上海市学龄儿童过敏性疾病流行现状及相关因素分析

  目的  了解上海市学龄儿童过敏性疾病患病现状及相关影响因素，为预防儿童过敏性疾病提供参考。  方法  2019年4—6月期间，在上海市开展多阶段整群抽样，共有17所小学的10 686名7~12岁学龄儿童被纳入调查。采用国际儿童哮喘和过敏研究(ISAAC)量表评估儿童过敏性疾病，采用多因素Logistic回归模型分析儿童过敏性疾病的影响因素。  结果  上海市学龄儿童中过敏性疾病的总体患病率为47.0%，男童(50.4%)患病率高于女童(43.3%)(χ2=54.44，P < 0.01)。常见过敏性疾病患病率为哮喘(13.9%)、过敏性鼻炎(18.2%)、特应性皮炎(34.3%)。部分儿童同时患有多种过敏性疾病。多因素Logistic回归分析结果显示，与哮喘、过敏性鼻炎、特应性皮炎3类过敏性疾病均呈正相关的因素为男童(OR值分别为1.52，1.44，1.22)、母亲学历本科及以上(OR值分别为1.26，1.77，1.84)、有过敏性疾病家族史(OR值分别为2.87，4.24，2.57)、是独生子女(OR值分别为1.16，1.28，1.22)、窗帘清洗频率 < 1次/月(OR值分别为1.41，1.79，1.77)、没有每天打扫房间(OR值分别为1.14，1.18，1.20)、粉尘暴露频率≥1次/月(OR值分别为1.45，1.56，1.42)(P值均 < 0.05)。3类过敏性疾病另存在特有的社会-环境-行为危险因素。  结论  上海市学龄儿童过敏性疾病患病率较高，相关影响因素涉及社会、环境和行为暴露的多个变量，值得后续深入探索。

Prevalence of allergic diseases and associated factors among school-aged children in Shanghai

  Objective  To examine the prevalence of allergic diseases in school-aged children from Shanghai and to explore related factors so as to produce epidemiological data regarding allergic diseases in children.  Methods  Multi-stage cluster sampling was used to carry out the study in Shanghai from April to June 2019. A total of 10 686 children aged 7-12 years from 17 primary schools participated in the survey. The International Study of Asthma and Allergies in Childhood (ISAAC)Scale was used to evaluate allergic diseases. Multivariate Logistic regression analysis was performed to analyze the related factors.  Results  The overall prevalence of allergic diseases among school-aged children in Shanghai was 47.0%. A higher prevalence was observed among boys (50.4% vs 43.3% in girls, χ2=54.44, P < 0.01). Common allergic diseases included asthma (13.9%), allergic rhinitis (18.2%), and atopic dermatitis (34.3%). The Logistic regression analysis showed that the common risk factors of asthma, allergic rhinitis and atopic dermatitis included the following: male gender (OR=1.52, 1.44, 1.22); mother has a bachelor's degree or above (OR=1.26, 1.77, 1.84); family history of allergic diseases (OR=2.87, 4.24, 2.57); only child (OR=1.16, 1.28, 1.22); curtain cleaning frequency < 1 time/month (OR=1.41, 1.79, 1.77); room not cleaned daily (OR=1.14, 1.18, 1.20); and dust exposure frequency ≥1 time/month (OR=1.45, 1.56, 1.42), all P < 0.05. These three types of allergic diseases were also associated with unique risk factors that dependent on social-environmental-behavioral factors.  Conclusion  Compared with previous data, the prevalence of allergic diseases among school-aged children in Shanghai increased significantly in 2019. The related influencing factors involve multiple variables including demographics, environmental exposure and behavior, which warrant further exploration.