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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, Ikolishi Lezokwelapha i-Assagam;3 Umnyango Wezokwelapha Zomphakathi, i-Assam Medical College, i-Dibrugarh, i-Assam, i-India;I-4 Tezpur College of Medicine and Hospital Surgery, Tezpur, Assam, India;5 Umnyango Wezokwelapha Ze-Radiology, u-Fakhruddin Ali Ahmed Ikolishi Lezokwelapha Nesibhedlela, i-Barpeta, i-Assam, i-India Umbhali ohambelanayo: u-Putul Mahanta, uMnyango we-Forensic Medicine kanye ne-Toxicology, i-Assam Medical College kanye neSibhedlela, i-Dibrugarh, i-Assam, i-786002, i-India, ucingo.+919435017802, i-imeyili [i-imeyili ivikelwe] ukuvinjwa kwendlela yomoya.Zombili izici zofuzo nezemvelo zinomthelela emazingeni aphezulu esifuba somoya.Inhloso yalolu cwaningo bekuwukuhlola izici ezahlukahlukene zenhlalo yabantu nezemvelo ezithonya i-etiology ye-asthma yezingane ezigulini ezethula emnyangweni wezingane we-Gauhati Medical College and Hospital (GMCH) e-Assam.Izimpahla nezindlela.Ingqikithi yeziguli ze-150 ezine-asthma ezitholwe emtholampilo zikhethwe ngesilinganiso se-1: 1 phakathi kwamacala aneminyaka engu-3-12 kanye neziguli zeqembu elifanayo elingenazo izifo zokuphefumula kanye nomlando we-asthma njengokulawula.Idatha iqoqwe kusetshenziswa ifomethi eklanywe kusengaphambili nehlolwe ngaphambilini, futhi imvume ebhaliwe enolwazi yatholwa kubo bonke abagadi abasemthethweni babahlanganyeli.Idatha yahlaziywa ngokuhlolwa kwe-chi-square kanye nokuhlehla kokungena kanambambili kusetshenziswa i-SPSS V20 elungiselwe amanani we-p.Imiphumela: Izingane zasemadolobheni nezabesilisa zitholakale zisengozini enkulu yokuba nesifuba somoya.Izingane ezisezindaweni zasemadolobheni (NOMA = 4, 53; 95% CI: 1.57-13.09; ppppppp Iziphetho: Izingane zisengozini yokuba nesifuba somoya esibangelwa imvelo Ziyadingeka izinyathelo zokuqwashisa nokuvimbela ukuze kulawulwe futhi kuncishiswe umthwalo wesifuba somoya ezinganeni Amagama angukhiye: isifuba somoya, izici zemvelo, izingane, ukungezwani komzimba nezinto ezithile, a
Isifuba somoya yisifo samaphaphu esingamahlalakhona esibonakala ngokuvimbeka komzila wokuphefumula okubuyisela emuva okubangelwa ukuvuvukala kwemigudu yomoya emaphashini kanye nokushuba kwemisipha ezungezile.Imihlahlandlela yakamuva evela ku-Global Initiative on Asthma (GINA) ichaza isifuba somoya ngokuthi “isifo esihlukahlukene esivame ukubonakala ukuvuvukala okungapheli kwemigudu yomoya”.Izimpawu zokuphefumula ezinjengokuhefuzela, ukuphelelwa umoya, ukucinana kwesifuba nokukhwehlela, kanye nomkhawulo oshintshashintshayo wokugeleza kokuphefumula, yizimpawu zesifuba somoya.eyodwa
Kubantu abanesifuba somoya, izimpawu ezinzima zingenzeka ngenxa yezimbangela ezihlukahlukene, ezifana nogwayi nezinye izinhlobo zokubhema, isikhunta, impova, uthuli, isikhumba sezilwane, ukuzivocavoca umzimba, umoya obandayo, imikhiqizo yasendlini neyezimboni, ukungcoliswa komoya, kanye nezifo.2 Inhlanganisela yezinto zofuzo kanye nemvelo ichaza izehlakalo eziphezulu zesifuba somoya kweminye imiphakathi.Ngokuvamile, lezi ezinye izici zingaba nomthelela ekwehlukeni, lapho uhlanga noma ubuzwe kuyizinto ezibonakala kalula phakathi kwamaqembu ahlukene abantu.3
Ukuxilongwa kwesifuba somoya kuwumtholampilo ngoba ayikho incazelo emisiwe yohlobo, ubukhali, noma imvamisa yezimpawu.I-asthma ye-bronchial yisifo esivamile esibeka umthwalo omkhulu emisebenzini yezokwelapha evamile kanye nokulaliswa esibhedlela.4 Nakuba ukuxilongwa kwesifuba somoya ezinganeni nakubantu abadala kunokufana okuningi, ukuxilongwa okuhlukile, inkambo yemvelo yokushaywa umoya, ikhono lokuhlinzeka ngokwelashwa okuqondile, kanye nenani laso lokuxilongwa kuncike eminyakeni yobudala.
Emhlabeni wonke, bangaphezu kwezigidi ezingu-300 abantu abaphethwe isifuba somoya.Ezinganeni, isifuba somoya siphakathi kwezifo ezingama-20 eziphezulu ezingalapheki eminyakeni yokuphila elungiswe ngokukhubazeka emhlabeni wonke, ngezinga lokufa kwabantu abangu-0.0-0.7 kubantu abayizi-100,000.5.Ukudlondlobala kwesifuba somoya e-India kubikwe ukuthi kusuka ku-2% kuya ku-23%, cishe ngenxa yokungafani okukhulu kwezwe kanye nemvelo.6 Ocwaningweni lwakamuva, lesi sibalo sitholakale singu-10.4% e-Assam.7
Isifuba somoya ezinganeni sibangela izimpawu zokuphefumula eziphindaphindekayo njengokuhefuzela, ukukhwehlela, ukuphefumula kanzima, nokucinana kwesifuba, okuthi uma kungelashwanga ngendlela efanele, kubangele isifuba somoya esingapheli.Isifuba somoya ebuntwaneni singalimaza kakhulu izinga lempilo yezingane ezigulayo ngokwandisa ukulova nokunciphisa ukuhlanganyela okumatasa emsebenzini.
Naphezu kwamasu olwazi oluthuthukisiwe kanye namasu okwelapha, kuye kwaba nokwanda okuphawulekayo kokusabalala, ukugula nokufa kwe-asthma ezinganeni eminyakeni yamuva8,9, nokuqonda okwengeziwe kwe-pathogenesis ye-asthma kuyadingeka ukuze uphathe ngokuphumelelayo i-asthma.Nakuba ucwaningo oluningi lwenziwa ezingxenyeni ezihlukahlukene zaseNdiya, kuncane kakhulu okwenziwayo kule ndawo engathuthukile kangako enyakatho-mpumalanga yeNdiya.
Lolu cwaningo lwenziwe esifundeni esisenyakatho-mpumalanga ye-Assam, eNdiya.Isibalo sabantu base-Assam sakhiwe izinhlanga ezahlukene, okuthi i-12.45% iyingxenye yemiphakathi yezizwe ezifana ne-Bodo, Khachari, Karbi, Miri, Mishimi, Rabah, njll. Izindawo zasemakhaya zihlakazekile esifundeni sonke.Umbuso waziwa ngezinhlobonhlobo zezinto eziphilayo.Ezolimo, ikakhulukazi irayisi, itiye nama-pulses, zenza ngaphezu kwengxenye eyodwa kwezintathu zeholo lika-Assam futhi zisebenzisa cishe amaphesenti angama-69 abasebenzi.Umbuso ukhiqiza u-50% womkhiqizo wetiye waseNdiya.Amanye amabhizinisi ezolimo anenzuzo ahlanganisa ukufuya izingulube, ukufuya ubisi nokudoba ngokuhlanganyela kwabantu basemaphandleni.Ezolimo, itiye, uwoyela negesi, amalahle kanye ne-limestone yizimboni eziphambili.Ukwehluka okukhulu kwezinhlanga kanye nezindawo kuhulumeni kubangelwa kakhulu ukuguquguquka okuhlukahlukene kanye ne-pathogenesis yalesi sifo.
I-GMCH iyisikhungo sokudlulisela phambili esihamba phambili esifundeni, selapha iziguli ezisuka kulo lonke elaseNyakatho-mpumalanga ye-India, okuhlanganisa kokubili abantu basemakhaya nasemadolobheni.Iningi leziguli lalinesimo esiphansi senhlalo-mnotho kanye nezinga eliphansi lemfundo.I-asthma ye-bronchial ezinganeni iyinkinga evamile ku-inpatient pediatrics.
Lolu cwaningo luhlose ukuhlola izici ezihlukahlukene zenhlalo yabantu nemvelo ezithonya i-etiology ye-asthma yezingane ezigulini ezineminyaka engu-3-12 ezethula kudokotela wezingane we-GMCH.
Kusukela ngo-April 2013 kuya ku-March 2017, ucwaningo lokulawulwa kwe-case-retrospective lwenziwa eMnyangweni we-Anatomy ngokubambisana ne-Pediatrics Assam GMCH ukuze kuphenywe izici zenhlalo yabantu kanye nemvelo ye-asthma yezingane ezinganeni ezineminyaka engu-3-12.
Ocwaningweni olungakaze lube khona lokulawulwa kwecala, amacala angu-150 kanye nezilawuli ezingu-150 zikhethwe ngesilinganiso esingu-1:1 ukuze kufundwe izici ezihlukahlukene ku-asthma yezingane.Iziguli ezinesifuba somoya ezitholwe ngokomtholampilo ezineminyaka engu-3 kuya kwengu-12 ezethula emitholampilo yezingane ngaphandle nasendlini zakhethwa njengezimo, kuyilapho izilawuli kwakuyiziguli zeqembu leminyaka efanayo, okungcono kakhulu eziphila ngaphansi kwezimo ezifanayo ngaphandle kwezinkinga zokuphefumula.umlando wesifo kanye nesifuba somoya.
Usayizi wesampula unqunywe kusetshenziswa inguqulo ye-WinPepi 11.65.Idatha yocwaningo lwangempela ibonisa ukuthi ukusabalala kwesifuba somoya phakathi kwezingane zaseNdiya kusuka ku-1% kuya ku-4%.Ngakho-ke, uma kubhekwa ingxenye engu-1% yezingane ezinesifuba somoya kanye nosayizi weqembu elilinganayo lesiguli nokulawula, ucwaningo ludinga usayizi wesampula ophelele wabantu abangu-274 ukuze kuzuzwe amandla angu-80% okuthola umehluko we-4% wemisila emibili phakathi kwemibili..Womabili amaqembu anezinga lokubaluleka lika-5%.
Ukwengeza, kucatshangwa ukuthi cishe u-10% wabangaphenduli kungenxa yokulahlekelwa noma ukunganamatheli okulandelayo, kunengqondo ukudweba isampula yabantu abangu-300 (okuhlanganisa amacala angu-150 nezilawuli ezingu-150).
Sebenzisa amafomethi aklanywe ngaphambili nahloliwe okuqoqwa kwedatha.Imvume ebhaliwe enolwazi itholwe kubo bonke abagadi abasemthethweni babahlanganyeli bocwaningo.Idatha yaqoqwa ngezinhlobonhlobo zenhlalo yabantu kanye nemvelo.Uhlobo lwendlu luchazwa ngokuthi
Indlu yePucca, uma izindonga nophahla zenziwe ngezitini, usimende namatshe;indlu yaseKatcha yakhiwe ngokhuni, umhlaba, utshani namaqabunga omile uma indlu yakhiwe ngezindonga zezitini nezindonga ze-adobe ezifulelwe ngotshani noma ngothayela kanye nokhonkolo.phansi Uma kuqediwe, lena yindlu ye-Semi pucca.Isimo senhlalakahle yezomnotho sihlolwe kusetshenziswa isikali esilungisiwe se-Kuppuswami (2014).
Imodi yabahlanganyeli yokubeletha, umlando wokuzalwa kwe-asphyxia, uhlobo lokuphakela, umlando wokungezwani nokudla, umlando womama wokulutha, umlando womndeni wesifuba somoya, umlando we-atopy noma ukungezwani komzimba, kanye nomlando womndeni wokubhema noma ugwayi kagwayi nakho kwabhalwa.Noma yimaphi amalungu omndeni ahlala endaweni eyodwa ayebhekwa njengababhemayo emlandweni womndeni.Ngokwe-GINA Epidemiological and Clinical Trial Participant Image Guidelines, ukuqina kwesifo kwahlukaniswa ngokwezinyathelo zokwelashwa ezinqunyiwe, kucatshangelwa ukuthi iziguli ezabelwe isigaba sesi-2 zinesifuba somoya esingenamandla, kanti iziguli ezabelwe isigaba 3-4 zinesifuba somoya esincane.babenesifuba somoya esimaphakathi futhi babelwa isigaba-5.ukwelashwa kwe-asthma enzima.
Imibandela yokufakwa nokungabandakanyi: Izincwadi ziphakamisa ukuthi amacala ezingane kufanele afakwe ocwaningweni kuze kube yiminyaka eyi-18.Kodwa-ke, kwa-GMCH, iningi lokudluliselwa kwezingane lingaphansi kweminyaka engu-12. Ngaphezu kwalokho, izehlakalo zesifuba somoya ebuntwaneni zidlule ukusabalala kwalesi sifo ngaphambi nangemuva kokuthomba.Ngakho-ke, iqembu lobudala elisukela eminyakeni emi-3 kuye kweyi-12 lakhethwa kulolu cwaningo.Ucwaningo lwaluhlanganisa iziguli ezine-asthma ye-bronchial ezitholwe ngokomtholampilo ezineminyaka engu-3 kuya kweyi-12 ezavuma ukubamba iqhaza ocwaningweni.Izingane ezineminyaka engu-3 kuya ku-12 ubudala abavuma ukubamba iqhaza ocwaningweni ngaphandle kwesifo sokuphefumula, okungcono ukuhlala ezimweni ezifanayo, bakhethwa njengeqembu lokulawula.
Izingane ezineminyaka engu-0-3 ubudala azifakwanga ocwaningweni ngoba ukushaywa umoya kuleli qembu leminyaka kwakungenele ukuxilonga isifuba somoya.Ukwengeza, izingane zeminyaka yobudala efanelekile kanye nabanakekeli bazo abangazange bavume ukubamba iqhaza ocwaningweni baye bashiywa ngaphandle.
Ukuhlaziywa kwezibalo.Umehluko ngezilinganiso wahlaziywa kusetshenziswa ukuhlolwa kuka-χ.Ukuhlehla kokusebenza kanambambili kusetshenziswe kumapharamitha wokubaluleka ekuhlaziyeni okungaguquki, futhi ukuhlolwa kuka-Wald χ 2 kwasetshenziswa ukukala umnikelo ozimele wokwelashwa.
Ukugunyazwa Kwezimiso Zokuziphatha: Ngaphambi kokuqoqwa kwedatha, ukugunyazwa kwezimiso zokuziphatha kwatholwa kumaKomidi Ezimiso Zokuziphatha Esikhungo, okungukuthi Amakomiti Ezimiso Zokuziphatha Esikhungo se-GMCH, Guwahati, Assam and India, Ref: No: 233/2018/215.
Ezigulini ezingu-112,323 ezihambele ophikweni lwezingane ngesikhathi socwaningo, u-18.88% kwakuyiziguli zokuphefumula.Phakathi kwezingane ezineminyaka engu-3-12 ubudala, u-2.96% wahlushwa isifuba somoya.Amacala amaningi e-asthma yengane kwenzeka ekwindla kaSepthemba no-Okthoba (Fig. 1).
Lolu cwaningo lokulawula amacala lubandakanya izingane eziyi-150 ezinesifuba somoya kanye nezilawuli eziyi-150.Isilinganiso (± SD) seminyaka yobudala yabahlanganyeli bocwaningo sasiyiminyaka engu-8.38 (± 2.69).Ukukhwehlela kanye nokuphelelwa umoya kwakuyizimpawu zomtholampilo ezivame kakhulu ezimweni.Iningi (77.3%) lamacala aba ne-episodic asthma attack futhi amaphesenti angu-8.7 kuphela ayenesifuba somoya esibi kakhulu.Ukusabalala kwamacala kwaphawulwa ekwindla (30%).Cishe ku-38% wamacala, izimpawu zabikwa ebusuku (Ithebula 1).
Ngokusho kwabaphendulile, iziphuzo ezibandayo (82.7%), u-ayisikhilimu (71.6%) kanye nokuchayeka othulini (35%) yizinto ezivamile ezivusa isifuba somoya.Cishe u-19.3% wamacala abike ukulova ngenxa yokugula.
Isilinganiso seminyaka yobudala (ukuchezuka okujwayelekile) sabahlanganyeli bekuyiminyaka eyi-8.34 (2.69).Iningi lamacala bekuseqenjini leminyaka eyi-7-12 futhi bekungabesilisa.Abahlanganyeli bocwaningo bekungamaHindu kakhulu futhi bengezona izizwe.
Izingane nabesilisa abaneminyaka engu-7-12 babenezinga eliphezulu lezehlakalo, nakuba inhlangano yayingabalulekile ngokwezibalo. Futhi, i-asthma yezingane yayihlotshaniswa kakhulu ne-BMI (i-p-value <0.05). Futhi, i-asthma yezingane yayihlotshaniswa kakhulu ne-BMI (i-p-value <0.05). Кроме того, детская астма была значительно связана с ИМТ (значение р<0,05). Ukwengeza, i-asthma yezingane yayihlotshaniswa kakhulu ne-BMI (i-p value <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). Ukwengeza, i-asthma yezingane yayihlotshaniswa kakhulu ne-BMI (inani le-p <0.05).Amathuba okuba ukhuluphele ngokweqile (NOMA = 2.22, 95% CI: 1.17–4.18) nokukhuluphala (NOMA = 2.72, 95% CI: 1.46–5.09) ayengaphezu kokuphindwe kabili uma kuqhathaniswa nezingane ezinesisindo esivamile.Izingane zasemadolobheni ezihlala emindenini ehlanganyelwe, ezindlini ezingcolile, nezindawo zokuhlala ezinomswakama, ezingenawo umoya okwanele zisengozini enkulu kakhulu yokungenwa yilesi sifo. Emakhishini anamathiselwe, izibaseli ezikhiqiza intuthu ngaphandle kwe-LPG, izinto ezixosha omiyane, i-Dhuna, njll., nazo zihlotshaniswa kakhulu nesifo sesifuba somoya ebuntwaneni (p-value<0.05). Emakhishini anamathiselwe, izibaseli ezikhiqiza intuthu ngaphandle kwe-LPG, izinto ezixosha omiyane, i-Dhuna, njll., nazo zihlotshaniswa kakhulu nesifo sesifuba somoya ebuntwaneni (p-value<0.05). В примыкающих кухнях использование значительно выделяющего дым топлива, кроме сжиженного нефтяного газа, репеллентов от, пеллентов от.д., также связано с детской астмой (значение p<0,05). Emakhishini akhelene, ukusetshenziswa kwezibaseli ezikhiqiza intuthu kakhulu ngaphandle kwe-LPG, izinto ezixosha omiyane, i-Dhuna, njll., nakho kuhlotshaniswa nesifo sesifuba somoya ebuntwaneni (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）, 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). Izibaseli eziphehla intuthu ngaphandle kwe-LPG, into exosha omiyane, i-Dhuna, njll. nazo zazihlotshaniswa kakhulu nesifo sesifuba somoya ebuntwaneni emakhishini axhumene (p value <0.05).Kuphinde kwaphawulwa ukuthi izingane ezinezilwane ezifuywayo zazinethuba eliphindwe kayisi-8 lokuthuthukisa isifuba somoya (Ithebula 2).
Njengoba kukhonjisiwe kuThebula lesi-3, ama-46.7% amacala bekungeyemindeni enesimo esiphansi senhlalo-mnotho. Imfundo yokubeletha nayo yayiphansi phakathi kwamacala (p-value<0.05). Imfundo yokubeletha nayo yayiphansi phakathi kwamacala (p-value<0.05). I-Материнское образование также было ниже среди случаев (значение p<0,05). Imfundo yomama nayo ibiphansi phakathi kwezimo (p value<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）。 I-Матери в этих случаях также были менее образованными (значение p <0,05). Omama kulezi zimo nabo babengafundile kangako (p value <0.05).
Izingane ezizalwa ngokuhlinzwa (CS) noma ezinye izindlela zokubeletha, kanye nezingane ezinomlando we-asphyxia yokuzalwa, zisengozini enkulu yalesi sifo.Ukwengeza, izingane eziphezulu/ezidla ukudla okuxubile zazicishe zibe kahlanu amathuba okuba zithole lesi sifo kunezingane ezinceliswa ibele (Ithebula 4).
Umlando wokungezwani nokudla kwezingane kanye ne-atopy uye waxhunyaniswa kakhulu nesifuba somoya sezingane. Futhi, izingane ezivela emindenini enomlando wokungezwani komzimba nesifuba somoya (p-value<0.05) zazithambekele kakhulu ekutholeni lesi sifo. Futhi, izingane ezivela emindenini enomlando wokungezwani komzimba nesifuba somoya (p-value<0.05) zazithambekele kakhulu ekutholeni lesi sifo. Также высокой склонностью к заболеванию отличались дети из семей с анамнезом аллергии и астмы (значение p<0,05). Futhi, izingane ezivela emindenini ezinomlando we-allergies kanye ne-asthma zine-propensity ephezulu kulesi sifo (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 and астмой в анамнезе (р-значение <0,05) были высоко восприимчивы. Ukwengeza, izingane ezivela emindenini ezinomlando wokungezwani komzimba nesifuba somoya (i-p-value <0.05) zazisengozini kakhulu. Ukubhema ugwayi ngamanye amalungu omndeni nakho kwenyuse cishe ngokuphindwe kasishiyagalombili ingozi yesifuba somoya ezinganeni (p-value<0.05). Ukubhema ugwayi ngamanye amalungu omndeni nakho kwenyuse cishe ngokuphindwe kasishiyagalombili ingozi yesifuba somoya ezinganeni (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). Ukubhema ugwayi ngamanye amalungu omndeni nakho kwandisa ingozi yokuba nesifuba somoya ezinganeni cishe izikhathi eziyisishiyagalombili (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 ku 8 раз (p-значение <0,05). Ukubhema ugwayi ngamanye amalungu omndeni nakho kwandisa ingozi yokuhlaselwa yisifuba somoya ezinganeni cishe izikhathi eziyisi-8 (inani le-p <0.05).(Ithebula 5)
Ukuhlehla okuphindwe kabili kwezinhlelo zokusebenza kubonise ukuthi izingane ezisezindaweni zasemadolobheni, izindawo ezinomswakama, isimo esiphansi senhlalo-mnotho, izilwane ezifuywayo, umlando womndeni we-atopy/allergies, umlando womndeni wokubhema/ukubhema ugwayi, kanye nokudla okuxubile kwaba negalelo elikhulu.Izinto eziyingozi zesifuba somoya ebuntwaneni (Ithebula 6).
Ithebula 6 Ukuhlaziywa kokuhlehla kwezinto eziningi ukuze kuhlolwe izici ezibalulekile ezithonya isifuba somoya ebuntwaneni.
Phakathi neminyaka engamashumi amabili kuya kwamathathu edlule, inani lezifo ze-atopic liye landa, okwenza kube nezingxoxo eziningi mayelana nokushintsha kwemvelo, ukungcola, kanye nezimpendulo zokuzivikela ezifweni ezithathelwanayo.Kokubili ukuchayeka kwemvelo kanye nokuba sengozini kwebhayoloji kanye nezakhi zofuzo kudlala indima ekuthuthukisweni kwesifuba somoya.
Kulolu cwaningo, u-2.96% weziguli eziseqenjini leminyaka emi-3 kuya kweyi-12 zabika isifuba somoya sezingane.Kodwa-ke, ezinye izifundo zangaphambilini ziye zabika izinhlobo ezihlukahlukene ze-asthma yezingane ezinganeni zaseNdiya.6,10-12 Umehluko wendawo kanye nemvelo eNdiya uthonya ngokuqondile futhi uthinte izici eziyingozi ezihlobene nesifo somoya.6 Ngakho, ukuze kuvinjwe lesi sifo ngendlela efanele nangesikhathi esifanele, ukuhlolwa kwesifunda kwezici eziyinhloko zesifuba somoya ebuntwaneni kuyadingeka.
Izingane ezineminyaka engu-7-12 ubudala, amadoda kanye nezingane ezihlala ezindaweni zasemadolobheni zisengozini enkulu ye-asthma yezingane.Ukubusa kwezindawo zasemadolobheni nabesilisa ekwandeni kwesifuba somoya kwabonwa ocwaningweni lwaseNdiya,10 olufana nokutholwe kwethu.Nokho, lokhu kuhlotshaniswa bekubaluleke ngokwezibalo kuphela kumongo wendawo yasekhaya.
Ucwaningo luye lwabonisa ukuthi izinguquko zamahomoni eziqondene nobulili zingase zibe nomthelela kusifuba somoya, njengoba abafana besengozini enkulu yokuba nesifuba somoya ebuntwaneni.Nokho, lesi sithombe siyashintsha ngemva kokuthomba, futhi abesifazane bahlakulela lesi sifo kaningi kunabesilisa.13-15 Ngaphezu kwalokho, abafana abangaphansi kweminyaka engu-10 ubudala banemigudu yokuphefumula emincane kunamantombazane aneminyaka efanayo, futhi ukuphakama nakho kucatshangwa ukuthi kuyimbangela yesifuba somoya ebuntwaneni kubafana.16.17
I-Metro Kamstrup, inhloko-dolobha yase-Assam, ibonise ukukhula kwamadolobha ngokushesha eminyakeni yamuva.Ucwaningo oluningi lubika ukuthi ukufudukela emadolobheni kuyisici esithonya izehlakalo zesifuba somoya, okuhambisana nocwaningo lwethu.I-18,19 Ocwaningweni lwamanje, ukuhlehliswa kwezinto okungalungisiwe kubonise ukuthi izingane ezikhuluphele ngokweqile futhi ezikhuluphele zazingaphezu kokuphindwe kabili amathuba okuba ne-asthma kunezingane ezine-BMI evamile, ehambisana nokubuyekezwa kwakamuva.20 Ngaphezu kwalokho, isimo esiphansi senhlalo-mnotho siyisici esiyingozi esingaba khona sesifuba somoya ebuntwaneni.Izingane eziphuma emindenini enesimo esiphansi somnotho zisengozini enkulu yokuba nesifuba somoya ngenxa yokusabela okuphansi kwamasosha omzimba kanye nezinsiza zokunakekelwa kwezempilo eziphansi.21-23
Izingane ezihlala emndenini ohlanganyelwe, izindlu ze-kaccha, izindawo zokuhlala ezinomswakama, ukungena komoya okwanele, amakhishi anamathiselwe, izinto zokubasa ezikhiqiza intuthu, izinto ezixosha omiyane kanye ne-Dhuna, njll., zazihlotshaniswa kakhulu nesifo sesifuba somntwana (p-value<0.05). Izingane ezihlala emndenini ohlanganyelwe, izindlu ze-kaccha, izindawo zokuhlala ezinomswakama, ukungena komoya okwanele, amakhishi anamathiselwe, izinto zokubasa ezikhiqiza intuthu, izinto ezixosha omiyane kanye ne-Dhuna, njll., zazihlotshaniswa kakhulu nesifo sesifuba somntwana (p-value<0.05).Izingane ezihlala emndenini ohlanganyelwe, ezibalekela ikhaya, izindlu ezinomswakama, ukungena komoya okwanele, amakhishi anamathiselwe, uphethiloli okhiqiza intuthu, izinto zokuxosha omiyane kanye neDhuna njll.д., были достоверно связаны с детской астмой (значение р<0,05). e., zazihlotshaniswa kakhulu ne-asthma yezingane (inani 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、驱剘光、驱公光、驱公光、驱公寓显着相关 (p 值<0.05). Izingane ezihlala emizini ehlanganyelwayo, ezindlini zama-kaccha, izindlu ezimanzi, ukuntula umoya okwanele, ikhishi elinamathiselwe, uphethiloli okhiqiza intuthu, izinto ezixosha omiyane, kanye ne-Dhuna zihlobene kakhulu nesifo sesifuba sezingane (p value<0.05). Дети в общих домохозяйствах, домах качча, сырых жилищах, неадекватной вентиляции, пристроенных кухнях, задымлищах, неадекватной вентиляции, пристроенных кухнях, задымленонном уна были в значительной степени связаны с детской астмой (значение p <0,05). Izingane ezihlala emizini ehlanganyelwe, ukugijima kwezindlu, izindlu ezimanzi, ukuntula umoya okwanele, amakhishi afakiwe, uphethiloli oshunqayo, izinto ezixosha omiyane kanye ne-dhuna zazihlotshaniswa kakhulu nesifo sesifuba somoya ebuntwaneni (p value <0.05).Ucwaningo lwangaphambilini luphinde lwabonisa ukuthi izici ezihlukahlukene zemvelo zasendlini zingabangela isifuba somoya ezinganeni.24-27 Ukuhlotshaniswa kwezifo ezifuywayo zasendlini nesifuba somoya ebuntwaneni kuyimpikiswano, njengoba abacwaningi abambalwa bakholelwa ukuthi ukuchayeka kusenesikhathi ezintweni ezingezwani nakho kungase kube nomthelela ekuthuthukisweni kokubekezelelana.28
Ucwaningo oluningi luye lwabonisa ukuthi izingane ezizalwa ngokuhlinzwa zinengozi eyengeziwe yokuba nesifuba somoya ebuntwaneni uma kuqhathaniswa nokuzalwa okuvamile.Lokhu kuhambisana nemiphumela yethu.29-32 Izingane ezinomlando we-asphyxia yokuzalwa nazo zisengozini enkulu yokuba nesifuba somoya.Isifuba somoya komama sinomthelela obalulekile ezinkingeni zokukhulelwa ezifana nesifo sokuphefumula kokuphefumula kanye neonatal asphyxia.33
Njengakwezinye izifundo, okutholakele kwamanje kubonisa ukuthi umlando wezingane wokungezwani nokudla noma i-atopy noma umlando womndeni wokungezwani komzimba nesifuba somoya kwandisa kakhulu ingozi yesifuba somoya ebuntwaneni.I-34,35 Ngokuvumelana nocwaningo lwethu, izifundo zangaphambilini eziningi ziye zabonisa ukuthi imikhuba yokubhema phakathi kwezizukulwane ingaholela ekushintsheni kofuzo ku-epigenome okwandisa ingozi ye-asthma kubantwana.36
Ezinsukwini zamuva nje, ukufudukela kwabantu emadolobheni ngokushesha kuye kwathinta zonke izigaba zomphakathi.Ngenxa yemithombo ehlukene yemali engenayo nemisebenzi, abantu bancamela ukuhlala emadolobheni futhi ngaleyo ndlela bachayeke ezintweni ezingcolisa imvelo ezihlukahlukene.Amalungu omndeni ezingane ezisengozini yokungenwa yilesi sifo ayalulekwa ukuthi anake kakhulu ukugwema umswakama, ukubhema, ukugcina izilwane ezifuywayo emndenini ezingezwani nezinto ezithile, kanye nokugwema izinto ezingezwani nomzimba/izinto ezingezwani nomzimba ezinganeni ezinomlando womndeni wokungezwani komzimba nezinto ezithile.Kufanele kube nokuqwashisa okwengeziwe ngokuncelisa ibele kuphela ngenxa yezinzuzo zokuncelisa ekuvimbeleni isifuba somoya.
Iningi leziguli eziza eGuwahati Medical College zivela kulo lonke elaseNyakatho East India njengoba iGuwahati Medical College iyisikhungo sochwepheshe esisezingeni eliphezulu esifundeni.Iningi leziguli lalinesimo esiphansi senhlalo-mnotho kanye nezinga eliphansi lemfundo.I-asthma ye-bronchial ezinganeni iyinkinga evamile emnyangweni wezingane esibhedlela sethu.Amasu okuvimbela afanelekile alezi ziguli ezisengozini enkulu azosiza ukunciphisa ukugula futhi anciphise imvamisa yokwanda.
Naphezu kwakho konke ukwelashwa okutholakalayo kwesifuba somoya, iziguli eziningi zihlala zingalawuleki kahle, kodwa ukuhlonzwa kwenani elithile leziguli, okuhlanganisa ama-phenotypes nama-endotypes, kungathuthukisa ukuphathwa kwazo.Ngakho-ke, izifundo zesifunda zokuvama kwesifuba somoya ebuntwaneni kanye nezici zobungozi zizosiza ekulawuleni ngempumelelo lezi zimo.
Kulolu cwaningo, ezinye iziguli azibuyanga ukuze zihlolwe futhi zilandelelwe.Lokhu kungase kube ngenxa yokungaqapheli izimbangela nemiphumela yalesi sifo.Ngenxa yezinhlelo zokuxhumana ezingezinhle, asikwazanga ukulandelela zonke iziguli.
Izingane zisengozini yokuba nesifuba somoya semvelo, futhi ukuqonda kahle izimbangela ze-asthma yemvelo kanye nezinto ezingezwani nazo kungasiza ukulawula nokunciphisa umthwalo wesifo.Emindenini enomlando wokungezwani komzimba nezinto ezithile noma isifuba somoya, kufanele kuthathwe ukunakekelwa okufanele ukuze kuvikelwe izingane ezingaba sengozini ezicini ezingase zibe khona.
Yonke idatha yagcinwa iyimfihlo futhi ucwaningo lwenziwa ngokuhambisana neSimemezelo sase-Helsinki.
Sibonga bonke odokotela bezingane abasize ukuqoqa idatha nokuhlola okuqukethwe kolwazi lwabo.Bonke ozakwethu bomnyango abasisize ukuthi sifinyelele emitapweni yolwazi yomnyango nasezindaweni ezizungezile ngesikhathi socwaningo nabo baqashelwe.
Bonke ababhali benze igalelo elibalulekile emsebenzini wombiko, kungakhathaliseki ukuthi kumqondo, umklamo wocwaningo, ukubulawa, ukuqoqwa kwedatha, ukuhlaziya nokuchazwa, noma zonke lezi zindawo;babambe iqhaza ekubhalweni, ekubuyekezweni noma ekubuyekezweni okubucayi kwesihloko.Qedela inguqulo ukuze ishicilelwe, vumelana ngejenali okuzothunyelwa kuyo isihloko, futhi uvume ukuba nesibopho kuzo zonke izici zomsebenzi.
1. Isu lomhlaba wonke lokwelapha nokuvimbela isifuba somoya.I-Global Asthma Initiative.2018. Itholakala ku: https://ginasthma.org/wp-content/uploads/2019/01/2018-GINA.pdf.Kusukela ngomhla ka-2 Disemba 2021