青春期后哮喘患者病情预后相关因素分析

目的 了解青春期后哮喘患者病情缓解的基本状况及相关因素.方法 对392例12～26岁的哮喘患者进行有关“青春期前后病情缓解的基本状况”的问卷调查.对与青春期后哮喘缓解有关的因素进行计数资料x2检验,将单因素分析筛选出的变量行多因素Logistic回归分析.结果 392例哮喘患者青春期后病情缓解率为66.6％(261/392),男性患者、女性患者缓解率比较差异无统计学意义.在青春期后病情未缓解的哮喘患者哮喘首次发作年龄及末次发作年龄均较缓解组大(均P ＜0.01).单因素x2检验分析显示:8岁后哮喘发作仍频繁者(年最多发作6次以上)其病情在青春期后缓解率较低(P＜0.01).伴发的变应性鼻炎症状越严重(中-重度)的哮喘患者青春期后的缓解率较低,与轻度或无明显鼻炎患者比较差异有统计学意义(P＜0.01).个人哮喘急性发作的高发季节在春夏秋季者其在青春期后哮喘病情缓解率较低,与冬季发病者比较差异有统计学意义(P＜0.05).血总IgE越高的哮喘患者,青春期后哮喘病情缓解率较低(P＜0.05).规范化的吸入激素联合特异性免疫治疗的哮喘患者在青春期后缓解率较高,与吸入激素组及未规范治疗组比较差异有统计学意义(P＜0.01).经常运动健身的哮喘患者在青春期后缓解率更高,与不经常运动健身的哮喘患者比较,差异有统计学意义(P＜0.01).而多因素logistic回归分析显示:8岁后哮喘发作越少、伴发的变应性鼻炎程度越轻、经过吸入激素联合特异性免疫治疗、经常运动健身、8岁前年患呼吸道感染3次以上及无明显变应原的哮喘患者在青春期后哮喘病情更易缓解(P＜0.05).结论 青春期后哮喘患者病情缓解率较高,减轻自身变态反应性炎症程度及给予积极的干预治疗措施如特异性免疫治疗及运动健身等,能使青春期后哮喘病情的缓解率提高.

Investigation of disease relief status and correlation factors among patients with asthma after adolescence

Objective To realize the basic disease relief status and correlation factors of patients with asthma after adolescence. Methods Questionnaire survey of "basic disease relief status around adolescence" was conducted on 392 asthma patients aged 12-26 years old.Single-factor analysis with Chi-square test and multiple logistic regression were performed to determine correlation factors among the patients with asthma after adolescence. Results Disease relief rate among 392 patients with asthma after adolescence was 66.6%(261/392),and the difference of the disease relief rate between males and females in comparison showed no statistical significance.The non-relief patients with asthma after adolescence were at higher age than the relief patients with asthma after adolescence in the first attack and last attack of asthma(both P<0.01),and the difference was statistically significant.Single-factor analysis with Chi-square test showed those patients who were still subject to frequent attacks of asthma(attacks up to more than 6 times every year) after 8 years old had smaller probability of relief after adolescence(P<0.01).The more severe the symptoms of allergic rhinitis(medium-severe),the lower the relief rate of the patients with asthma after adolescence;compared with the patients with mild or no significant rhinitis,the difference was statistically significant(P<0.01).Individuals with high attack season in spring,summer and autumn had even lower asthma relief rate than winter after adolescence,the difference was statistically significant(P<0.05).The patients with asthma after adolescence who had higher total blood IgE showed lower remission rate(P<0.05).The patients with asthma subject to standardized inhalation of steroids in combination with specific immunotherapy had higher relief rate after adolescence,compared with the patients subject to inhalation of steroids but without standard treatment(P<0.01).The patients with asthma subject to regular exercise and body building had even higher relief rate(75.5%) in adolescence,compared to the children with asthma subject to irregular exercise and body building,the difference was statistically significant(P<0.01).By multiple logistic regression analysis,the less frequent attacks of asthma after 8 years old,the patients with mild or no significant rhinitis,the patients subject to standardized inhalation of steroids in combination with specific immunotherapy,regular exercise and body building,respiratory infection more than 3 times every year before 8 years old and non-sensibilization children subject to asthma,the higher relief rate of asthma after adolescence can be observed(P<0.05). Conclusion After adolescence,most of children with asthma can get relief and the relief rate of asthma after adolescence can be improved through positive intervention measures,such as relieving allergic inflammation,specific immunotherapy,exercise,body building and others.