Analysis Of Risk Factors On Children Suffered From Asthma With Bronchiolitis In Five Years In Shijiazhuang City

Brochiolitis is a kind of common infection of the lower respiratory tract in infants and young children, restricted to infants and young children under 2 years,especially 1-6 months old, associated with bronchial anatomy features. Asthma is a chronic nonspecific inflammatory reaction disease, which is a chronic airway inflammation lesion and is to point to by a variety of inflammatory cells(including mast cells, eosinophils and neutrophils, T lymphocytes, hide cells, etc.) and cell components interact with each other. This kind of inflammation causes the airway reactivity increasing, when contacted with the outside a variety of incentives, the airway often arise extensive and reversible airflow obstruction, and clinical symptoms can be characterized by recurrent episodes of wheezing, difficulty breathing, cough, chest tightness, shortness of breath, etc., more and(or) in the early morning or at night. Most children can be alleviated by the treatment or by themselves. Recently, the relationship between Capillary bronchitis and the development of asthma had been studied and confirmed. The influence factors caused the bronchiolitis to asthma are multiaspect and interactional. The previous studies demonstrated that RSV infection is the definite inducing factors while atopic habitus, positive family history, respiratory infections, passive smoking and infant eczema etc. are its risk factors. Moreover, breastfeeding, inhaled corticosteroids, capillary bronchitis in winter illness, BCG vaccination is the protection facts to prevent bronchiolitis develop into asthma, so the control and prevention of capillary bronchitis is a measure to prevent asthma.Objective: To investigate the incidence of asthma on children suffered from bronchiolitis in five years in Shijiazhuang city, and to find the relations between bronchiolitis and asthma.Methods:1 This present study is for large sample retrospective cohort with questionnaire and outpatient follow-up method. 10 000 children from Qiaoxi、Yuhua、Xinhua and Changan districts of Shijiazhuang City were selected in 2011 at random, which is 0-14 years old and the gender were no limited. Refer to the early screening questionnaire; we have a telephone and outpatient follow-up combination to the children who has a history of wheezing. Follow-up content including: the initial onset of breathing time, onset age, attack symptoms, signs and chest X-ray findings, we got 203 children who were conformed to the diagnostic criteria of bronchioltis at the age of 0-3 years old.2 The children in according with the diagnostic criteria of bronchiolitis were investigated by filling out an asthma investigation table. At last until 2016-2-29 we got the children according with the diagnostic criteria of bronchiolitis. Then the incidence rate of them after 5 yeas were calculated.3 According to the children whether occur asthma, they were divided into three groups, including <6 month group, 6-12 month group and >12 month group, And then each group was divided into two subgroups: asthma of <6 month group, non-asthma of <6 month group, asthma of 6-12 month group, non-asthma of 6-12 month group, asthma of >12 month group, non-asthma of 6-12 month group. Finally, the incidence rate of each age group was calculated.4 The data obtained from the above investigation were analyzed statistically and the significant levels was P<0.05, which include gender, production situation, pregnancy, birth weight, allergic factors(allergic rhinitis, atopic dermatitis, food allergies, drug allergy history, asthma history of first-degree relatives, asthma history of second-degree relatives), vicinal factors, antibiotic use age, feeding, passive smoking history and environmental exposure(carpet, mould, animals, flowers and plants in the room). The logistic regression analyses were conducted and the risk factors were screened out.Results: 1 The incident rate of asthma after bronchiolitis in five years in Shijiazhuang city was 43.84%(89 examples in 203 examples); 2 In all ages group, the incident rate of asthma increased with the prolonging of ages. However, there were no significant differences among these ages(Χ~2=1.955,P>0.05); 3 The incident rate of asthma existed the significant difference among the genders in <6 month group(Χ~2=4.628,P<0.05), production situation(Χ~2= 6.768,P<0.05), pregnancy(Χ~2= 4.877,P<0.05) and birth weight(Χ~2=56.000,P<0.05) in 6~12 month group, production situation(Χ~2= 13.888, P<0.05), pregnancy( Χ~2= 5.797, P<0.05) and birth weight(Χ~2=17.656,P<0.05) in >12 months groups; 4. The incident rate of asthma existed the significant difference among the atopic dermatitis, drug allergy, history of asthma first-degree relatives and secondary family, breastfeeding for six months in <6 months groups(P<0.05). And there were significant differences among the atopic dermatitis, food allergy, drug allergy, history of asthma first-degree relatives and breastfeeding for six months in the incident rate of asthma of 6~12 months groups(P<0.05).Moreover, there were significant differences among the anaphylactic rhinitis, the atopic dermatitis, food allergy, drug allergy, history of asthma first-degree relatives, antibiotic use in one years old and breastfeeding for six months in the incident rate of asthma of >12 month group(P<0.05); 5 The incident rate of asthma existed the significant difference among the environmental exposure factors in >12 month group(Χ~2=25.704,P=0.000); 6 The results showed that the atopic dermatitis and the history of asthma first-degree relatives and secondary family were the main factors resulted in the incident and development of asthma in <6 month group(P<0.05). And the atopic dermatitis, the history of asthma first-degree relatives and food allergy were the main factors resulted in the incident and development of asthma in 6~12 month group(P<0.05). In addition, the atopic dermatitis, the drug allergy, the history of asthma first-degree relatives and passive smoking were the main factors resulted in the incident and development of asthma in >12 month group(P<0.05).Conclusions: 1 The incident rate of asthma after bronchiolitis in five years in Shijiazhuang city was 43.84%.2 There were no significant differences among the different age groups, which showed that the factor of age was not the main factors on the incident rate of asthma after capillary bronchiolitis pathogenesis in five years.3 The atopic dermatitis and the history of asthma first-degree relatives and history of asthma second-degree relatives were the main factors resulted in the incident and development of asthma in <6 months group(P<0.05). And the atopic dermatitis, the history of asthma first-degree relatives and food allergy were the main factors resulted in the incident and development of asthma in 6~12 month group(P<0.05). In addition, the atopic dermatitis, the drug allergy, the history of asthma first-degree relatives and passive smoking were the main factors resulted in the incident and development of asthma in >12 months group(P<0.05).