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目的探讨超重肥胖与被动吸烟对儿童哮喘及哮喘样症状的交互效应,为采取控制和预防措施提供理论依据。方法采用分层整群随机抽样方法对在辽宁省沈阳市大东、沈河、和平、皇姑、铁西5个行政区抽取的5所小学和10所幼儿园共8 733名儿童进行问卷调查和体格检查。结果儿童持续咳嗽、持续咳痰、哮喘、哮喘现患、喘鸣现患的发生率分别为9.57%、4.42%、6.40%、2.46%、6.05%,超重和肥胖患病率分别为11.97%和12.13%,被动吸烟暴露率为46.34%;调整儿童的性别、年龄、父母受教育水平、母乳喂养、生活用煤、父母过敏史等混杂因素后,多因素非条件logistic回归分析结果表明,与既不超重肥胖又不被动吸烟的儿童比较,有超重肥胖或被动吸烟的儿童患哮喘的风险分别增高了47%(OR=1.47,95%CI=0.95~2.27)和53%(OR=1.53,95%CI=1.08~2.16),而同时暴露于这2个因素的儿童患哮喘的风险增加了117%(OR=2.17,95%CI=1.46~3.23),近似于2个因素单独效应之和,超重肥胖与被动吸烟对儿童患哮喘的影响存在相加效应,但相乘效应并不显著。结论超重肥胖和被动吸烟均可增加儿童患哮喘及哮喘样症状的风险,且两者对儿童患哮喘的影响存在相加效应。
Objective To explore the interactive effects of overweight and obesity and passive smoking on asthma and asthma-like symptoms in children and provide a theoretical basis for taking control and preventive measures. Methods A stratified cluster random sampling method was used to conduct questionnaire and physical examination on a total of 8 733 children from 5 primary schools and 10 kindergartens in Dadong, Shenhe, Heping, Huanggu and Tiexi in Liaoning Province. . Results The prevalence rates of persistent cough, persistent sputum, asthma, asthma and asthma were 9.57%, 4.42%, 6.40%, 2.46% and 6.05% respectively, and the prevalence rates of overweight and obesity were 11.97% and 12.13%, and passive smoking exposure rate was 46.34%. After adjusting for confounding factors such as sex, age, educational level of parents, breastfeeding, domestic coal and parents’ allergy history, multivariate non-conditional logistic regression analysis showed that, Children with overweight or passive smoking increased their risk of asthma by 47% (OR = 1.47, 95% CI = 0.95-2.27) and 53% (OR = 1.53, 95% % CI = 1.08-2.16). However, children exposed to these two factors at the same time increased their risk of asthma by 117% (OR = 2.17, 95% CI = 1.46-3.23), similar to the sum of the two effects alone. The effects of overweight and obesity and passive smoking on children with asthma have an additive effect, but the multiplication effect is not significant. Conclusion Both overweight and obesity and passive smoking can increase children’s risk of asthma and asthma-like symptoms, and their additive effects on children’s asthma are additive.