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Himamoni Deka, 1 Putul Mahanta, 2 Sultana Jesmin Ahmed, 3 Madhab Ch Rajbangshi, 4 Ranjumoni Konwar, 5 Bharati Basumatari51 Dhipatimendi reAnatomy, Guwahati Medical College, Assam, India, 2 Dib, Assam, India Department of Forensic Medicine uye Toxicology, Assam Medical College;3 Dhipatimendi reMushonga Wevanhu, Assam Medical College, Dibrugarh, Assam, India;4 Tezpur College yeMishonga uye Kuvhiyiwa Kwechipatara, Tezpur, Assam, India;5 Dhipatimendi reRadiology, Fakhruddin Ali Ahmed Medical College uye Chipatara, Barpeta, Assam, India Munyori anowirirana: Putul Mahanta, Dhipatimendi reForensic Medicine uye Toxicology, Assam Medical College uye Chipatara, Dibrugarh, Assam, 786002, India, tel.+919435017802, email [email protected] kuvharirwa kwemhepo.Zvese zviri zviviri genetic uye zvakatipoteredza zvinokonzeresa kuwanda kweasma.Chinangwa chechidzidzo ichi chaive chekuongorora kwakasiyana magariro-demographic uye zvakatipoteredza zvinhu zvinopesvedzera etiology yehucheche asthma muvarwere vaiuya kudhipatimendi revana veGauhati Medical College uye Chipatara (GMCH) muAssam.Zvishandiso uye nzira.Huwandu hwevarwere ve150 vane chirwere chechirwere cheasthma vakasarudzwa muchiyero che1: 1 pakati pezviitiko zvemakore 3-12 uye varwere vezera rimwechete vasina chirwere chekufema uye nhoroondo yeasthma sekutonga.Dhiyabhorosi yakaunganidzwa uchishandisa chimiro chakafanogadzirirwa uye chisati chaedzwa, uye kubvumirwa kwakanyorwa kwakanyorwa kwakawanikwa kubva kune vese vachengeti vemutemo vevatori vechikamu.Data yakaongororwa ne-chi-square bvunzo uye bhinari logistic regression uchishandisa SPSS V20 yakagadziridzwa p-values.Results: Vana vemudhorobha nevechirume vakawanikwa vari panjodzi huru yekubatwa neasthma.Vana vari mumaguta (OR = 4, 53; 95% CI: 1.57-13.09; ppppppp Mhedziso: Vana vanogona kubatwa nemamiriro ekunze anokonzerwa neasthma Kuziva-kusimudza uye kudzivirira matanho anodiwa kudzora uye kuderedza mutoro weasthma muvana Mazwi akakosha: asima, zvakatipoteredza, vana, allergies, a.
Asthma chirwere chisingaperi chemapapu chinoratidzwa nekuchinjika kuvharika kwemhepo kunokonzerwa nekuzvimba kwenzira dzemhepo mumapapu uye kutenderera kwetsandanyama.Nhungamiro dzichangobva kuitika kubva kuGlobal Initiative pamusoro peAsthma (GINA) inotsanangura asthma se "chirwere chakasiyana chinowanzoonekwa nekusingaperi kuzvimba kwemhepo".Zviratidzo zvekufema zvakadai sekufema, kupfupika kwekufema, kusimba kwechipfuva uye kukosora, pamwe nekudzikira kuyerera kwekufema, zviratidzo zveasthma.Poshi
Muvanhu vane asthma, zviratidzo zvakakomba zvinogona kuitika nekuda kwezvikonzero zvakasiyana-siyana, zvakadai sefodya uye mamwe marudzi ekusvuta, mold, pollen, guruva, mhuka yemhuka, kurovedza muviri, mhepo inotonhora, imba uye zvigadzirwa zvemaindasitiri, kusvibiswa kwemhepo, uye zvirwere.2 Kusanganiswa kwemajini uye zvakatipoteredza zvinotsanangura kuwanda kweasima mune dzimwe nharaunda.Kazhinji, izvi zvimwe zvinhu zvinogona kuita kuti pave nekusiyana, nerudzi kana dzinza zviri izvo zvinozivikanwa zviri nyore pakati pemapoka akasiyana evanhu.3
Kuongororwa kweasthma ikiriniki nekuti hapana tsananguro yakamisikidzwa yerudzi, kuomarara, kana kuwanda kwezviratidzo.Bronchial asthma chirwere chakajairika chinoisa mutoro wakakura pane zvakajairika zvekurapa uye kuchipatara.4 Kunyange zvazvo kuongororwa kweasthma muvana nevakuru kune zvakawanda zvakafanana, kusiyanisa kuongororwa, maitiro echisikigo ekufema, kukwanisa kupa kurapa kwakananga, uye kukosha kwayo kwekuongorora kunoenderana nezera.
Munyika yose, vanhu vanopfuura mamiriyoni 300 vanotambura neasthma.Muvana, asima iri pakati pezvirwere makumi maviri zvepamusoro zvisingaperi mumakore ehupenyu hwehurema hwepasi rose, nehuwandu hwekufa kwe0.0-0.7 pa100,000.5 vanhu.Huwandu hweasthma muIndia hwakanzi hunobva pa2% kusvika pa23%, zvichida nekuda kwekusiyana kwakakura kwenzvimbo uye kwezvakatipoteredza.6 Muchidzidzo chechangobva kuitika, nhamba iyi yakawanikwa iine 10.4% muAssam.7
Asthma muvana inokonzeresa zviratidzo zvekufema zvinodzokororwa sekufema, kukosora, kufema kwakanyanya, uye kusungwa kwechipfuva, izvo, kana zvikasarapwa zvakanaka, zvinogona kutungamirira kuchirwere cheasthma chisingaperi.Asima yehucheche inogona kukanganisa zvakanyanya hupenyu hwevana vanorwara nekuwedzera kusarovha uye kuderedza kutora chikamu mukushanda.
Pasinei neruzivo rwepamusoro uye mazano ekurapa, pane kuwedzera kunoshamisa kwekupararira, hutsinye uye kufa kwechirwere muvana mumakore achangopfuura8,9, uye kuwedzera kunzwisisa kwepathogenesis ye asthma inodiwa kuti ibudirire kubata asthma.Nepo kunzvera kwakawanda kuri kuitwa munzvimbo dzakasiana-siana dzeIndia, zvishomanene zvikuru zvakaitwa muiyi nharaunda isina kusimukira yokuchamhembe kwakadziva kumabvazuva kweIndia.
Chidzidzo ichi chakaitwa kuchamhembe kwakadziva kumabvazuva kweAssam, India.Huwandu hweAssam hunoumbwa nemarudzi akasiyana-siyana, ayo 12.45% ndeenharaunda dzemadzinza seBodo, Khachari, Karbi, Miri, Mishimi, Rabah, etc. Nzvimbo dzekumaruwa dzakapararira munzvimbo zhinji dzedunhu.Nyika inozivikanwa nekusiyana-siyana kwayo.Zvekurima, kunyanya mupunga, tii uye pulses, inodarika chikamu chimwe muzvitatu chemari yaAssam uye inoshandisa chikamu che69 muzana chevashandi.Nyika inogadzira makumi mashanu muzana eIndia yekugadzira tii.Mamwe mabhindauko ekurima ane pundutso anosanganisira kurima nguruve, mombe dzemukaka nekuredza vanhu vari kumaruwa.Zvekurima, tii, mafuta uye gasi, marasha uye limestone ndiwo maindasitiri makuru.Kusiyana kwakakura kwemadzinza uye kwenzvimbo muhurumende kunonyanya kukonzerwa nekusiyana kwemasimba uye pathogenesis yechirwere.
GMCH ndiyo inotungamira tertiary referral centre mudunhu, ichirapa varwere vanobva kuchamhembe kwakadziva kumabvazuva kweIndia, kusanganisira vese vekumaruwa nemumaguta.Vazhinji vevarwere vaive nemamiriro akaderera ezvehupfumi uye mwero wakaderera wedzidzo.Bronchial asthma muvana idambudziko rakajairika mune inpatient pediatrics.
Ichi chidzidzo chine chinangwa chekuongorora zvakasiyana-siyana zvemagariro evanhu uye zvakatipoteredza zvinokonzera etiology yehucheche asthma muvarwere vane makore 3-12 makore vachiuya kune GMCH chiremba wevana.
Kubva muna Kubvumbi 2013 kusvika munaKurume 2017, ongororo yakaitwa paDhipatimendi reAnatomy yakabatana nePediatrics Assam GMCH kuti iongorore magariro evanhu uye zvakatipoteredza zvehucheche asthma muvana vane makore 3-12.
Muchidzidzo chisati chamboitika chekuongorora, 150 kesi uye 150 zvidzoreso zvakasarudzwa muchiyero che1: 1 chekudzidza zvinhu zvakasiyana-siyana muhuduku asthma.Varwere vane chirwere chechirwere cheasthma vane makore 3 kusvika kumakore gumi nemaviri vachipa vana makiriniki ekunze uye emukati vakasarudzwa sezviitiko, nepo vanodzora vaiva varwere vezera rimwe chete, zvichida vachigara mumamiriro ezvinhu akafanana pasina matambudziko ekufema.nhoroondo yechirwere uye asthma.
Saizi yemuenzaniso yakatemwa uchishandisa WinPepi vhezheni 11.65.Dhata kubva kuongororo yekutanga inoratidza kuti kuwanda kweasthma pakati pevana veIndia kubva pa1% kusvika 4%.Nokudaro, tichitora chikamu che1% chevana vane asthma uye vakaenzana nemurwere uye hukuru hweboka rekutonga, chidzidzo chinoda huwandu hwemuenzaniso wevanhu 274 kuti vawane 80% simba rekuona 4% mutsauko wemiswe miviri pakati peviri..Mapoka ese ari maviri ane kukosha kwechikamu che5%.
Mukuwedzera, tichifunga kuti inenge 10% yevasina kupindura inokonzerwa nekurasikirwa kunotevera kana kusateerera, zvine musoro kutora muenzaniso wevanhu mazana matatu (kusanganisira 150 kesi uye 150 controls).
Shandisa mafomati akagadzirwa uye akaedzwa ekuunganidza data.Mvumo yakanyorwa ine ruzivo yakawanikwa kubva kune vese vanochengeta zviri pamutemo vevatori vechikamu.Data yakaunganidzwa pane zvakasiyana-siyana zvemagariro evanhu uye zvakatipoteredza.Imba yemhando inotsanangurwa se
Pucca imba, kana madziro uye denga rakagadzirwa nezvidhinha, simende nematombo;imba yeKatcha inogadzirwa nematanda, ivhu, mashanga uye mashizha akaoma kana imba yacho yakagadzirwa nemadziro ezvidhinha uye madziro eadobe ane denga reuswa kana marata nekongiri.pasi Kana yapera, iyi imba yeSemi pucca.Mamiriro ehupfumi hwemagariro akaongororwa uchishandisa yakagadziridzwa Kuppuswami scale (2014).
Nzira yeVatori vechikamu yekusununguka, nhoroondo yekuzvarwa asphyxia, rudzi rwekudya, nhoroondo yekusawirirana kwezvokudya, nhoroondo yaamai yekupindwa muropa, nhoroondo yemhuri yeasthma, nhoroondo yeatopy kana allergy, uye nhoroondo yemhuri yekusvuta kana kusvuta fodya zvakanyorwa zvakare.Chero nhengo dzemhuri dzaigara muimba imwe chete dzainzi dzinoputa munhoroondo yemhuri.Zvinoenderana neGINA Epidemiological and Clinical Trial Participant Image Guidelines, kuomarara kwechirwere kwakarongedzerwa zvichienderana nematanho akatemerwa ekurapa, zvichitariswa kuti varwere vakapihwa nhanho yechipiri vaive nehunyoro hweasthma, uye varwere vakapihwa nhanho 3-4 vane asthma yakapfava.vaive neasima ine mwero uye vakapihwa nhanho-5.kurapwa kweasima yakaoma.
Kuisa uye kusabvisa maitiro: Zvinyorwa zvinoratidza kuti nyaya dzevana dzinofanira kuiswa muchidzidzo kusvika kumakore gumi nemasere.Zvisinei, paGMCH, ruzhinji rwekuendeswa kwevana vari pasi pezera re 12. Mukuwedzera, chiitiko chehucheche hwehucheche hwakapfuura kupararira kwechirwere chisati chaitika uye mushure mekuyaruka.Nokudaro, boka rezera kubva pamakore matatu kusvika kumakore gumi nemaviri rakasarudzwa nokuda kwechidzidzo.Chidzidzo ichi chaisanganisira varwere vane chirwere chebronchial asthma vane makore 3 kusvika kumakore gumi nemaviri vakabvuma kutora chikamu muchidzidzo.Vana vane makore 3 kusvika kumakore gumi nemaviri vakabvuma kutora chikamu muchidzidzo pasina chirwere chekufema, zviri nani kugara mumamiriro ezvinhu akafanana, vakasarudzwa seboka rinodzora.
Vana vane makore 0-3 makore havana kuverengerwa muchidzidzo nekuti kuhwihwidza muboka rezera iri hakuna kukwana kuongorora asima.Pamusoro pezvo, vana vemazera akakodzera nevachengeti vavo vasina kubvuma kutora chikamu muchidzidzo vakabviswa.
Statistical analysis.Misiyano yezviyero yakaongororwa uchishandisa iyo χ bvunzo.Binary logistic regression yakashandiswa pakukosha parameters muunivariate ongororo, uye Wald's χ 2 bvunzo yakashandiswa kuyera yakazvimirira mupiro wekurapa.
Ethical Approval: Pamberi pekuunganidza data, mvumo yetsika yakawanikwa kubva kuInstitutional Ethics Committees yeInstitute, kureva Institutional Ethics Committees yeGMCH, Guwahati, Assam neIndia, Ref: Kwete: 233/2018/215.
Pavarwere 112,323 vakapinda muchikamu chevana panguva yekudzidza, 18.88% vaive varwere vekufema.Pakati pevana vezera remakore 3-12, 2.96% vakatambura nechirwere chebronchial asthma.Zviitiko zvakawanda zvehucheche hwehucheche hwakaitika mukudonha kwaSeptember naOctober (Fig. 1).
Ichi chidzidzo chekutonga chaisanganisira vana 150 vane asthma uye 150 controls.Zvinoreva (± SD) zera revatori vechikamu mukudzidza raive 8.38 (± 2.69) makore.Chikosoro uye kupfupika kwekufema ndizvo zvainyanya kuzivikanwa zviratidzo zvekiriniki muzviitiko.Ruzhinji (77.3%) rwezviitiko zvaive ne episodic asthma kurwiswa uye 8.7% chete yezviitiko zvaive neasthma yakanyanya.Kuwanda kwemakesi kwakacherechedzwa mumatsutso (30%).Munenge 38% yezviitiko, zviratidzo zvakataurwa usiku (Tafura 1).
Sekureva kwevakapindura, zvinwiwa zvinotonhora (82.7%), ice cream (71.6%) uye kuratidzwa kweguruva (35%) ndizvo zvinowanzokonzera asthma.Vanoda kusvika 19.3% yenyaya dzakashuma kusaenda nekuda kwehurwere.
The mean age (standard deviation) yevatori vechikamu yaiva 8.34 (2.69) makore.Zvizhinji zvezviitiko zvaive muboka rezera re7-12 uye vaive varume.Vatori vechikamu muchidzidzo vainyanya kuve vaHindu uye vasiri vedzinza.
Vana nevarume vane makore 7-12 vaiva nehuwandu hwezviitiko, kunyange zvazvo kushamwaridzana kwakanga kusina kukosha. Zvakare, asthma yehudiki yaive yakabatana zvakanyanya neBMI (p-value <0.05). Zvakare, asthma yehudiki yaive yakabatana zvakanyanya neBMI (p-value <0.05). Кроме того, детская астма была значительно связана с ИМТ (значение р<0,05). Mukuwedzera, asthma yehucheche yakabatanidzwa zvakanyanya neBMI (p kukosha <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). Mukuwedzera, asthma yehucheche yakabatanidzwa zvakanyanya neBMI (p kukosha <0.05).Mikana yekuve yakawandisa (OR = 2.22, 95% CI: 1.17-4.18) uye yakanyanyisa (OR = 2.72, 95% CI: 1.46-5.09) yaipfuura kaviri kana ichienzaniswa nevana vane uremu hwemazuva ose.Vana vemumadhorobha vanogara mumhuri dzakagovaniswa, majunkyards, uye misha ine unyoro, isina mhepo inofefetera zvakakwana vane njodzi huru yekubatwa nechirwere ichi. Mumakicheni akabatanidzwa, mafuta anobudisa utsi kunze kweLPG, zvinodzinga umhutu, Dhuna, nezvimwewo, zvinobatanidzwawo zvakanyanya nehucheche hwehucheche (p-value <0.05). Mumakicheni akabatanidzwa, mafuta anobudisa utsi kunze kweLPG, zvinodzinga umhutu, Dhuna, nezvimwewo, zvinobatanidzwawo zvakanyanya nehucheche hwehucheche (p-value <0.05). В примыкающих кухнях использование значительно выделяющего дым топлива, кроме сжиженного нефтяного газа, репеллентов от, репеллентов от, репеллентов от.д., также связано с детской астмой (значение p<0,05). Mumakicheni akabatana, kushandiswa kwemafuta anobudisa utsi zvakanyanya kunze kweLPG, zvinodzinga mosquito, Dhuna, nezvimwewo, zvinosanganiswawo nechirwere chehucheche (p value <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相关（0p. Dhuna 等以外的产生与儿童哮喘显着相关（p 值<0.05）、 Дымобразующие 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). Mafuta anogadzira utsi asiri eLPG, anodzinga umhutu, Dhuna, zvichingodaro akabatanidzwa zvakanyanya neasthma yehudiki mumakicheni akabatana (p kukosha <0.05).Zvakaonekwawo kuti vana vane mhuka dzinovaraidza vaiva ne8 nguva yakawanda yekuvandudza asthma (Tafura 2).
Sezvinoratidzwa muTebhurari 3, 46.7% yemhosva dzaive dzemhuri dzakaderera magariro nehupfumi. Dzidzo yemadzimai yakaderera zvakare pakati pezviitiko (p-value <0.05). Dzidzo yemadzimai yakaderera zvakare pakati pezviitiko (p-value <0.05). Материнское образование также было ниже среди случаев (значение p<0,05). Dzidzo yemadzimai yakaderera zvakare pakati pezviitiko (p kukosha <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). Vanaamai mune idzi nyaya vaivewo vasina kudzidza (p kukosha <0.05).
Vana vanozvarwa necaesarean section (CS) kana dzimwe nzira dzokusununguka, pamwe chete nevana vane nhoroondo yekuzvarwa asphyxia, vari pangozi yechirwere ichi.Mukuwedzera, vana vepamusoro / vakasanganiswa-vakasanganiswa vangangoita kashanu mukana wekuita chirwere ichi kupfuura vana vanoyamwisa (Tafura 4).
Nhoroondo yekusawirirana kwechikafu cheudiki uye atopy yakanyanyobatanidzwa nehudiki hweasthma. Zvakare, vana vanobva kumhuri dzine nhoroondo yeallergies uye asthma (p-value <0.05) yaive yakanyanya kubatwa nechirwere ichi. Zvakare, vana vanobva kumhuri dzine nhoroondo yeallergies uye asthma (p-value <0.05) yaive yakanyanya kubatwa nechirwere ichi. Также высокой склонностью к заболеванию отличались дети из семей с анамнезом аллергии и астмы (значение p<0,05). Zvakare, vana vanobva kumhuri dzine nhoroondo yeallergies uye asthma vaive nepamusoro pechirwere chechirwere (p <0.05).此外，來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，來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 восприимчивы. Mukuwedzera, vana vanobva kumhuri dzine nhoroondo yeallergies uye asthma (p-value <0.05) vainyanya kunetseka. Kusvuta kusvuta kuburikidza nedzimwe nhengo dzemhuri zvakare kwakawedzera kanenge kasere njodzi yeasthma pakati pevana (p-value <0.05). Kusvuta kusvuta kuburikidza nedzimwe nhengo dzemhuri zvakare kwakawedzera kanenge kasere njodzi yeasthma pakati pevana (p-value <0.05). Пассивное курение через других членов семьи также увеличивает риск развития астмы у детей почти в восемь раз (значение p<0,05). Kusvuta kusvuta kuburikidza nedzimwe nhengo dzemhuri kunowedzerawo njodzi yekubatwa neasthma muvana kanenge kasere (p value <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 почти в 8 раз (p-значение <0,05). Kusvuta kusvuta kuburikidza nedzimwe nhengo dzemhuri zvakare kwakawedzera njodzi yekuva neasthma muvana kanenge ka8 (p-value <0.05).(tafura 5)
Multiple binary logistic regression yakaratidza kuti vana vari mumaguta, nharaunda dzine hunyoro, kuderera kwemagariro ehupfumi, mhuka dzinovaraidza, nhoroondo yemhuri yeatopy / allergies, nhoroondo yemhuri yekuputa / kusvuta kungoita, uye kudya kwakasanganiswa kwakabatsira zvikuru.Zvikonzero zveAsma yehuduku (Tafura 6).
Tafura 6 Multivariate logistic regression analysis yekuongorora zvinhu zvakakosha zvinopesvedzera asthma yehucheche.
Mumakore makumi maviri kusvika matatu apfuura, nhamba yezvirwere zveatopic yakawedzera, zvichikurudzira hurukuro yakawanda pamusoro pekuchinja kwezvakatipoteredza, kusvibiswa, uye mhinduro dzekudzivirira zvirwere kune zvirwere zvinotapukira.Zvese zviri zviviri kuratidzwa kwezvakatipoteredza uye zviri pasi pebiological uye genetic kukanganiswa kunoita basa mukuvandudza asima.
Muchidzidzo ichi, 2.96% yevarwere vari muboka remakore matatu kusvika gumi nemaviri vakashuma asima yehuduku.Nekudaro, zvimwe zvidzidzo zvekare zvakashuma maitiro akasiyana ehucheche hweasthma muvana veIndia.6,10-12 Kusiyana kweGeographical uye kwezvakatipoteredza muIndia kunopesvedzera zvakananga uye kunokanganisa njodzi dzine chekuita nechirwere cheasthma.6 Nokudaro, nokuda kwekudzivirira kwakakodzera uye panguva yekudzivirira kwechirwere, kuongororwa kwenharaunda kwezvinhu zvakakosha zvehucheche hwehucheche hunodiwa.
Vana vane makore 7-12 okuberekwa, varume nevana vanogara mumaguta vari panjodzi huru yeasima.Kutonga kwemaguta nevarume mukupararira kweasthma kwakaonekwa mune chidzidzo muIndia, 10 yakafanana nezvatakawana.Zvisinei, kushamwaridzana uku kwaingova nenhamba yakakosha mumamiriro ezvinhu epamusha.
Zvidzidzo zvakaratidza kuti shanduko yemahomoni emunhukadzi inogona kukanganisa asima, sezvo vakomana vanowanzoita asima vachiri vadiki.Zvisinei, mufananidzo uyu unoshanduka mushure mekuyaruka, uye vakadzi vanokura chirwere kakawanda kupfuura varume.13-15 Mukuwedzera, vakomana vari pasi pemakore gumi ezera vane nzira duku dzemhepo kupfuura vasikana vezera rimwe chete, uye kureba kunofungidzirwawo kuva chinhu chinokonzera asima yehuduku muvakomana.16.17
Metro Kamstrup, guta guru reAssam, yakaratidza kukurumidza kukurumidza kwemadhorobha mumakore achangopfuura.Zvidzidzo zvakawanda zvinoshuma kuti kuguta kwemaguta chinhu chinokonzera kuitika kweasthma, izvo zvinoenderana nekudzidza kwedu.18,19 Muchidzidzo chezvino, kusagadziriswa kwekugadzirisa zvinhu kwakaratidza kuti vana vakafutisa uye vakafutisa vainyanya kudarika kaviri mukana wekuita asthma kupfuura vana vane BMI yakajairwa, inopindirana nekuongorora kwechangobva kuitika.20 Pamusoro pezvo, kuderera kwemagariro nehupfumi chinhu chinogona kukonzera njodzi yeasima yehudiki.Vana vanobva kumhuri dzine mamiriro akaderera ehupfumi hwemagariro vari panjodzi huru yekubatwa neasthma nekuda kwekudzikira kwekudzivirira kwemuviri uye zviwanikwa zvehutano zvakaderera.21-23
Vana vanogara mumhuri yakabatana, dzimba dzekaccha, dzimba dzekugara dzakanyorova, mhepo isina kukwana, makicheni akabatanidzwa, mafuta anobudisa utsi, zvinodzinga umhutu uye Dhuna, nezvimwewo, zvakabatanidzwa zvakanyanya nehucheche hwehucheche (p-value <0.05). Vana vanogara mumhuri yakabatana, dzimba dzekaccha, dzimba dzekugara dzakanyorova, mhepo isina kukwana, makicheni akabatanidzwa, mafuta anobudisa utsi, zvinodzinga umhutu uye Dhuna, nezvimwewo, zvakabatanidzwa zvakanyanya nehucheche hwehucheche (p-value <0.05).Vana vanogara mumhuri yakabatana, vachitiza pamba, imba ine unyoro, mhepo isina kukwana, makicheni akabatanidzwa, mafuta anogadzira chiutsi, zvinodzinga umhutu neDhuna nezvimwe.д., были достоверно связаны с детской астмой (значение р<0,05). e., yakabatanidzwa zvakanyanya nehucheche asthma (kukosha 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、产生烟雾的燃和料、驱剘剘、驱剘、驱剘的燃和料。显着相关（p值<0.05）. Vana vari mudzimba dzinodyidzana, dzimba dzekaccha, dzimba dzakanyorova, mhepo isina mhepo yakakwana, kicheni yakabatanidzwa, mafuta anobudisa utsi, zvinodzinga umhutu, neDhuna vane hukama zvakanyanya neasthma yevana (p value<0.05). Дети в общих домохозяйствах, домах качча, Сырых жилищах, неадекватной вентиляции, пристроенных кухнях, задымлищах, пристроенных кухнях, задымленном, были в значительной степени связаны с детской астмой (значение p <0,05). Vana vanogara mudzimba dzakagovaniswa, imba inomhanya, imba ine unyoro, mhepo isina kukwana, makicheni akaiswa, mafuta anopfungaira, zvinodzinga umhutu uye dhuna zvakabatanidzwa zvakanyanya neasthma yehudiki (p value <0.05).Tsvagiridzo yapfuura yakaratidzawo kuti zvakasiyana-siyana zvemukati zvemukati zvinhu zvinogona kukonzera asima muvana.24-27 Kubatanidzwa kwezvipfuyo zvemumba zvine asthma yehudiki kune gakava, sezvo vashoma vaongorori vanotenda kuti kukurumidza kuratidzwa kune allergenic kunogona kubatsira mukukura kwekushivirira.28
Ongororo dzakawanda dzakaratidza kuti vana vanozvarwa necaesarean section vane njodzi yakawedzera yekubatwa neasthma muhuduku zvichienzaniswa nekuzvara kwamazuva ose.Izvi zvinoenderana nezvatinowana.29-32 Vana vane nhoroondo yekuzvarwa asphyxia vanewo njodzi huru yekubatwa neasthma.Maternal asthma chinhu chakakosha kumatambudziko epamuviri akadai sekufema kunetseka syndrome uye neonatal asphyxia.33
Sezvimwewo zvimwe zvidzidzo, zvakawanikwa zvino zvinoratidza kuti nhoroondo yehudiki yekusawirirana kwechikafu kana atopy kana nhoroondo yemhuri yeallergies uye asthma inowedzera zvakanyanya njodzi yehudiki asima.34,35 Maererano nekudzidza kwedu, zvidzidzo zvekare zvemarudzi akawanda zvakaratidza kuti maitiro ekusvuta emarudzi akasiyana-siyana anogona kutungamirira kukuchinja kwemajini mu epigenome iyo inowedzera njodzi yeasthma muvana.36
Mumazuva achangopfuura, kukura kwemaguta kwakakanganisa zvikamu zvose zvevanhu.Nekuda kwemabviro akasiyana emari nemabasa, vanhu vanosarudza kugara mumaguta nekudaro vanoratidzirwa kune kwakasiyana kusvibisa kwezvakatipoteredza.Nhengo dzemhuri dzevana vanotapurirana vanorayirwa kuti vatarise zvakanyanya kudzivirira hunyoro, kuputa, kuchengeta mhuka dzinovaraidza mumhuri ine allergies / allergies, uye kudzivirira allergies / allergic zvinokonzeresa muvana vane nhoroondo yemhuri yekusawirirana.Panofanira kuva neruzivo rwakawedzerwa rwekuyamwisa kwega nekuda kwekubatsira kwekuyamwisa mukudzivirira asima.
Vazhinji vevarwere vanouya kuGuwahati Medical College vanobva kwese kuNorth East India sezvo Guwahati Medical College ndiyo inotungamira nhanho yepamusoro nzvimbo mudunhu.Vazhinji vevarwere vaive nemamiriro akaderera ezvehupfumi uye mwero wakaderera wedzidzo.Bronchial asthma muvana idambudziko rakajairika mudhipatimendi revana rechipatara chedu.Nzira dzakakodzera dzekudzivirira kune ava varwere vane njodzi huru dzichabatsira kuderedza zvirwere uye kuderedza kuwanda kwekuwedzera.
Pasinei nekurapa kweasma kuripo, varwere vazhinji vanoramba vachidzorwa zvisina kunaka, asi kuzivikanwa kwehuwandu hwevarwere, kusanganisira phenotypes uye endotypes, kunogona kukwidziridza manejimendi avo.Nekudaro, zvidzidzo zvedunhu zvehucheche asthma kuwanda uye njodzi zvinhu zvichabatsira mukutonga kwakanaka kwezviitiko izvi.
Muchidzidzo ichi, vamwe varwere havana kudzoka kuzoongororwa zvakare uye kuteverwa.Izvi zvinogona kunge zvakakonzerwa nekusaziva zvikonzero nemigumisiro yechirwere.Nekuda kwemaitiro asina kunaka ekutaurirana, hatina kukwanisa kuronda varwere vese.
Vana vanotapukirwa neasma yezvakatipoteredza, uye kunzwisisa kwakaringana kwezvakatipoteredza asthma zvinokonzeresa uye allergens zvinogona kubatsira kudzora uye kuderedza mutoro wechirwere.Mumhuri dzine nhoroondo yeallergies kana asima, kutarisirwa kwakakodzera kunofanirwa kutorwa kudzivirira vana vanobatwa nenjodzi kubva kune zvinokonzeresa.
Yese data yakachengetwa yakavanzika uye chidzidzo chakaitwa maererano neDeclaration yeHelsinki.
Kutenda kune vese vana chiremba vakabatsira kuunganidza data uye kuongorora zviri muruzivo rwavo.Vese vatinoshanda navo mudhipatimendi vakatibatsira kuwana maraibhurari edhipatimendi uye zvakatipoteredza panguva yechidzidzo vakabvumwawo.
Vese vanyori vakapa zvakakosha kune basa remushumo, ingave mune pfungwa, kudzidza dhizaini, kuuraya, kuunganidza data, kuongorora uye kududzira, kana zvese izvi nzvimbo;vakapinda mukunyora, kudzokorora kana kuongorora kwakadzama kwechinyorwa.Pedzisa iyo vhezheni kuti ibudiswe, bvumirana pane iyo jenari iyo iyo chinyorwa chichaendeswa, uye bvuma kuve nemutoro wezvese zvikamu zvebasa.
1. Global strategy yekurapa nekudzivirira asthma.Global Asthma Initiative.2018. Inowanikwa pa: https://ginasthma.org/wp-content/uploads/2019/01/2018-GINA.pdf.Kubva muna Zvita 2, 2021