重庆地区儿童支气管哮喘急性加重住院危险因素分析

目的分析重庆地区儿童支气管哮喘急性加重住院的危险因素,为制定个体化防治方案,有效控制哮喘提供依据。方法随机选择2009年1月至2009年12月重庆医科大学附属儿童医院呼吸中心及江津区人民医院儿童哮喘急性发作住院患儿共193例,自行设计调查问卷,收集资料进行分析。随机选择门诊随访3个月,接受正规维持治疗的无哮喘发作慢性持续期维持控制治疗的患儿为对照组,分析儿童哮喘急性发作的危险因素。结果呼吸道感染为哮喘急性发作住院的第一独立危险因素,占85.5%(165/193)。未规范使用控制性药物者达71.5%(138/193),包括既往未诊断哮喘102例和已诊断哮喘但未用药的36例,与维持控制治疗组未规范用药(21/110,19.1%)相比有统计学意义(P0.01),为哮喘急性发作第二重要因素。各种过敏原诱发哮喘急性发作也较常见,占9.3%(18/193)。过敏性疾病家族史在急性发作组与维持治疗组间无明显差异(P0.05)。结论呼吸道感染为重庆地区儿童哮喘急性发作的首要危险因素,其次为未及时诊断哮喘、未正规使用哮喘控制药物,各种过敏原诱发哮喘急性发作也需引起重视。

Risk Factors of Hospitalized Children with Acute Exacerbation of Bronchial Asthma in Chongqing Region

Objective To analyze the risk factors of hospitalized children with acute asthma exacerbation in Chongqing region.Methods A total of 193 cases were randomly selected from the hospitalized children with acute asthma exacerbation in Chongqing Children＇s hospital and Jiangjin District People＇s Hospital from January 2009 to December 2009.A self-designed questionnaire was used to collect data.A control group of children were randomly selected from the out-patients who received regular maintain therapy without asthma attacks for more than 3 months.Results The first independent risk factor of asthma hospitalization was respiratory infection（85.5%,165/193）.Irregular use of control medications was the second important factor for the acute exacerbation.There were 75%（138/193） patients didn＇t take control medications regularly,includes 102 undiagnosed and 36 pre-diagnosed cases which was more common than that in regular maintain therapy group（21/110,19.1%）.A variety of allergen-induced acute exacerbation of asthma was also common,which accountted for 9.3 %（18/193）.There were more boys than girls（M/F：124/69） and no significant difference in the family history of allergic diseases（P0.05）.Conclusion Respiratory infection,under-diagnosis of asthma,and irregular use of the control medications are risk factors of acute exacerbation in children with asthma in Chongqing region.Meanwhile allergen exposure warrants more attention.