asthma(OR=2.93, 95%CI:1.52～4.08 ), pet raising(OR=1.67, 95%CI:1.39～4.70 ), disease course for 24 months(OR=1.09, 95%CI: 1.03～1.15), eating seafood(OR=1.78, 95%CI:1.06～4.81 )and second-hand smoke(OR=2.23,95%CI:1.64～3.03 )increased the risk of AR in children,while breastfeeding history was a protective factor for AR (OR=0.68,95%CI:0.53～0.89). Conclusions It is of clinical significance to avoid the allergens for the prevention and treatment of allergic rhinitis in children.