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目的探讨家庭环境中不同程度烟草烟雾暴露对儿童哮喘控制所产生的影响。方法收集2010年1月至2010年12月在中国医科大学附属盛京医院儿科哮喘门诊首次确诊并接受系统治疗的轻中度哮喘患儿232例,根据其家庭烟草烟雾暴露程度分为无暴露、轻度暴露、重度暴露3组,对患儿哮喘控制情况进行为期6个月的跟踪随访及动态评价。结果重度暴露组哮喘急性发作率显著高于无暴露组及轻度暴露组(P=0.006);重度暴露组吸入急救药物使用率高于无暴露组及轻度暴露组(P=0.010);治疗前重度暴露组的MMEF25%～75%pred值明显低于无暴露组(P=0.004)及轻度暴露组(P=0.014),治疗后重度暴露组的MMEF25%～75%pred值仍低于无暴露组(P=0.005)及轻度暴露组(P=0.004);治疗前、后不同程度烟草暴露组FEV1%pred值差异无统计学意义(P>0.05)。结论家庭环境中烟草烟雾暴露对儿童哮喘的控制会产生不良影响;室内禁烟是一种能够改善儿童哮喘控制不良的简单有效方法。
Objective To investigate the effects of different levels of tobacco smoke exposure in family environment on asthma control in children. Methods From January 2010 to December 2010, 232 children with mild-to-moderate asthma who were first diagnosed and treated with systemic asthma at Shengjing Hospital, China Medical University were collected and divided into three groups according to their family exposure to tobacco smoke: Mild exposure, severe exposure to 3 groups, the control of asthma in children with a 6-month follow-up and dynamic evaluation. Results The acute asthma attack rate in severely exposed group was significantly higher than that in non-exposed group and mild-exposed group (P = 0.006). The utilization rate of inhaled emergency medication in severe exposed group was higher than that in non-exposed group and mild-exposed group (P = 0.010) The values of MMEF25% -75% pred in the severe preexposed group were significantly lower than those in the non-exposed group (P = 0.004) and mild exposure group (P = 0.014) There was no significant difference in FEV1% pred between groups with no exposure (P = 0.005) and mild exposure (P = 0.004) before and after treatment. Conclusion Tobacco smoke exposure in a home environment has a negative effect on the control of childhood asthma; indoor smoking is a simple and effective method of improving poor asthma control in children.