家庭环境香烟烟雾暴露对哮喘患儿疾病控制状况的影响

目的 了解家庭环境香烟烟雾暴露(ETS)与哮喘患儿疾病控制情况的关系.方法 通过病例对照研究方法,对83名ETS和80名非ETS的哮喘儿童进行为期1年的随访,比较两组患儿的儿童哮喘控制测试(childhood asthma control test,C-ACT)评分良好(＞19分)的例次,哮喘控制用药增加天数、急救用药使用天数,以及尿cotinine含量.结果 ETS患儿C-ACT＞19分802例次,占总C-ACT评分例次的80.5%;非ETS患儿 C-ACT＞9分921例次,占95.9%,两组患儿的哮喘控制状况差异无统计学意义(P＜0.05);ETS患儿的尿cotinine含量、支气管扩张剂使用天数、吸入激素增加天数、全身激素使用天数也均明显多于非ETS患儿(P均＜0.05).ETS患儿以尿cotinine含量分为重度(＞4 ng/ml)和轻度(≤4 ng/ml),其中重度ETS患儿的C-ACT＞19分例次低于轻度ETS患儿,而支气管扩张剂使用天数、吸入激素增加天数、全身激素使用天数也均明显多于轻度ETS患儿,差异均有统计学意义(P均＜0.05).结论 ETS是儿童哮喘控制不良的重要危险因素之一.

Effect of household environmental tobacco smoke exposure on children's asthma control

Objective To study relationship between household environmental tobacco smoke exposure and asthma control in children.Methods Eighty-three bronchial asthma children exposed to household tobacco smoke(ETS)and 80 bronchial asthma children not exposed to household tobacco smoke(non-ETS)were selected.During one year follow-up,the frequency of children asthma control test(C-ACT)with great score(> 19),the days of medication in controlling asthma,the days of first aid medication and the concentration of urine cotinine were compared and analyzed between the two groups of children.Results The frequency of C-ACT with scores above than 19 was 802 and 921 in ETS group and non-ETS group,respectively,which was 80.5% and 95.6% of the total scores of C-ACT.The status between the two groups of children were significantly different(P < 0.05).In ETS group,significance was found the concentration of urine cotinine higher,days of bronchodilator using and days of inhaled corticosteroid using longer,and systematic glucocorticosteroids using more frequent than that in non-ETS group(P < 0.05).The ETS children were divided into severe(urine cotinine > 4 ng/ml)and mild cases(urine cotinine ≤ 4 ng/ml).The frequency of C-ACT with scores less than 19 in severe EST children was lower than that in mild ETS children.The days of bronchodilators using,days of inhaled corticosteroid using and systematic glucocorticosteroids using in severe ETS children were significantly more than those in mild ETS children(all P < 0.05).Conclusions Exposure of tobacco smoke is one of the important risk factors in poorly controlled asthma in children.