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Himamoni Deka, 1 Putul Mahanta, 2 Sultana Jesmin Ahmed, 3 Madhab Ch Rajbangshi, 4 Ranjumoni Konwar, 5 Bharati Basumatari51 Department of Anatomy, Guwahati Medical College, Assam, India, 2 Dib, Assam, India Department of Forensic Medicine and Toxicology, Assam College,3 Department of Public Medicine, Assam Medical College, Dibrugarh, Assam, Is Nrias teb;4 Tezpur Tsev Kawm Qib Siab Tshuaj thiab Tsev Kho Mob Kho Mob, Tezpur, Assam, Is Nrias teb;5 Department of Radiology, Fakhruddin Ali Ahmed Medical College thiab Tsev Kho Mob, Barpeta, Assam, Is Nrias teb Tus sau sau: Putul Mahanta, Department of Forensic Medicine and Toxicology, Assam Medical College and Hospital, Dibrugarh, Assam, 786002, India, tel.+919435017802, email [email tiv thaiv] airway obstruction.Ob qho tib si caj ces thiab ib puag ncig ua rau muaj tus mob hawb pob ntau dua.Lub hom phiaj ntawm txoj kev tshawb no yog los soj ntsuam ntau yam kev noj qab haus huv thiab ib puag ncig uas cuam tshuam rau etiology ntawm kev mob ntsws asthma thaum yau hauv cov neeg mob uas nthuav tawm rau lub chaw kho mob menyuam yaus ntawm Gauhati Medical College thiab Tsev Kho Mob (GMCH) hauv Assam.Cov ntaub ntawv thiab cov txheej txheem.Tag nrho ntawm 150 tus neeg mob uas kuaj mob hawb pob raug xaiv hauv 1: 1 piv ntawm cov neeg muaj hnub nyoog 3-12 xyoo thiab cov neeg mob ntawm tib lub hnub nyoog tsis muaj kab mob ua pa thiab keeb kwm ntawm mob hawb pob raws li kev tswj hwm.Cov ntaub ntawv raug sau los ntawm cov qauv tsim ua ntej thiab kuaj ua ntej, thiab sau ntawv tso cai tau txais los ntawm txhua tus neeg saib xyuas raug cai ntawm cov neeg koom.Cov ntaub ntawv tau txheeb xyuas los ntawm chi-square test thiab binary logistic regression siv SPSS V20 kho rau p-values.Cov txiaj ntsig: Cov menyuam yaus hauv nroog thiab cov txiv neej tau pom tias muaj kev pheej hmoo siab ntawm kev mob hawb pob.Cov menyuam yaus hauv nroog (OR = 4, 53; 95% CI: 1.57-13.09; ppppppp Cov ntsiab lus: Cov menyuam yaus raug mob hawb pob rau ib puag ncig kev mob ntsws asthma Kev paub-tsim thiab tiv thaiv kev ntsuas yuav tsum tau tswj thiab txo qhov hnyav ntawm hawb pob hauv menyuam yaus Cov lus tseem ceeb: mob hawb pob, ib puag ncig, cov menyuam yaus, txhua tus
Mob hawb pob yog ib yam kab mob ntsws ntev uas tshwm sim los ntawm kev rov qab los ntawm txoj hlab ntsws uas tshwm sim los ntawm kev mob ntawm cov hlab ntsws hauv lub ntsws thiab cov leeg nqaij ib puag ncig.Cov lus qhia tsis ntev los no los ntawm Lub Ntiaj Teb Initiative on Asthma (GINA) txhais tau tias mob hawb pob yog "ib kab mob heterogeneous feem ntau tshwm sim los ntawm kev mob ntsws ntev".Cov tsos mob ua pa xws li hawb pob, ua tsis taus pa, ua pa luv, hauv siab nruj thiab hnoos, nrog rau cov kev txwv tsis pub dhau mus, yog cov cim ntawm kev mob hawb pob.ib
Hauv cov neeg mob hawb pob, cov tsos mob hnyav tuaj yeem tshwm sim vim muaj ntau yam tshwm sim, xws li luam yeeb thiab lwm yam kev haus luam yeeb, pwm, paj ntoos, plua plav, tsiaj dander, kev tawm dag zog, huab cua txias, khoom siv hauv tsev thiab kev lag luam, huab cua paug, thiab kis kab mob.2 Kev sib xyaw ua ke ntawm cov caj ces thiab ib puag ncig piav qhia txog qhov muaj mob hawb pob ntau dua hauv qee lub zej zog.Feem ntau, lwm yam tseem ceeb no tuaj yeem ua rau muaj kev sib txawv, nrog rau haiv neeg lossis haiv neeg yog qhov yooj yim txheeb xyuas qhov sib txawv ntawm ntau pawg neeg.3
Kev kuaj mob ntsws asthma yog qhov chaw kho mob vim tias tsis muaj cov txheej txheem txhais rau hom, qhov hnyav, lossis zaus ntawm cov tsos mob.Bronchial hawb pob yog ib yam kab mob uas ua rau muaj lub nra hnyav rau kev kho mob thiab mus pw hauv tsev kho mob.4 Txawm hais tias kev kuaj mob ntsws asthma hauv cov menyuam yaus thiab cov neeg laus muaj ntau qhov sib xws, qhov kev kuaj mob sib txawv, lub cev ntawm hawb pob, muaj peev xwm muab kev kho mob tshwj xeeb, thiab nws qhov kev kuaj mob yog nyob ntawm lub hnub nyoog.
Thoob plaws ntiaj teb, ntau dua 300 lab tus tib neeg raug mob hawb pob.Hauv cov menyuam yaus, mob hawb pob yog nyob rau saum 20 cov kab mob ntev hauv lub ntiaj teb kev tsis taus-hloov lub neej xyoo, nrog kev tuag ntawm 0.0-0.7 rau 100,000.5 tus neeg.Feem ntau ntawm cov mob hawb pob hauv Is Nrias teb tau tshaj tawm los ntawm 2% mus rau 23%, feem ntau yog vim lub teb chaws thaj chaw loj thiab ib puag ncig tsis sib xws.6 Hauv kev tshawb fawb tsis ntev los no, tus lej no tau pom tias yog 10.4% hauv Assam.7
Kev mob ntsws asthma hauv cov menyuam yaus ua rau muaj cov tsos mob ua pa xws li hawb pob, hnoos, ua pa nyuaj, thiab mob hauv siab, uas, yog tias tsis kho kom raug, tuaj yeem ua rau mob hawb pob.Kev mob ntsws asthma thaum yau tuaj yeem ua rau lub neej tsis zoo ntawm cov menyuam yaus muaj mob los ntawm kev ua kom tsis tuaj kawm ntawv thiab txo qis kev koom tes hauv kev ua haujlwm.
Txawm hais tias muaj kev paub dhau los thiab cov tswv yim kho mob, tau muaj qhov tshwm sim ntau ntxiv, kev mob ntsws thiab kev tuag ntawm mob hawb pob hauv cov menyuam yaus xyoo tas los no 8,9, thiab kev nkag siab ntxiv txog cov kab mob hawb pob yog xav tau los kho mob hawb pob.Txawm hais tias muaj ntau qhov kev tshawb fawb tau ua tiav hauv ntau qhov chaw ntawm Is Nrias teb, tsawg heev tau ua tiav hauv thaj tsam tsawg dua ntawm sab qaum teb Is Nrias teb.
Txoj kev tshawb no tau ua nyob rau sab qaum teb sab hnub tuaj ntawm Assam, Is Nrias teb.Cov pej xeem ntawm Assam yog tsim los ntawm ntau haiv neeg, ntawm 12.45% yog cov neeg zej zog xws li Bodo, Khachari, Karbi, Miri, Mishimi, Rabah, thiab lwm yam. Cov cheeb tsam nyob deb nroog tau tawg mus thoob plaws hauv cheeb tsam.Lub xeev paub txog nws cov biodiversity.Kev ua liaj ua teb, feem ntau yog nplej, tshuaj yej thiab pulses, suav txog ntau dua ib feem peb ntawm Assam cov nyiaj tau los thiab ntiav txog 69 feem pua ​​​​ntawm cov neeg ua haujlwm.Lub xeev tsim 50% ntawm Is Nrias teb cov tshuaj yej ntau lawm.Lwm cov lag luam ua liaj ua teb muaj txiaj ntsig suav nrog kev ua liaj ua teb npua, ua liaj ua teb thiab nuv ntses nrog kev koom tes ntawm cov neeg nyob deb nroog.Kev ua liaj ua teb, tshuaj yej, roj thiab roj, thee thiab limestone yog cov lag luam loj.Cov haiv neeg loj thiab thaj chaw tsis sib xws hauv lub xeev feem ntau yog vim qhov sib txawv ntawm qhov sib txawv thiab cov kab mob ntawm tus kab mob.
GMCH yog lub chaw xa mus rau theem nrab hauv cheeb tsam, kho cov neeg mob los ntawm thoob plaws sab qaum teb sab hnub tuaj ntawm Is Nrias teb, suav nrog cov neeg nyob deb nroog thiab nroog.Feem ntau ntawm cov neeg mob muaj kev noj qab haus huv tsis zoo thiab kev kawm qis.Bronchial hawb pob nyob rau hauv cov me nyuam yog ib qho teeb meem tshwm sim nyob rau hauv cov me nyuam nyob rau hauv cov me nyuam.
Txoj kev tshawb no yog tsom rau kev ntsuas ntau yam kev sib raug zoo-cov pej xeem thiab ib puag ncig cuam tshuam cuam tshuam rau etiology ntawm kev mob ntsws asthma thaum yau hauv cov neeg mob hnub nyoog 3-12 xyoo qhia rau GMCH tus kws kho mob.
Txij lub Plaub Hlis 2013 txog Lub Peb Hlis 2017, kev tshawb fawb rov qab los ntawm kev tswj xyuas qhov xwm txheej tau ua nyob rau hauv Lub Tsev Haujlwm Saib Xyuas Kev Kho Mob hauv kev koom tes nrog Pediatrics Assam GMCH los tshawb xyuas cov pej xeem thiab ib puag ncig ntawm kev mob ntsws asthma rau menyuam yaus hnub nyoog 3-12 xyoo.
Hauv kev tshawb fawb txog kev tswj xyuas tsis tau pom dua, 150 tus neeg mob thiab 150 kev tswj tau raug xaiv hauv 1: 1 piv los kawm ntau yam hauv kev mob ntsws asthma thaum yau.Cov neeg mob uas tau kuaj pom mob hawb pob hnub nyoog 3 txog 12 xyoos nthuav tawm rau cov chaw kho mob sab nraum zoov thiab sab hauv tsev raug xaiv los ua cov neeg mob, thaum cov kev tswj hwm yog cov neeg mob ntawm tib lub hnub nyoog, nyiam nyob hauv cov xwm txheej zoo sib xws yam tsis muaj teeb meem ua pa.keeb kwm ntawm kab mob thiab mob ntsws asthma.
Tus qauv loj tau txiav txim siab siv WinPepi version 11.65.Cov ntaub ntawv los ntawm thawj txoj kev tshawb fawb qhia tau hais tias feem ntau ntawm mob hawb pob ntawm cov menyuam yaus Indian yog li ntawm 1% mus rau 4%.Yog li, piv txwv li 1% feem pua ​​​​ntawm cov menyuam yaus muaj mob hawb pob thiab sib npaug ntawm cov neeg mob thiab tswj cov pab pawg ntau thiab tsawg, txoj kev tshawb fawb xav tau tag nrho cov qauv loj ntawm 274 tus neeg kom ua tiav 80% lub zog txhawm rau txheeb xyuas 4% ob-tailed sib txawv ntawm ob..Ob pawg muaj qhov tseem ceeb ntawm 5%.
Tsis tas li ntawd, xav tias kwv yees li 10% ntawm cov neeg tsis teb yog vim kev poob lossis tsis ua raws li, nws yog qhov tsim nyog los kos tus qauv ntawm 300 tus neeg (suav nrog 150 tus neeg thiab 150 kev tswj hwm).
Siv cov qauv tsim ua ntej thiab kuaj cov ntaub ntawv khaws tseg.Sau ntawv tso cai tau txais los ntawm txhua tus neeg saib xyuas kev cai lij choj ntawm cov neeg koom nrog kev kawm.Cov ntaub ntawv tau sau los ntawm ntau yam kev sib raug zoo-demographic thiab ib puag ncig hloov pauv.Hom tsev yog txhais raws li
Pucca lub tsev, yog cov phab ntsa thiab lub ru tsev yog ua los ntawm cib, cement thiab pob zeb;Lub tsev Katcha yog ua los ntawm ntoo, av, straw thiab nplooj qhuav yog lub tsev yog ua los ntawm cib ntsa thiab adobe phab ntsa nrog ib tug thatched los yog tin ru tsev thiab pob zeb.pem teb Yog ua tiav, qhov no yog lub tsev Semi pucca.Socioeconomic xwm txheej raug soj ntsuam siv qhov hloov kho Kuppuswami scale (2014).
Cov neeg koom nrog kev xa tawm, keeb kwm ntawm kev yug me nyuam asphyxia, hom kev pub mis, keeb kwm ntawm kev tsis haum zaub mov, keeb kwm ntawm leej niam ntawm kev quav tshuaj, keeb kwm ntawm tsev neeg mob hawb pob, keeb kwm ntawm atopy lossis allergy, thiab tsev neeg keeb kwm ntawm kev haus luam yeeb lossis haus luam yeeb thib ob kuj tau sau tseg.Txhua tsev neeg nyob hauv tib lub tsev raug suav hais tias yog neeg haus luam yeeb hauv tsev neeg keeb kwm.Raws li GINA Epidemiological thiab Clinical Trial Participant Image Guidelines, cov kab mob hnyav tau raug cais raws li cov txheej txheem kho mob, suav nrog cov neeg mob uas tau muab rau theem 2 muaj mob hawb pob me me, thiab cov neeg mob uas raug mob rau theem 3-4 muaj mob hawb pob me.muaj mob ntsws asthma nruab nrab thiab tau muab theem-5.kho mob hawb pob.
Kev suav nrog thiab cais tawm: Cov ntaub ntawv qhia tias cov neeg mob menyuam yaus yuav tsum suav nrog hauv txoj kev tshawb fawb txog li 18 xyoo.Txawm li cas los xij, ntawm GMCH, feem ntau ntawm cov neeg xa mus rau cov menyuam yaus hnub nyoog qis dua 12 xyoos. Tsis tas li ntawd, qhov tshwm sim ntawm kev mob ntsws asthma thaum yau tshaj qhov muaj tus kab mob ua ntej thiab tom qab puberty.Yog li ntawd, pawg hnub nyoog ntawm 3 mus rau 12 xyoo raug xaiv rau txoj kev tshawb no.Txoj kev tshawb no suav nrog cov neeg mob uas tau kuaj pom mob ntsws asthma hnub nyoog 3 txog 12 xyoos uas tau pom zoo koom nrog hauv txoj kev tshawb no.Cov menyuam yaus hnub nyoog 3 txog 12 xyoos uas pom zoo koom nrog hauv txoj kev tshawb no yam tsis muaj kab mob ua pa, nyiam nyob hauv cov xwm txheej zoo sib xws, raug xaiv los ua pawg tswj hwm.
Cov menyuam yaus hnub nyoog 0-3 xyoos raug cais tawm ntawm txoj kev tshawb no vim tias hawb pob hauv pawg hnub nyoog no tsis txaus los kuaj mob hawb pob.Tsis tas li ntawd, cov menyuam yaus ntawm pawg hnub nyoog tsim nyog thiab lawv cov neeg saib xyuas uas tsis pom zoo koom nrog hauv txoj kev tshawb no raug cais tawm.
Kev txheeb cais.Qhov sib txawv ntawm cov proportions tau txheeb xyuas siv qhov kev xeem χ.Binary logistic regression tau siv rau qhov tseem ceeb tsis nyob rau hauv kev tshuaj ntsuam univariate, thiab Wald's χ 2 xeem tau siv los ntsuas qhov kev ywj pheej ntawm kev kho mob.
Kev pom zoo rau kev coj ncaj ncees: Ua ntej sau cov ntaub ntawv, kev pom zoo txog kev ncaj ncees tau txais los ntawm Pawg Neeg Saib Xyuas Kev Ncaj Ncees ntawm Lub Tsev Haujlwm, piv txwv li Pawg Saib Xyuas Kev Ncaj Ncees ntawm GMCH, Guwahati, Assam thiab Is Nrias teb, Ref: No: 233/2018/215.
Ntawm 112,323 tus neeg mob tuaj koom lub tsev kho mob thaum lub sijhawm kawm, 18.88% yog cov neeg mob ua pa.Ntawm cov menyuam yaus hnub nyoog 3-12 xyoos, 2.96% raug kev txom nyem los ntawm bronchial hawb pob.Feem ntau cov mob hawb pob thaum yau tshwm sim thaum lub caij nplooj zeeg lub Cuaj Hlis thiab Kaum Hli (Fig. 1).
Qhov kev tshawb fawb txog kev tswj xyuas no suav nrog 150 tus menyuam yaus uas muaj mob hawb pob thiab 150 tus tswj.Qhov nruab nrab (± SD) hnub nyoog ntawm cov neeg koom nrog kev kawm yog 8.38 (± 2.69) xyoo.hnoos thiab ua pa luv yog cov tsos mob tshwm sim tshaj plaws nyob rau hauv cov neeg mob.Feem ntau (77.3%) ntawm cov neeg mob tau mob hawb pob episodic thiab tsuas yog 8.7% ntawm cov neeg mob hawb pob hnyav.Feem ntau ntawm cov neeg mob tau sau tseg rau lub caij nplooj zeeg (30%).Hauv yuav luag 38% ntawm cov neeg mob, cov tsos mob tau tshaj tawm thaum hmo ntuj (Table 1).
Raws li cov neeg teb, dej txias (82.7%), ice cream (71.6%) thiab plua plav paug (35%) yog qhov ua rau mob hawb pob.Ze li ntawm 19.3% ntawm cov neeg mob qhia tias tsis tuaj kawm ntawv vim muaj mob.
Qhov nruab nrab hnub nyoog (tus qauv sib txawv) ntawm cov neeg koom yog 8.34 (2.69) xyoo.Feem ntau ntawm cov mob yog nyob rau hauv pawg hnub nyoog 7-12 thiab yog txiv neej.Cov neeg koom nrog txoj kev tshawb fawb no feem ntau yog Hindu thiab tsis yog haiv neeg.
Cov menyuam yaus thiab cov txiv neej hnub nyoog 7-12 xyoo muaj qhov tshwm sim ntau dua, txawm hais tias lub koom haum tsis tseem ceeb. Tsis tas li ntawd, mob hawb pob thaum yau tau cuam tshuam nrog BMI (p-tus nqi <0.05). Tsis tas li ntawd, mob hawb pob thaum yau tau cuam tshuam nrog BMI (p-tus nqi <0.05). Кроме того, детская астма была значительно связана с ИМТ (значение р<0,05). Tsis tas li ntawd, mob hawb pob thaum yau tau cuam tshuam nrog BMI (p tus nqi <0.05).此外，儿童哮喘与 BMI 显着相关 (p 值 <0.05).此外，儿童哮喘与 BMI 显着相关 (p 值 <0.05). Кроме того, детская астма была значительно связана с ИМТ (значение p <0,05). Tsis tas li ntawd, mob hawb pob thaum yau tau cuam tshuam nrog BMI (p tus nqi <0.05).Qhov sib txawv ntawm kev rog dhau (OR = 2.22, 95% CI: 1.17–4.18) thiab rog (OR = 2.72, 95% CI: 1.46–5.09) tau ntau dua ob zaug siab dua piv nrog cov menyuam yaus qhov hnyav.Cov menyuam yaus hauv nroog nyob hauv cov tsev neeg sib koom, cov vaj tsev tsis zoo, thiab cov chaw ntub dej, cov tsev tsis muaj cua txaus muaj feem yuav kis tus kab mob ntau dua. Hauv cov chav ua noj uas txuas nrog, cov pa luam yeeb uas tsis yog LPG, tshuaj yoov tshaj cum, Dhuna, thiab lwm yam, kuj tseem cuam tshuam nrog kev mob ntsws asthma thaum yau (p-value <0.05). Hauv cov chav ua noj uas txuas nrog, cov pa luam yeeb uas tsis yog LPG, tshuaj yoov tshaj cum, Dhuna, thiab lwm yam, kuj tseem cuam tshuam nrog kev mob ntsws asthma thaum yau (p-value <0.05). В примыкающих кухнях использование значительно выделяющего дым топлива, кроме сжиженного ововномтяного нефктяного нефктяного , Дхуна и т.д., также связано с детской астмой (значение p<0,05). Hauv cov chav ua noj uas nyob ib sab, kev siv cov pa luam yeeb ntau dua li LPG, tshuaj yoov tshaj cum, Dhuna, thiab lwm yam, kuj tseem cuam tshuam nrog kev mob hawb pob thaum yau (p tus nqi <0.05).在附属厨房中，除LPG、驱蚊剂、Dhuna 等以外的产生烟雾的燃料也与儿童哮喘显着縛 (<p5 关) Dhuna 等以外的产生与儿童哮喘显着相关（p 值<0.05）、 Дымообразующие виды топлива, кроме сжиженного нефтяного газа, средства от комаров, Dhuna и т.д., также были в значительной степени связаны с детской астмой на примыкающих кухнях (значение p <0,05). Cov pa luam yeeb tsim cov roj uas tsis yog LPG, tshuaj yoov tshaj cum, Dhuna, thiab lwm yam kuj tseem cuam tshuam nrog kev mob hawb pob thaum yau hauv chav ua noj (p tus nqi <0.05).Nws kuj tau pom tias cov menyuam yaus nrog tsiaj muaj 8 npaug ntau dua los ua mob hawb pob (Table 2).
Raws li pom nyob rau hauv Table 3, 46.7% ntawm cov neeg mob yog cov tsev neeg uas muaj kev noj qab nyob zoo. Kev kawm niam txiv kuj tseem qis dua ntawm cov xwm txheej (p-value <0.05). Kev kawm niam txiv kuj tseem qis dua ntawm cov xwm txheej (p-value <0.05). Материнское образование также было ниже среди случаев (значение p<0,05). Kev kawm niam txiv kuj tseem qis dua ntawm cov mob (p tus nqi <0.05).病例中的母亲教育程度也较低 (p 值 <0.05).病例中的母亲教育程度也较低 (p 值 <0.05). Матери в этих случаях также были менее образованными (значение p <0,05). Cov niam txiv hauv cov xwm txheej no kuj tau kawm tsawg (p tus nqi <0.05).
Cov me nyuam yug los ntawm txoj kev caesarean (CS) los yog lwm txoj kev xa, nrog rau cov me nyuam uas muaj keeb kwm ntawm kev yug me nyuam asphyxia, muaj feem yuav kis tau tus kab mob.Tsis tas li ntawd, cov menyuam yaus uas tau noj cov zaub mov saum toj kawg nkaus yog yuav luag tsib npaug ntawm qhov yuav kis tus kab mob ntau dua li cov menyuam noj mis (Table 4).
Cov keeb kwm ntawm kev ua xua rau menyuam yaus thiab atopy tau txuas nrog rau kev mob ntsws asthma thaum yau. Tsis tas li ntawd, cov menyuam yaus los ntawm cov tsev neeg uas muaj keeb kwm ntawm kev ua xua thiab mob hawb pob (p-value <0.05) tau kis tus kab mob ntau heev. Tsis tas li ntawd, cov menyuam yaus los ntawm cov tsev neeg uas muaj keeb kwm ntawm kev ua xua thiab mob hawb pob (p-value <0.05) tau kis tus kab mob ntau heev. Также высокой склонностью к заболеванию отличались дети из семей с анамнезом аллергии и астмени 50 p. Tsis tas li ntawd, cov menyuam yaus los ntawm cov tsev neeg uas muaj keeb kwm ntawm kev ua xua thiab mob hawb pob muaj qhov zoo rau tus kab mob (p <0.05).此外，来自有过敏和哮喘病史的家庭（p 值<0.05）的儿童极易患病。此外，来自有过敏和哮喘病史的家庭（p 值<0.05）的儿童极易患病。 Кроме того, дети из семей с аллергией и астмой в анамнезе (р-значение <0,05) были высоко восприим Tsis tas li ntawd, cov menyuam yaus los ntawm cov tsev neeg uas muaj keeb kwm ntawm kev ua xua thiab mob hawb pob (p-value <0.05) tau raug mob heev. Kev haus luam yeeb dhau los ntawm lwm cov neeg hauv tsev neeg kuj nce yuav luag yim npaug ntawm kev pheej hmoo mob hawb pob ntawm cov menyuam yaus (p-value <0.05). Kev haus luam yeeb dhau los ntawm lwm cov neeg hauv tsev neeg kuj nce yuav luag yim npaug ntawm kev pheej hmoo mob hawb pob ntawm cov menyuam yaus (p-value <0.05). Пасссе ррвв ррение черение ререз рарьв уивити уочти почти почти почти почти почти восениениениеротои восениениениениениерочти 05). Kev haus luam yeeb dhau los ntawm lwm cov neeg hauv tsev neeg kuj ua rau muaj kev pheej hmoo ntawm kev mob hawb pob hauv cov menyuam yaus yuav luag yim npaug (p tus nqi <0.05).通过其他家庭成员被动吸烟也使儿童患哮喘的风险增加了近8 倍（p 值<0.05）.通过其他家庭成员被动吸烟也使儿童患哮喘的风险增加了近8 Пассивное курение через других членов семьи также увеличивало риск развития астмы у детей почей почти в 8. Kev haus luam yeeb dhau los ntawm lwm tus neeg hauv tsev neeg kuj ua rau muaj kev pheej hmoo ntawm kev mob hawb pob hauv cov menyuam yaus yuav luag 8 npaug (p-value <0.05).(tab 5)
Ntau qhov kev sib tw binary logistic tau pom tias cov menyuam yaus nyob hauv nroog, thaj chaw ntub dej, qis kev lag luam hauv zej zog, tsiaj, tsev neeg keeb kwm ntawm atopy / allergies, tsev neeg keeb kwm ntawm kev haus luam yeeb / kev haus luam yeeb, thiab kev noj zaub mov sib xyaw yog cov tseem ceeb.Kev pheej hmoo rau kev mob ntsws asthma thaum yau (Table 6).
Table 6 Multivariate logistic regression tsom xam los soj ntsuam yam tseem ceeb cuam tshuam rau menyuam yaus mob hawb pob
Nyob rau ob mus rau peb lub xyoos dhau los, tus naj npawb ntawm cov kab mob atopic tau nce, ua rau muaj kev sib tham ntau txog kev hloov pauv ib puag ncig, kev ua qias tuaj, thiab kev tiv thaiv kab mob rau cov kab mob sib kis.Ob qho tib si raug rau ib puag ncig thiab cov kab mob lom thiab caj ces tsis zoo ua lub luag haujlwm hauv kev txhim kho mob hawb pob.
Nyob rau hauv txoj kev tshawb no, 2.96% ntawm cov neeg mob nyob rau hauv 3 mus rau 12 pab pawg neeg hnub nyoog qhia tau hais tias thaum yau mob hawb pob.Txawm li cas los xij, qee qhov kev tshawb fawb yav dhau los tau tshaj tawm ntau hom mob hawb pob thaum yau hauv cov menyuam yaus Indian.6,10-12 Qhov sib txawv ntawm thaj chaw thiab ib puag ncig hauv Is Nrias teb ncaj qha cuam tshuam thiab cuam tshuam rau cov xwm txheej muaj feem cuam tshuam nrog kev mob hawb pob.6 Yog li, txhawm rau tiv thaiv tus kab mob kom raug thiab raws sijhawm, kev soj ntsuam hauv cheeb tsam ntawm cov ntsiab lus tseem ceeb ntawm kev mob ntsws asthma thaum yau yog tsim nyog.
Cov menyuam yaus hnub nyoog 7-12 xyoos, cov txiv neej thiab cov menyuam yaus nyob hauv nroog muaj kev pheej hmoo siab mob ntsws asthma thaum yau.Hauv nroog thiab cov txiv neej dominance nyob rau hauv mob hawb pob tau pom nyob rau hauv ib txoj kev tshawb fawb hauv Is Nrias teb, 10 zoo ib yam li peb qhov kev tshawb pom.Txawm li cas los xij, lub koom haum no tsuas yog qhov tseem ceeb hauv cov ntsiab lus ntawm qhov chaw nyob hauv tsev.
Cov kev tshawb fawb pom tau hais tias poj niam txiv neej cov kev hloov pauv hormonal tuaj yeem cuam tshuam rau mob hawb pob, vim tias cov tub hluas muaj feem yuav mob hawb pob thaum menyuam yaus.Txawm li cas los xij, daim duab no hloov pauv tom qab yug me nyuam, thiab cov poj niam tsim tus kab mob ntau dua li cov txiv neej.13-15 Tsis tas li ntawd, cov tub hluas hnub nyoog qis dua 10 xyoo muaj cov pa me me dua cov ntxhais ntawm tib lub hnub nyoog, thiab qhov siab kuj tau xav tias yog qhov ua rau mob hawb pob rau menyuam yaus.16.17 Nws
Metro Kamstrup, lub peev ntawm Assam, tau pom kev loj hlob sai hauv lub xyoo tsis ntev los no.Ntau qhov kev tshawb fawb qhia tias kev loj hlob hauv nroog yog qhov cuam tshuam rau qhov tshwm sim ntawm kev mob hawb pob, uas zoo ib yam nrog peb txoj kev tshawb fawb.18,19 Nyob rau hauv txoj kev tshawb no, unadjusted logistic regression qhia tau hais tias rog rog thiab rog cov me nyuam muaj ntau tshaj ob npaug li yuav ua rau mob hawb pob dua li cov me nyuam uas muaj BMI ib txwm, raws li kev soj ntsuam tsis ntev los no.20 Tsis tas li ntawd, kev lag luam hauv zej zog qis yog qhov muaj feem cuam tshuam rau kev mob ntsws asthma thaum yau.Cov menyuam yaus los ntawm cov tsev neeg uas muaj kev noj qab haus huv tsawg yog qhov muaj feem pheej hmoo ntawm kev mob hawb pob vim muaj kev tiv thaiv kab mob qis dua thiab cov kev pab kho mob qis dua.21-23
Cov menyuam yaus nyob hauv ib tsev neeg sib koom ua ke, cov tsev kaccha, cov tsev ntub dej, qhov cua tsis txaus, cov chav ua noj txuas nrog, cov pa luam yeeb tsim hluav taws xob, cov tshuaj yoov tshaj cum thiab Dhuna, thiab lwm yam, muaj feem cuam tshuam rau menyuam yaus mob hawb pob (p-value <0.05). Cov menyuam yaus nyob hauv ib tsev neeg sib koom ua ke, cov tsev kaccha, cov tsev ntub dej, qhov cua tsis txaus, cov chav ua noj txuas nrog, cov pa luam yeeb tsim hluav taws xob, cov tshuaj yoov tshaj cum thiab Dhuna, thiab lwm yam, muaj feem cuam tshuam rau menyuam yaus mob hawb pob (p-value <0.05).Cov menyuam yaus nyob hauv ib tsev neeg sib koom ua ke, khiav tawm hauv tsev, tsev nyob tsis zoo, qhov cua tsis zoo, chav ua noj txuas nrog, cov pa luam yeeb ua rau roj, tshuaj yoov tshaj cum thiab Dhuna thiab lwm yam.д., были достоверно связаны с детской астмой (значение р<0,05). e., tau cuam tshuam nrog kev mob ntsws asthma thaum yau (tus nqi p<0.05).共同家庭的儿童、kaccha 房屋、潮湿的住宅、通风不足、附属厨房、产生烟雾的牃料、帍足。哮喘显着相关 (p 值 <0.05). Cov menyuam yaus hauv tsev neeg sib koom, tsev kaccha, vaj tsev tsis zoo, qhov cua tsis txaus, chav ua noj txuas nrog, cov pa luam yeeb tsim roj, tshuaj yoov tshaj cum, thiab Dhuna muaj feem cuam tshuam rau menyuam yaus mob hawb pob (p tus nqi <0.05). Дети в общих домохозяйствах, домах качча, сырых жилищах, неадекватной вентиляции, пристроенныя, пристроенных е, репеллентах от комаров и Дхуна были в значительной степени связаны с детской астмой (значение). p <0, Cov menyuam yaus nyob hauv cov tsev neeg sib koom, kev khiav hauv tsev, cov vaj tse ntub dej, qhov cua tsis txaus, cov chav ua noj, cov pa luam yeeb, cov tshuaj yoov tshaj cum thiab dhuna tau cuam tshuam nrog kev mob hawb pob thaum yau (p tus nqi <0.05).Kev tshawb fawb yav dhau los kuj tau qhia tias ntau yam nyob hauv tsev tuaj yeem ua rau mob hawb pob hauv cov menyuam yaus.24-27 Kev koom tes ntawm cov tsiaj txhu hauv tsev nrog kev mob hawb pob thaum yau yog qhov tsis txaus ntseeg, vim qee cov kws tshawb fawb ntseeg tias kev kis tus kab mob thaum ntxov tuaj yeem ua rau muaj kev ua siab ntev.28
Ntau cov kev tshawb fawb tau pom tias cov me nyuam yug los ntawm qhov chaw caesarean muaj kev pheej hmoo ntawm kev mob hawb pob thaum yau piv rau cov kev yug me nyuam.Qhov no yog raws li peb qhov kev tshawb pom.29-32 Cov menyuam yaus uas muaj keeb kwm ntawm kev yug menyuam asphyxia kuj muaj kev pheej hmoo ntau dua ntawm kev mob hawb pob.Maternal asthma yog ib qho tseem ceeb rau kev xeeb tub cov teeb meem xws li kev ua pa nyuaj siab thiab neonatal asphyxia.33
Raws li nrog rau lwm cov kev tshawb fawb, kev tshawb pom tam sim no qhia tau hais tias thaum yau keeb kwm ntawm kev tsis haum zaub mov lossis atopy lossis tsev neeg keeb kwm ntawm kev ua xua thiab mob hawb pob ua rau muaj kev pheej hmoo ntawm kev mob hawb pob thaum yau.34,35 Raws li peb txoj kev tshawb fawb, kev tshawb fawb ntau tiam dhau los tau pom tias kev haus luam yeeb sib txawv tuaj yeem ua rau muaj kev hloov caj ces hauv cov epigenome uas ua rau muaj kev pheej hmoo mob hawb pob hauv cov xeeb ntxwv.36
Nyob rau hauv cov hnub tsis ntev los no, kev loj hlob sai sai tau cuam tshuam tag nrho cov sectors ntawm zej zog.Vim muaj ntau qhov chaw ntawm cov nyiaj tau los thiab kev ua haujlwm, tib neeg nyiam nyob hauv nroog thiab yog li raug rau ntau yam khoom paug ib puag ncig.Cov neeg hauv tsev neeg ntawm cov menyuam yaus raug mob raug qhia kom ua tib zoo saib xyuas kom tsis txhob muaj av noo, haus luam yeeb, khaws cov tsiaj hauv tsev neeg nrog kev ua xua / ua xua, thiab zam kev ua xua / ua xua rau cov menyuam yaus nrog tsev neeg keeb kwm ntawm kev ua xua / ua xua.Yuav tsum muaj kev paub txog kev pub niam mis tshwj xeeb vim muaj txiaj ntsig ntawm kev pub niam mis rau kev tiv thaiv mob hawb pob.
Feem ntau ntawm cov neeg mob uas tuaj rau Guwahati Medical College yog los ntawm thoob plaws North East Is Nrias teb raws li Guwahati Medical College yog lub chaw ua haujlwm tshwj xeeb tshaj plaws hauv cheeb tsam.Feem ntau ntawm cov neeg mob muaj kev noj qab haus huv tsis zoo thiab kev kawm qis.Bronchial hawb pob nyob rau hauv cov me nyuam yog ib qho teeb meem tshwm sim nyob rau hauv lub chaw kho mob ntawm peb lub tsev kho mob.Cov tswv yim tiv thaiv tsim nyog rau cov neeg mob uas muaj kev pheej hmoo siab no yuav pab txo qis kev mob nkeeg thiab txo qhov zaus ntawm exacerbations.
Txawm hais tias muaj tag nrho cov kev kho mob hawb pob, ntau tus neeg mob tseem tswj tsis tau zoo, tab sis kev txheeb xyuas cov neeg mob tshwj xeeb, suav nrog phenotypes thiab endotypes, tuaj yeem txhim kho lawv txoj kev tswj hwm.Yog li, cov kev tshawb fawb hauv cheeb tsam ntawm kev mob ntsws asthma rau menyuam yaus thiab cov xwm txheej pheej hmoo yuav pab tswj tau zoo ntawm cov xwm txheej no.
Hauv qhov kev tshawb fawb no, qee cov neeg mob tsis rov qab los rau kev kuaj mob ntxiv thiab kev soj ntsuam ntxiv.Qhov no yuav yog vim tsis paub txog qhov ua rau thiab qhov tshwm sim ntawm tus kab mob.Vim muaj kev sib txuas lus tsis zoo, peb tsis tuaj yeem taug qab txhua tus neeg mob.
Cov menyuam yaus raug mob hawb pob ib puag ncig, thiab kev nkag siab zoo ntawm ib puag ncig kev mob ntsws asthma thiab cov tshuaj tsis haum tuaj yeem pab tswj thiab txo tus kab mob.Hauv cov tsev neeg uas muaj keeb kwm ntawm kev ua xua lossis mob hawb pob, kev saib xyuas tsim nyog yuav tsum tau coj los tiv thaiv cov menyuam yaus uas raug mob los ntawm cov xwm txheej tshwm sim.
Tag nrho cov ntaub ntawv raug khaws cia tsis pub lwm tus paub thiab txoj kev tshawb fawb tau ua raws li Kev Tshaj Tawm ntawm Helsinki.
Ua tsaug rau txhua tus kws kho menyuam yaus uas tau pab sau cov ntaub ntawv thiab ntsuas cov ntsiab lus ntawm lawv cov kev paub.Txhua tus neeg ua haujlwm hauv chav haujlwm uas tau pab peb nkag mus rau lub tuam tsev cov tsev qiv ntawv thiab ib puag ncig thaum lub sijhawm kawm kuj tau lees paub.
Txhua tus kws sau ntawv tau muaj txiaj ntsig zoo rau kev ua haujlwm ntawm daim ntawv tshaj tawm, txawm nyob hauv lub tswv yim, kev tsim qauv, kev ua tiav, kev sau cov ntaub ntawv, kev tshuaj xyuas thiab kev txhais lus, lossis tag nrho cov cheeb tsam no;lawv tau koom nrog hauv kev sau ntawv, kho dua lossis kev tshuaj xyuas qhov tseem ceeb ntawm tsab xov xwm.Ua kom tiav cov qauv rau kev tshaj tawm, pom zoo rau hauv phau ntawv xov xwm uas tsab xov xwm yuav raug xa mus, thiab pom zoo ua lub luag haujlwm rau txhua yam ntawm txoj haujlwm.
1. Ntiaj teb no lub tswv yim rau kev kho mob thiab tiv thaiv mob hawb pob.Ntiaj teb no Asthma Initiative.2018. Muaj nyob ntawm: https://ginasthma.org/wp-content/uploads/2019/01/2018-GINA.pdf.Raws li lub Kaum Ob Hlis 2, 2021