Lee Eun, Song Dae Jin, Kim Woo Kyung, Suh Dong In, Baek Hey Sung, Shin Meeyong, Yoo Young, Kim Jin Tack, Kwon Ji Won, Jang Gwang Cheon, Lim Dae Hyun, Yang Hyeon Jong, Kim Hwan Soo, Seo Ju Hee, Woo Sung Il, Kim Hyung Young, Shin Youn Ho, Lee Ju Suk, Yoon Jisun, Jung Sungsu, Han Minkyu, Eom Eunjin, Yu Jinho
Department of Pediatrics, Chonnam National University Hospital, Chonnam National University Medical School, Gwangju, Korea.
Department of Pediatrics, Korea University College of Medicine, Seoul, Korea.
Allergy Asthma Immunol Res. 2020 Jan;12(1):86-98. doi: 10.4168/aair.2020.12.1.86.
Childhood asthma has a considerable social impact and economic burden, especially in severe asthma. This study aimed to identify the proportion of childhood asthma severity and to evaluate associated factors for greater asthma severity.
This study was performed on 667 children aged 5-15 years with asthma from the nationwide 19 hospitals in the Korean childhood Asthma Study (KAS). Asthma was classified as mild intermittent, mild persistent, and moderate/severe persistent groups according to the National Asthma Education and Prevention Program recommendations. Multinomial logistic regression models were used to identify the associated factors for greater asthma severity.
Mild persistent asthma was most prevalent (39.0%), followed by mild intermittent (37.6%), moderate persistent (22.8%), and severe persistent asthma (0.6%). Onset later than 6 years of age (adjusted odds ratio [aOR], 1.69 for mild persistent asthma; aOR, 1.92 for moderate/severe persistent asthma) tended to increase asthma severity. Exposure to environmental tobacco smoke (aOR, 1.53 for mild persistent asthma; aOR, 1.85 for moderate/severe persistent asthma), and current dog ownership with sensitization to dog dander (aOR, 5.86 for mild persistent asthma; aOR, 6.90 for moderate/severe persistent asthma) showed increasing trends with greater asthma severity. Lower maternal education levels (aOR, 2.32) and no usage of an air purifier in exposure to high levels of outdoor air pollution (aOR, 1.76) were associated with moderate/severe persistent asthma.
Modification of identified environmental factors associated with greater asthma severity might help better control childhood asthma, thereby reducing the disease burden due to childhood asthma.
儿童哮喘具有相当大的社会影响和经济负担，尤其是在重度哮喘中。本研究旨在确定儿童哮喘严重程度的比例，并评估与更严重哮喘相关的因素。
本研究对来自韩国儿童哮喘研究（KAS）中全国19家医院的667名5至15岁哮喘儿童进行。根据国家哮喘教育和预防计划的建议，哮喘被分为轻度间歇性、轻度持续性和中度/重度持续性组。采用多项逻辑回归模型来确定与更严重哮喘相关的因素。
轻度持续性哮喘最为普遍（39.0%），其次是轻度间歇性（37.6%）、中度持续性（22.8%）和重度持续性哮喘（0.6%）。6岁以后发病（轻度持续性哮喘的调整优势比[aOR]为1.69；中度/重度持续性哮喘的aOR为1.92）往往会增加哮喘严重程度。接触环境烟草烟雾（轻度持续性哮喘的aOR为1.53；中度/重度持续性哮喘的aOR为1.85），以及当前拥有宠物狗且对狗毛过敏（轻度持续性哮喘的aOR为5.86；中度/重度持续性哮喘的aOR为6.90）随着哮喘严重程度的增加呈上升趋势。母亲教育水平较低（aOR为2.32）以及在暴露于高水平室外空气污染时未使用空气净化器（aOR为1.76）与中度/重度持续性哮喘相关。
改变已确定的与更严重哮喘相关的环境因素可能有助于更好地控制儿童哮喘，从而减轻儿童哮喘带来的疾病负担。
