The Analysis Of Control Effects And Influencing Factors Of Children With Asthma In Outpatient

Objective To understand the current status of control of children with bronchial asthma attending the pediatric outpatient clinic in Hospital of Ning Xia and the factors influencing asthma control treatment.To provide a relevant basis for further improving the effectiveness of asthma treatment.Methods A total of 142 children aged 0-14 years with confirmed asthma who attended the pediatric outpatient clinic in Hospital of Ning Xia from October 2019 to February 2021 were selected.A baseline survey was gathered using a questionnaire to understand the basic information and prior medical history of the children.After outpatient medication,the children were regularly treated with pulmonary function test,fractional exhaled nitric oxide,allergen test and clinical symptoms,the asthma control status was evaluated by assessment scales and control degree criteria,and relevant influencing factors were recorded;children were divided into fully controlled,partially controlled and uncontrolled groups corresponding to the asthma control status,then the factors that influence the control effect of children were screened out.The collected data were statistically analyzed by SPSS26.0 software,including descriptive analysis,chi-square test,and logistic regression analysis.Results A total of 142 cases were collected,49 children(34.51%)with fully controlled asthma,78 children(54.93%)with partially controlled asthma,and 15 children(10.56%)with uncontrolled asthma within the last 1 year.There were 93 children(65.49%)with asthma attacks in the last 1 year,41 children(28.87%)with asthma attacks during the epidemic prevention and control period from March to June 2020,52 children(36.62%)with asthma attacks in the last 3 months,and 19 children(13.38%)with asthma attacks in the last 1 month.The optimal threshold of pulmonary function parameters(FEV1/FVC)for complete control in children over 5 years of age was 79.90 not determined by the ROC survival curve;the optimal threshold of exhaled breath nitric oxide measurement for complete control was 21.50 ppb.By using Logistic regression analysis to assess the factors that may influence the control effect of children in the complete control group and in the insufficient control group,six factors were statistically different(p < 0.05)in the level of asthma control in the children.The supportive factors(3)included: medication regimen(OR=0.309,p=0.035,95% CI:0.104-0.919),standardized treatment(OR=0.06,p=0.023,95% CI: 0.11-0.85),improved respiratory hygiene(OR=0.217,p=0.012,95% CI: 0.066-0.719);risk factors(3)included:respiratory infections(OR=4.99,P=0.002,95% CI: 1.812-13.746),participation in strenuous exercise(OR=5.509,P=0.001,95% CI: 1.954-15.529),exposure to asthma-causing factors(OR=6.111,P=0.001,95% CI: 2.066-18.073).Conclusion1.Asthma control was better than before(34.5% percent complete control rate,54.9%percent partial control rate,and 10.6% percent uncontrolled rate),but there is still a big gap comparison with the overall level of asthma control in China.2.Supportive variables for asthma control: standardized medication,good compliance with treatment,attention to respiratory hygiene;risk factors: acute respiratory infection,exposure to asthma-causing factors,inappropriate exercise.3.We need to continue to strengthen family health education and joint participation of all relevant departments to maintain good hygiene habits during the prevention and control of the COVID-19 epidemic.