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目的调查与儿童支气管哮喘相关的环境因素、遗传因素及免疫学因素,以便指导哮喘临床防治。方法对124例儿科门诊诊治的哮喘患儿进行问卷调查、采血及随访观察。对不同严重程度下的性别、年龄、出生喂养情况、饮食习惯、居住环境、个人过敏史、家族过敏史及诱因等定性资料之间进行检验。对总IgE(TIgE)、25-羟维生素D3(25-(OH)D3)与嗜酸性粒细胞(EOS)定性资料之间进行秩和检验。对免疫学之间进行Spearman相关分析并用Z检验对等级相关系数进行检验。结果男女比例为2.32∶1,就诊中位年龄6(4,9)岁,病程为24(9,48)个月。其中个人过敏史与哮喘严重程度相关。血清[TIgE]中位数为314 IU/mL,血清EOS中位数为0.5×109.L-1,血清25-(OH)D3中位数为26.80 ng/mL。TIgE与EOS、病程、年龄呈正相关,25-(OH)D3仅与母乳喂养时间有正相关。结论湛江地区儿童哮喘与饮食习惯密切相关;哮喘儿童的TIgE及EOS明显升高,而维生素D不足,但维生素D水平不能反映哮喘的严重程度,有个人过敏史哮喘严重程度更明显。
Objective To investigate the environmental factors, genetic factors and immunological factors related to bronchial asthma in children in order to guide the clinical prevention and treatment of asthma. Methods A total of 124 pediatric outpatients with asthma were investigated by questionnaire, blood sampling and follow-up. The tests of qualitative data such as gender, age, birth feeding, eating habit, living environment, personal allergy history, family history of allergy and triggers of different severity were tested. The rank sum test was performed between qualitative data for total IgE (TIgE), 25-hydroxyvitamin D3 (25- (OH) D3) and eosinophils (EOS). Spearman correlation analysis was performed on immunology and the rank correlation coefficient was tested using the Z test. Results The male-female ratio was 2.32:1. The median age of the patients was 6 (4,9) years and the duration of illness was 24 (9,48) months. The history of personal allergies is related to the severity of asthma. The median serum TIgE was 314 IU / mL, serum EOS median was 0.5 × 109.L-1, and serum 25- (OH) D3 median was 26.80 ng / mL. TIgE and EOS, duration, age was positively correlated, 25- (OH) D3 only with breastfeeding time is positively correlated. Conclusion There is a close relationship between childhood asthma and dietary habits in Zhanjiang. The levels of TIgE and EOS in children with asthma are significantly higher than those in children with vitamin D, but the level of vitamin D does not reflect the severity of asthma. The severity of asthma with personal allergies is more obvious.