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目的探讨毛细支气管炎后发生哮喘的相关因素。方法对2002年1月-2003年5月住院的115例毛细支气管炎患儿进行临床资料统计,包括年龄、性别、出生体质量、发病季节、肥胖情况、病情轻重、病原学及过敏原检测、湿疹史、哮喘家族史、母孕期吸烟、喂养方式等;出院后门诊或电话随访5 a,包括呼吸道感染及喘息发作情况,并记录居住环境污染(煤/矿)、养宠物等资料;根据5 a内是否发生哮喘,采用Logistic统计学方法对各可能因素与哮喘发生之间的关系及相关程度进行回归分析。结果毛细支气管炎患儿115例5 a内有39例发生哮喘(占33.9%)。哮喘组与非哮喘组单因素比较,在哮喘家族史、1岁内反复下呼吸道感染(LRTI)和患毛细支气管炎时的年龄、病情轻重、肥胖构成方面均有显著差异(P=0,0,0.004,0.004,0.020)。毛细支气管炎患病季节、病情轻重、哮喘家族史、婴幼儿湿疹、1岁内反复LRTI等因素共同影响着哮喘的发生(OR=0.49,3.82,6.12,3.76,3.14 P=0.000 7,0.026 0,0,0.030 9,0.000 5)。性别、出生体质量、先天性心脏病、居住环境污染、动物接触、喂养方式、母孕期吸烟及患毛细支气管炎时的年龄、感染病原、血IgE、肥胖等因素与毛细支气管炎后发生哮喘均无相关性。结论重型毛细支气管炎、哮喘家族史、婴幼儿湿疹、1岁内反复LRTI是毛细支气管炎后发生哮喘的危险因素,而毛细支气管炎冬季患病是其保护因素。
Objective To investigate the related factors of asthma after bronchiolitis. Methods The clinical data of 115 cases of bronchiolitis hospitalized from January 2002 to May 2003 were collected, including age, sex, birth weight, season of onset, obesity, severity of illness, detection of etiology and allergens, History of eczema, family history of asthma, smoking during the first trimester of pregnancy, ways of feeding, etc .; outpatient clinic or telephone follow-up 5 a, including respiratory infections and wheezing episodes, and records of living environment pollution (coal / a within the occurrence of asthma, the use of Logistic statistical methods of possible factors and the relationship between asthma and the correlation between the degree of regression analysis. Results Of the 115 patients with bronchiolitis, 39 developed asthma (33.9%) within 5 years. Asthma group and non-asthma group of single-factor comparison, family history of asthma, 1-year-old repeated lower respiratory tract infection (LRTI) and suffering from bronchiolitis when the age, severity and composition of obesity were significantly different (P = 0,0 , 0.004, 0.004, 0.020). The prevalence of bronchiolitis, severity of illness, family history of asthma, eczema in infants and young children, repeated LRTI within 1 year of age and other factors together affected the occurrence of asthma (OR = 0.49,3.82,6.12,3.76,3.14 P = 0.000 7,0.026 0 , 0,0.030 9,0.000 5). Sex, birth weight, congenital heart disease, living environment pollution, animal exposure, feeding patterns, smoking during motherhood, and bronchiolitis age, infectious pathogens, blood IgE, obesity, and asthma after bronchiolitis No correlation. Conclusions Severe bronchiolitis, family history of asthma, infantile eczema, repeated LRTI within 1 year are the risk factors of asthma after bronchiolitis, and the prevalence of bronchiolitis in winter is the protective factor.