本文選題：大氣污染 + 幼兒　； 參考：《重慶醫(yī)科大學》2012年碩士論文

【摘要】：目的：分析孕期及嬰幼兒期煤煙型大氣污染暴露與幼兒呼吸系統(tǒng)癥狀及疾病發(fā)生的相關關系，探討幼兒呼吸系統(tǒng)癥狀及疾病發(fā)生的危險因素，為預防幼兒呼吸系統(tǒng)癥狀及疾病的發(fā)生提供流行病學依據(jù)。 方法：采用前瞻性隊列研究的方法，于火電廠關閉前后隨機選取銅梁縣公立醫(yī)院出生的符合納入標準的健康活產(chǎn)兒295名，隨訪至2歲。按照煤煙型大氣污染暴露程度分為暴露組與對照組，分別于出生及2歲時對家長或其監(jiān)護人進行《出生問卷》及《呼吸系統(tǒng)疾病調(diào)查表》問卷調(diào)查。 結(jié)果：（1）煤煙型大氣污染暴露組呼吸系統(tǒng)癥狀發(fā)生率高于對照組：呼吸系統(tǒng)總癥狀（98.37%57.05%）、鼻涕鼻塞（92.80%54.36%）、咳嗽（82.54%32.88%）、喉疼（17.60%12.59%）、哮鳴性咳嗽（3.17%0）、無感冒而咳（0.79%0.66%）、呼吸困難（0.79%0）。其中呼吸系統(tǒng)總癥狀、鼻涕鼻塞、咳嗽、哮鳴性咳嗽陽性發(fā)生率暴露組與對照組差異有統(tǒng)計學意義（P0.05）。多元Logistic回歸結(jié)果顯示煤煙型大氣污染暴露是呼吸系統(tǒng)總癥狀（OR=42.837）、鼻涕鼻塞（OR=9.780）和咳嗽（OR=10.281）發(fā)生的危險因素。 （2）近3個月內(nèi)煤煙型大氣污染暴露組與對照組幼兒肺炎、支氣管炎、支氣管哮喘、副鼻竇炎、細支氣管炎及肺結(jié)核等呼吸系統(tǒng)疾病的發(fā)生率差異無統(tǒng)計學意義。 （3）生后暴露組與對照組幼兒支氣管炎發(fā)生率有統(tǒng)計學差異（P0.05），呼吸系統(tǒng)疾病總發(fā)生率、肺炎、支氣管哮喘發(fā)生率兩組間差異無統(tǒng)計學意義。多元Logistic回歸結(jié)果顯示煤煙型大氣污染暴露是2歲幼兒生后支氣管炎發(fā)生的危險因素（OR=3.003）。 結(jié)論：（1）煤煙型大氣污染暴露引起幼兒呼吸系統(tǒng)癥狀發(fā)生率增高。（2）煤煙型大氣污染暴露對幼兒3個月內(nèi)呼吸系統(tǒng)疾病發(fā)生率影響不明顯。（3）生后煤煙型大氣污染暴露引起2歲幼兒支氣管炎發(fā)生率增高，，但對呼吸道疾病總發(fā)生率、肺炎及支氣管哮喘疾病發(fā)生率影響不明顯。
[Abstract]:Objective: to analyze the relationship between air pollution exposure of coal smoke type during pregnancy and infants, respiratory symptoms and diseases in infants, and to explore the risk factors of respiratory symptoms and diseases in infants. To provide epidemiological evidence for prevention of respiratory symptoms and diseases in young children. Methods: a prospective cohort study was used to randomly select 295 healthy live infants born in Tongliang public hospital before and after the closure of the power plant, who were followed up to 2 years old. According to the exposure degree of coal smoke air pollution, the parents or their guardians were investigated with birth questionnaire and respiratory diseases questionnaire respectively at birth and at the age of 2 years in the exposed group and the control group. Results the incidence of respiratory symptoms in the exposed group was higher than that in the control group: total respiratory symptoms were 98.37 W. 05, nasal obstruction 92.80 T.36, cough 82.542.88, larynx 17.60, wheezing cough 3.170, cough 0.790.66 without a cold, dyspnea 0.790, and dyspnea 0.7900.Results the incidence of respiratory symptoms in the exposed group was higher than that in the control group: 98.37 W. 05, 92.80 T.36, 82.542.88, 17.60 and 3.170, 0.790.66 and 0.790 respectively. The incidence of total respiratory symptoms, nasal obstruction, cough and wheezing cough in the exposed group was significantly higher than that in the control group (P 0.05). Multivariate Logistic regression analysis showed that air pollution exposure of coal smoke type was a risk factor for respiratory system symptoms: Orchus 42.837, nasal mucus 9.780) and cough Orr 10.281). The incidence of respiratory diseases such as pneumonia, bronchitis, bronchial asthma, paranasal sinusitis, bronchiolitis and pulmonary tuberculosis were not significantly different between the coal smoke air pollution exposure group and the control group in recent 3 months. (3) the incidence of bronchitis in postnatal exposure group was significantly different from that in control group (P 0.05). There was no significant difference between the two groups in the incidence of respiratory diseases, pneumonia and bronchial asthma. The results of multiple Logistic regression showed that exposure to coal smoke air pollution was a risk factor of postnatal bronchitis in children aged 2 years. Conclusion (1) the incidence of respiratory system symptoms in toddlers caused by air pollution exposure of coal smoke type is increased. 2) the incidence of respiratory diseases in children within 3 months is not significantly affected by exposure to coal smoke type air pollution. 3) after birth, there is no significant effect on the incidence of respiratory diseases in children with coal smoke type air pollution exposure. The incidence of bronchitis was increased in children aged 2 years. However, the incidence of respiratory diseases, pneumonia and bronchial asthma was not significantly affected.
【學位授予單位】：重慶醫(yī)科大學
【學位級別】：碩士
【學位授予年份】：2012
【分類號】：R725.6

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