Analysis Of Risk Factors Of Children5Years And Younger With Asthma

BACKGROUND: Bronchial asthma (asthma) is a variety of inflammatory cells,including eosinophils、mast cells、T lymphocytes, and epithelial cells and its cellularcomponents involved in the chronic airway inflammation. Clinical manifestations ofrecurrent wheezing, breathlessness, chest tightness and coughing and other symptoms.Asthma is a worldwide serious threat to public health, chronic diseases, whetherdeveloped or developing countries, asthma has become a disease that seriously threatenhuman health. Bronchial asthma is the most common chronic childhood respiratorydisease, the prevalence rate was also an upward trend, of pediatric asthma collaborativegroup told the National Child asthma prevalence survey in2000and1990, results showedthat: our children asthma prevalence increased from0.91%in1990to1.5percent in2000,an increase of64.84%, and the2000survey shows that90.33%of children with asthmafor the first time wheezing occurred in the previous five years,69.26%in the3years ofage,29.74%in1year old below. Children5years and younger with asthma accounted fora high proportion of children with asthma, most of the incidence of persistent asthmabegan preschool. Amost of Children5years and younger, in addition to the commonfeatures of asthma symptoms are non-specific,variability of the symptoms of asthma inthis age group is more prominent. In the past years the definition of early childhoodasthma has repeatedly amended several times, but so far still no exact definition suitablefor all children, the complexity of this point also reflects the years of early childhoodasthma risk factors, cause of asthma a lot of research, but has not yet been clearly articulated. May2009, the global Asthma (GINA) has released Children5years andyounger with asthma diagnosis and management of the global strategy ", which is AsthmaGINA first time set the administration Guide for Children5years and younger. Moresurvey data on children’s asthma risk factors and related factors, but are rarely analyze thedata on risk factors for Children5years and younger with asthma Care and more thanunivariate analysis. In the past, children with asthma risk factors for epidemiologicalinvestigations aimed at children over5years, and domestic information are more based ofunivariate analysis. Survey data for children5years and younger with asthma is not tooperfect, only the questionnaire, such as the survey of allergens just only based on thejudgment from the previous physician diagnosis or family history rather than childrenlaboratory tests basis; and young children wheezing relatively older children may be morewith viral infections, allergens exposed, genetic.Therefore, from different angles study the years of early childhood asthma riskfactors can be targeted to provide a theoretical basis for the effective prevention and thedevelopment of asthma control.PURPOSE:Though case-control study, the risk factors of asthma in Children5yearsand younger a single factor, multi-factor analysis to explore the Child Care of childrenwith asthma risk factors in the region where targeted for effective prevention and controlof children with asthma children with wheezing sustainable development to provide atheoretical basis to prevent the development of asthma with persistent wheezing.METHODS:The passage uses Case-control study methods. object of study：Study224cases of the outpatients and inpatients Children in5years and younger with asthma ofFirst Affiliated Hospital of Guangzhou Medical School from January2010to June2011,141cases were male and83cases were female, age2.0±1.46years. A total of151casesof the same age healthy children control group,71cases were male,80female, age2.5±0.3years.Through the quest the two groups case control study, survey the factor aboutasthma in children. Children asthma diagnosis standard reference in2008nationalchildren’s asthma group formulated the unified standards. All objects was extracted fromvenous blood4ml, and separated Serum, the total serum IgE and serum specific SIgE of the16common allergens were detected by ELISA and were venous blood about1ml forblood eosinophil count. In addition, all children with asthma were venous bloodspecimens from virus throat swabs PCR DNA detection, nine kinds of serum respiratoryetiology serum antibodies. Returned questionnaires is checked, removed lost to follow, donot cooperate with the investigation, the failure questionnaire.Actually asthma group get acomplete and pass data of171questionnaires, with a pass rate of76.34%, including127cases of male and44cases of female, the average age are2.67±1.64years. Removedfrom the healthy control group of no cooperate with the investigation, failedquestionnaires. Actually obtained a complete, qualified information on a total of127questionnaires with a pass rate of84.11%,including62males and65females,and theiraverage age are2.94±1.38years.There is no significant difference between the twogroups in age, weight, height.the survey results into the computer using SPSS17.0statistical software to establish a database and statistical analysis. First, the variableassignment into the single-factor logistic regression analysis, then the univariate analysis,statistically significant variables into a multivariate unconditional logistic regressionanalysis, fitting the main effects model, find the optimal effect equation to estimate thevarious risk factors of children with asthma incidence integrated relative risk, and furtherinvestigate the role of various factorsRESULT:1.Single factor analysis results are as follows:①The relationshipbetween birth history and asthma: male (OR=3.026); preterm delivery or low birthweight <2.5kg (OR=2.547). oxygen at birth (OR=3.603); neonatal period complainedof repeated sputum (OR=24.671) is the onset of asthma risk factors (P <0.05), vaginaldeliveries are protective factors for asthma (OR=0.363,P <0.01).②The relationshipbetween feeding history, body mass index and asthma: breast-feeding duration≥6months(OR=0.288) Adding probiotics duration≥6months is protective factors for asthma(OR=0.273) Adding the duration of nutrients (vitamin D, calcium) short (OR=1.051) isrisk factor for asthma (P <0.01).③The relationship between home environment, aroundthe external environment and asthma: the first year of postnatal smoking exposure (OR=1.752); wet (OR=5.573); more flowers and plants (OR=4.828); more fabric sofa or home carpets (OR=3.874); cockroaches (OR=6.495); more hair cashmere toys (OR,=10.624); residence in the city (OR=2.642); nearby factories (OR,=1.969); houses nearthe road (OR,=1.901); domestic and the surrounding environment, dust, large (OR,=4.543)are the dangerous risk factors of asthma (P <0.05). Good of housing convectiveventilation (OR=0.118); regular cleaning of filtration (OR=0.472); sanitary cycle≥3times/week (OR=0.049) are protective factors of asthma (P <0.05).Habitat living area ofthe asthma group is23.25±11.24m2, the control group was33.92±17.86m2, per capitaliving space is large protective factors for asthma (OR=0.250, P <0.001).④Therelationship between nutritional diseases of children and asthma: rickets, suffer from othernutritional diseases (including malnutrition, anemia, zinc deficiency) is a risk factor forasthma (OR=10.702, and12.524, P <0.01).⑤The relationship between genetic history ofallergies and asthma: children with a history of allergies (OR=128.348); parents with ahistory of allergy (either parent have a history of allergies.)(OR=21.888); the motherwith a history of allergies (OR=16.109); father with a history of allergy (OR=7.687);other1,2-grade relatives of a history of allergies (OR=34.791) is the onset of asthma riskfactors (P <0.01).⑥Cough and asthma:1st lower respiratory tract infections age <6months (OR=2.926); the times of lower respiratory tract infection in a year (bronchitis orbronchial pneumonia)(OR=6.250); cough duration≥2weeks (OR=5.889); cough onsettime regular(often in the early morning or at night coughing attack)(OR=8.830); muchof winter and spring cough (OR=2.871); dry cough symptoms (oR=7.950);(activities,milk, after crying) cough, asthma exacerbated (oR=6.103); sudden violent cough (oR=37.539); cough often accompanied by rhinitis (OR=5.887); symptoms of pruritus oritching eyes (oR, accompanied by pruritus=38.473, OR, accompanied by itching=17.567); often use of antibiotics≥1times/month (OR=9.389); number ofhospitalizations due to respiratory tract infection (OR=120.780) is a risk factor forasthma (P <0.05).⑦S erum allergens, blood eosinophils and asthma: The positive rate theTIgE in the asthma group, The SIgE the positive rate all higher than the control group, therisk factors for asthma (OR TIgE≥1class positive rate=2.888and OR The SIgE≥1class positive rate=4.034, P <0.01). Asthma group inhaled allergens are base of mites, house dust allergy, the main food allergens is milk allergy, follow is the whole eggallergies.⑧The comparative analysis of other two groups auxiliary examination: positiverate of asthma in children with viral infections, mycoplasma infection positive rate allhigher than compared with healthy children,which is the risk factor for asthma (OR=14.974, and OR=7.944, P <0.01).2.Multivariate analysis results showed: Male (OR=6.554); more flowers andplants (OR=6.155); home and surrounding environment dust(OR=7.389); parents with ahistory of allergy (either parent have a history of allergies.)(OR=75.048); cough onsettime regular(often in the early morning or at night coughing attack)(OR=20.172);muchof Winter and spring cough(OR=6.495); dry cough symptoms (OR=25.413); mitesallergy.The SIgE≥Level1-positive rate(OR=18.704); TIgE≥2class positive rate(OR=10.201) with children5years and younger with asthma was significantly associated, isasthma important dangerous factor (P <0.05).CONCLUSION: Case-control analysis shows that the allergens, The factors ofvisible allergens, viruses, home environment, cough, and the law is an important riskfactor for children with asthma, the virus may one of the risk factors lead to earlychildhood asthma (especially under3years old with asthma) of recurrent or worseningsymptoms of asthma. Early prevention, diagnosis and treatment children with asthma toprevent asthma sustainable development is of great significance. The passage throughstudy and analysis of Children5years and younger with asthma risk factors, in order toclear the pathogenesis of asthma, and found asthma early, diagnosis and treatment ofasthma early, to avoid the years of early childhood with asthma development andcontinued to adulthood is significant.