Srisingh Klaita, Weerakul Jiranun, Srijuntongsiri Sarunya, Ngoenmak Thitima
J Med Assoc Thai. 2017 Feb;100(2):183-9.
To identify risk factors which may lead to the occurrence of recurrent wheezing in children under five years of age.
A cross-sectional study was conducted in children under 5 years old at the Out Patient Department at Naresuan University Hospital, from October 2013 to October 2014. Fifty-five children who had signs and symptoms of recurrent wheezing were assigned to the study group, whereas another fifty-five children matching on age and sex with the case who had no symptoms of recurrent wheezing were assigned to the control group. All of the parents completed the given questionnaires. Descriptive data analysis were statistically conducted to understand the characteristics of the study groups. The risk factors were analysed using both bivariate and multivariate statistical analyses which included all the important predictors with a statistically significant level of p<0.05.
Mean age in the study group was 36.1 months and in the control group 25.0 months. The mean weights and heights showed no difference between the case and control groups. Bivariate analysis showed that upper respiratory tract infection [odds ratio (OR) 7.273; 95% confidence interval (CI) 2.277-23.232)], lower respiratory tract infection (OR 5.332; 95% CI 2.326-12.225), passive smoking (OR 2.368; 95% CI 1.094-5.129), and day care center attendance (OR 2.590; 95% CI 1.168-5.745) were the risk factors of recurrent wheezing. Multivariate logistic regression analysis indicate that lower respiratory tract infection [adjusted odds ratios (aOR) 0.241; 95% CI 0.088-0.659] was the most important risk factor leading to recurrent wheezing.
Lower respiratory tract infection, upper respiratory tract infection, passive smoking and day care center attendance were found to be risk factors of recurrent wheezing in children under five years of age, with lower respiratory tract infection being the most risk. Targeted surveillance of these risk factors should reduce the incidence of recurrent wheezing. This is especially important for high risk patients such as asthma patients.
确定可能导致5岁以下儿童反复喘息发作的危险因素。
2013年10月至2014年10月，在那黎宣大学医院门诊部对5岁以下儿童进行了一项横断面研究。55名有反复喘息体征和症状的儿童被分配到研究组，另外55名年龄和性别与病例匹配但无反复喘息症状的儿童被分配到对照组。所有家长都完成了给定的问卷。进行描述性数据分析以了解研究组的特征。使用双变量和多变量统计分析对危险因素进行分析，其中包括所有具有统计学意义（p<0.05）的重要预测因素。
研究组的平均年龄为36.1个月，对照组为25.0个月。病例组和对照组的平均体重和身高无差异。双变量分析显示，上呼吸道感染[比值比（OR）7.273；95%置信区间（CI）2.277 - 23.232]、下呼吸道感染（OR 5.332；95% CI 2.326 - 12.225）、被动吸烟（OR 2.368；95% CI 1.094 - 5.129）和日托中心入托（OR 2.590；95% CI 1.168 - 5.745）是反复喘息的危险因素。多变量逻辑回归分析表明，下呼吸道感染[调整后比值比（aOR）0.241；95% CI 0.088 - 0.659]是导致反复喘息的最重要危险因素。
下呼吸道感染、上呼吸道感染、被动吸烟和日托中心入托是5岁以下儿童反复喘息发作的危险因素，其中下呼吸道感染风险最高。对这些危险因素进行针对性监测应能降低反复喘息的发生率。这对哮喘患者等高风险患者尤为重要。
