过敏性鼻炎患儿生存质量调查及其影响因素分析

摘要

目的 探讨重庆地区过敏性鼻炎(AR)患儿生存质量及其影响因素,为预防儿童AR、提高其生存质量提供参考.方法 选择2014年4月—2015年6月在重庆医科大学附属儿童医院耳鼻喉科确诊的AR患儿348例为研究对象,采用自制的儿童过敏性鼻炎生存质量量表(Cronbach's α系数为0.897,分半信度为0.872)评价患儿的生存质量,采用AR相关影响因素问卷收集可能影响患儿生存质量的因素,分析重庆地区AR患儿生存质量现况及其相关影响因素.结果 共发放问卷348份,回收有效问卷332份,有效回收率95.4%.生存质量较好及以上者91例(27.4%),一般者162例(48.8%),较差及以下者79例(23.8%).男性患儿的儿童过敏性鼻炎生存质量量表总得分、眼部症状维度得分及情感功能维度得分高于女性患儿(P<0.05);郊县患儿非鼻/眼症状维度得分和情感功能维度得分高于市区患儿(P<0.05).不同年龄患儿儿童过敏性鼻炎生存质量量表总得分、非鼻/眼症状维度得分及情感功能维度得分比较,差异有统计学意义(P<0.05);且儿童过敏性鼻炎生存质量量表总得分、非鼻/眼症状维度得分、情感功能维度得分与年龄呈正相关(r=0.158,P=0.004;r=0.256,P<0.001;r=0.111,P=0.043).多元逐步回归分析结果显示:年龄、鼻部症状每天累计时间、鼻部症状持续时间、接触性皮炎史、对家庭经济影响是AR患儿儿童过敏性鼻炎生存质量量表总得分的影响因素(P<0.05);孩子出生时有无窒息史、家里是否饲养宠物对睡眠维度得分有影响(P<0.05);年龄、鼻部症状持续时间、家里是否饲养宠物及对家庭经济影响对非鼻/眼症状维度得分有影响(P<0.05);年龄、鼻部症状每天累计时间、鼻部症状持续时间、是否纯母乳喂养及对家庭经济影响对实际问题维度得分有影响(P<0.05);鼻部症状每天累计时间、鼻部症状持续时间、接触性皮炎史、对家庭经济影响对鼻部症状维度得分有影响(P<0.05);鼻部症状持续时间、变应性结膜炎史、AR家族史对眼部症状维度得分有影响(P<0.05);地域、鼻部症状持续时间、接触性皮炎史、变应性结膜炎史、家里是否饲养宠物对情感功能维度得分有影响(P<0.05).结论 AR可严重影响患儿的生存质量,其主要影响因素为年龄、鼻部症状每天累计时间、鼻部症状持续时间、接触性皮炎史、对家庭经济影响,预防AR应从多方面入手.%Objective To investigate the quality of life in children with allergic rhinitis(AR) and its influencing factors in Chongqing,providing scientific advice for the improvement of quality of life in such patients and prevention of AR in children.Methods 348 children confirmed with AR were enrolled from Department of ENT,Children's Hospital of Chongqing Medical University from April 2014 to June 2015.A modified Chinese version of Pediatric Rhinoconjunctivitis Quality of Life Questionnaire (PRQLQ-C) with a Cronbach's α of 0.897 and a split-half reliability of 0.872 was used to assess the quality of life.A survey with Associated Factors for Children with AR Questionnaire was conducted for collecting the data related to quality of life.Analyses were performed to investigate the status and associated factors for children with AR in Chongqing.Results 332 returned responsive questionnaires,achieving a response rate of 95.4%.The overall PRQLQ-C score showed that 91 of them (27.4%) had excellent or good quality of life,162(48.8%) had fair quality of life,and other 79 (23.8%) had poor or poorer quality of life.Male children scored higher in the overall PRQLQ-C,eye symptoms domain,and emotional function domain than female children (P<0.05).Children from suburban counties scored higher in non-nose/eye symptoms domain and emotional function domain compared with those from urban districts(P<0.05).The overall PRQLQ-C score,non-nose/eye symptoms domain score and emotional function domain score differed significantly by age(P<0.05),and increased with age (r=0.158,P=0.004;r=0.256,P<0.001;r=0.111,P=0.043).Stepwise multiple linear regression analysis revealed that the main associated factors of quality of life included age,the nasal symptoms daily cumulative time,duration of nasal symptoms, history of contact dermatitis and the impact of family economy(P<0.05);the history of birth asphyxia,raising pets at home had impact on sleep domain score(P<0.05);age,nasal symptoms daily cumulative time,raising pets and the impact of family economy had impact on non-nose/eye symptoms domain score(P<0.05);age,nasal symptoms daily cumulative time, duration of nasal symptoms,exclusive breastfeeding and the impact of family economy had impact on the practical problems domain score(P<0.05);nasal symptoms daily cumulative time,duration of nasal symptoms,history of contact dermatitis and the impact of family economy had impact on nasal symptoms domain score (P<0.05);nasal symptoms daily cumulative time,history of allergic conjunctivitis and family history of AR had impact on eye symptoms domain score(P<0.05);home locationz,nasal symptoms daily cumulative time,history of contact dermatitis,history of allergic conjunctivitis and raising pets at home had impact on emotional function domain score(P<0.05).Conclusion AR could seriously impair the patient's quality of life,which was mainly affected by age,nasal symptoms daily cumulative time,duration of nasal symptoms,history of contact dermatitis and the impact of family economy.AR prevention should be considered from multi-aspects.