土源性线虫感染对农村学龄前儿童喘息、哮喘和皮肤点刺试验阳性的影响

doi:10.12140/j.issn.1000-7423.2023.03.012

中国寄生虫学与寄生虫病杂志 ›› 2023, Vol. 41 ›› Issue (3): 336-343.doi: 10.12140/j.issn.1000-7423.2023.03.012

土源性线虫感染对农村学龄前儿童喘息、哮喘和皮肤点刺试验阳性的影响

李芳¹(), 王淑芳², 贺朋飞³, 徐淑慧⁴^,^*()

1 运城护理职业学院微生物免疫教研室，山西运城 044000
2 运城护理职业学院预防医学教研室，山西运城 044000
3 运城市中心医院体检科，山西运城 044000
4 海南医学院热带医学院临床检验教研室，海口 570100

收稿日期:2022-10-28 修回日期:2023-03-28 出版日期:2023-06-30 发布日期:2023-06-25
通讯作者: *徐淑慧（1980-），女，博士，副教授，从事病原生物的分子生物学研究，E-mail：17111010072@fudan.edu.cn
作者简介:李芳（1986-），女，硕士，从事常见寄生虫与相关疾病的研究。E-mail：li13028005703@163.com

Effects of soil-transmitted nematode infection on wheezing, asthma, and skin prick test positivities in rural preschool children

LI Fang¹(), WANG Shufang², HE Pengfei³, XU Shuhui⁴^,^*()

1 Department of Microbial Immunology Teaching and Research Office, Yuncheng Nursing College, Yuncheng 044000, Shanxi, China
2 Department of Preventive Medicine, Yuncheng Nursing College, Yuncheng 044000, Shanxi, China
3 Department of Physical Examination, Yuncheng Central Hospital， Yuncheng 044000, Shanxi, China
4 Department of Clinical Laboratory Teaching and Research, Tropical Medical College, Hainan Medical College, Haikou 570100, China

Received:2022-10-28 Revised:2023-03-28 Online:2023-06-30 Published:2023-06-25
Contact: *E-mail: 17111010072@fudan.edu.cn

摘要/Abstract

摘要：

目的探讨农村母亲和儿童土源性线虫感染对学龄前儿童喘息、哮喘和皮肤点刺试验（SPT）阳性的影响。方法收集2020年4月—2021年3月在运城市中心医院门诊进行健康体检的居住在农村地区的学龄前儿童及其母亲。通过问卷收集母亲与儿童基本资料，及关于喘息/哮喘的情况。收集研究对象粪样，采用改良加藤厚涂片法检测土源性线虫感染情况，并进行SPT试验，收集研究对象过敏特应性数据。应用多因素非条件logistic回归分析探讨影响儿童哮喘、喘息、SPT阳性的相关因素。结果本研究中儿童及其母亲各2 014人，母亲的土源性线虫感染率为14.40%（290/2 014），学龄前儿童的土源性线虫感染率为7.99%（161/2 014）。有喘息症状的儿童117例，发生率为5.81%（117/2 014）；哮喘149例，发生率为7.40%（149/2 014）；SPT阳性304例，阳性率为15.09%（304/2 014）。早产儿、母亲有过敏史、家中有人吸烟是儿童喘息的危险因素（P < 0.05，OR > 1）；儿童性别为女、完全母乳喂养是儿童喘息的保护因素（P < 0.05，OR < 1）。母亲有过敏史、家中有人吸烟、家中种植花草是儿童哮喘的危险因素（P < 0.05，OR > 1）；儿童性别为女、完全母乳喂养是儿童哮喘的保护因素（P < 0.05，OR < 1）。母亲有过敏史是儿童SPT阳性的危险因素（P < 0.05，OR > 1），儿童性别为女、儿童有土源性线虫感染、母亲有土源性线虫感染是儿童SPT阳性的保护因素（P < 0.05，OR < 1）。结论母亲和儿童土源性线虫感染可能会降低儿童过敏性疾病的发生。

关键词: 线虫, 儿童, 喘息, 哮喘, SPT阳性

Abstract:

Objective To investigate the effects of soil-transmitted nematode infection of mother and child on wheezing, asthma, and skin prick test (SPT) positive in rural preschool children. Methods Preschool children and their mohers in rural area were enrolled respectively, who underwent physical examination in the Yuncheng Central Hospital outpatient sector from April 2020 to March 2021. Basic information of mothers and children and children’s wheezing/asthma condition were collected through questionnaires. Fecal samples were collected from participants, and examined for soil-transmitted nematode eggs by the Kato-Katz thick smaear method, The SPT test was performed for children to collect allergic and atopic data. Multivariate unconditional logistic regression analysis was used to explore the relevant factors affecting asthma, wheezing, and SPT positivity in children. Results In this study, there were 2 014 children and their mothers each. The infection rate of soil-transmitted nematodes among the mothers was 14.40% (290/2 014), and among the preschool children was 7.99% (161/2 014). There were 117 children had wheezing symptoms, with an occurrence rate of 5.81% (117/2 014); 149 cases had asthma, with an occurrence rate of 7.40% (149/2 014) and 304 cases were positive for SPT, with a positive rate of 15.09% (304/2 014). Premature infants, mothers with a history of allergies, and family members smoking are risk factors for wheezing in children (P < 0.05, OR > 1); female gender and complete breastfeeding are protective factors for wheezing in children (P < 0.05, OR < 1). Mothers with a history of allergies, having someone smoking at home, and planting flowers and plants at home are risk factors for childhood asthma (P < 0.05, OR > 1); female and complete breastfeeding are protective factors for childhood asthma (P < 0.05, OR < 1). Mothers with a history of allergies is a risk factor for SPT positivity in children (P < 0.05, OR > 1), while the gender of the child, presence of soil-transmitted nematode infection in the child, and presence of soil-transmitted nematode infection in the mother are protective factors for SPT positivity in children (P < 0.05, OR < 1). Conclusion Mothers and children infected with soil-transmitted nematode may reduce the occurrence of allergic diseases in children.

Key words: Worm, Children, Wheezing, Asthma, SPT positive

中图分类号:

R383.1

李芳, 王淑芳, 贺朋飞, 徐淑慧. 土源性线虫感染对农村学龄前儿童喘息、哮喘和皮肤点刺试验阳性的影响[J]. 中国寄生虫学与寄生虫病杂志, 2023, 41(3): 336-343.

LI Fang, WANG Shufang, HE Pengfei, XU Shuhui. Effects of soil-transmitted nematode infection on wheezing, asthma, and skin prick test positivities in rural preschool children[J]. Chinese Journal of Parasitology and Parasitic Diseases, 2023, 41(3): 336-343.

图/表 6

表1

表2

表3

调查对象中儿童喘息、哮喘、SPT影响因素的单因素分析

特征 Feature	全部（构成比/%） Total (constituent ratio/%)	喘息史（构成比/%） Wheezing history (constituent ratio/%)	哮喘（构成比/%） Asthma history (constituent ratio/%)	SPT阳性（构成比/%） SPT Positive (constituent ratio/%)	χ²（F）	P
母亲 Mothers
分娩年龄/岁 Delivery age/year	25.14 ± 3.82	26.74 ± 3.26	25.99 ± 3.65	26.01 ± 3.74	-2.282	> 0.05
教育年限/年 Education years/year	11.38 ± 3.02	11.25 ± 3.17	11.49 ± 2.98	11.67 ± 2.95	-0.870	> 0.05
过敏史 Allergy history
否 No	1 137（56.45）	54（46.15）	60（40.27）	115（37.83）	2.437	> 0.05
是 Yes	877（43.55）	63（53.85）	89（59.73）	189（62.17）
儿童 Children
性别 Gender
男 Male	1 083（53.77）	84（71.79）	103（69.13）	197（64.80）	2.163	> 0.05
女 Female	931（46.23）	33（28.21）	46（30.87）	107（35.20）
剖宫产 Cesarean section
否 No	1 341（66.58）	85（72.65）	102（68.46）	203（66.78）	1.349	> 0.05
是 Yes	673（33.42）	32（27.35）	47（31.54）	101（33.22）
早产 Premature birth
否 No	1 805（89.62）	86（73.50）	134（89.93）	272（89.47）	20.475	< 0.05
是 Yes	209（10.38）	31（26.50）	15（10.07）	32（10.53）
出生顺序 Birth order	1.94 ± 0.57	2.01 ± 0.32	1.86 ± 0.62	1.99 ± 0.45
出生后母乳喂养 Postnatal breastfeeding
否 No	143（7.10）	0（0.00）	17（11.41）	31（10.20）	34.154	< 0.05
不完全 Incompletely	1 204（59.78）	66（56.41）	56（37.58）	181（59.54）
完全 Completely	667（33.12）	51（43.59）	76（51.01）	92（30.26）
家庭居住面积/m² Household living area/m²	87.24 ± 23.25	90.25 ± 24.16	82.37 ± 28.94	85.19 ± 30.26	-2.267	> 0.05
共同居住人口数/人 No. co residents/person	4.06 ± 1.37	4.84 ± 1.52	4.66 ± 1.28	4.93 ± 1.14	-1.663	> 0.05
家庭宠物数/只 No. family pets/piece	1.06 ± 0.33	1.21 ± 0.40	1.38 ± 0.29	1.25 ± 0.17	-14.500	< 0.05
家中种植花草 Planting flowers and plants at home
否 No	1 197（50.43）	68（58.12）	61（40.94）	183（60.20）	15.647	< 0.05
是 Yes	817（40.57）	49（41.88）	88（59.06）	121（39.80）
饲养大型家畜 Raising large livestock
否 No	761（37.79）	50（42.74）	64（42.95）	117（38.49）	1.125	> 0.05
是 Yes	1 253（62.21）	67（57.26）	85（57.05）	187（61.51）
家中有人吸烟 Someone smoking at home
否 No	917（45.53）	31（26.50）	35（23.49）	143（47.04）	30.438	< 0.05
是 Yes	1 097（54.47）	86（73.50）	114（76.51）	161（52.96）
母亲土源性线虫感染 Mothers infected by soil borne nematodes
否 No	1 724（85.60）	96（82.05）	122（81.88）	282（92.76）	15.386	< 0.05
是 Yes	290（14.40）	21（17.95）	27（18.12）	22（7.24）
儿童土源性线虫感染 Children infected by soil borne nematodes
否 No	1 853（92.01）	106（90.60）	134（89.93）	294（96.71）	10.132	< 0.05
是 Yes	161（7.99）	11（9.40）	15（10.07）	10（3.29）

表3

表4

表5

表6

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因素 Factor	赋值 Assignment	因素 Factor	赋值 Assignment
母亲年龄/岁 Age of mothers/year	≤ 30 = 0，≥ 31 = 1	母亲文化程度 Education level of mothers	中学及以下 = 0，大专及以上 = 1 Middle school and below = 0, College and above = 1
儿童年龄/岁 Age of children/year	3~5 = 0，6~8 = 1	儿童性别 Gender of children	男 = 0，女 = 1 Male = 0, Female = 1
母亲分娩年龄/岁 Delivery age of mothers/year	< 24 = 0，≥ 24 = 1	母亲过敏史 Allergy history of mothers	否 = 0，是 = 1 No = 0, Yes = 1
剖宫产 Cesarean section	否 = 0，是 = 1 No = 0, Yes = 1	早产 Premature birth	否 = 0，是 = 1 No = 0, Yes = 1
出生顺序 Birth order	1 = 0，≥ 2 = 1	完全母乳喂养 Complete breastfeeding	否 = 0，是 = 1 No = 0, Yes = 1
家庭居住面积/m² Household living area/m²	< 50 = 0，≥ 50 = 1	家庭宠物数目/只 No. family pets/piece	≤ 2 = 0，≥ 2 = 1
家中种植花草 Planting flowers and plants at home	否 = 0，是 = 1 No = 0, Yes = 1	饲养大型家畜 Raising large livestock	否 = 0，是 = 1 No = 0, Yes = 1
母亲土源性线虫感染 Mothers infected with soil borne nematodes	否 = 0，是 = 1 No = 0, Yes = 1	儿童土源性线虫感染Children infected by soil borne nematodes	否 = 0，是 = 1 No = 0, Yes = 1
家中有人吸烟 Someone smoking at home	否 = 0，是 = 1 No = 0, Yes = 1	儿童有喘息史 Wheezing history of children	否 = 0，是 = 1 No = 0, Yes = 1
儿童有哮喘史 Asthma history of children	否 = 0，是 = 1 No = 0, Yes = 1	儿童SPT阳性 SPT positive in children	否 = 0，是 = 1 No = 0, Yes = 1

特征 Feature	检查人数 No. examined	鞭虫 Trichuris trichura		钩虫 Hookworm		蛔虫 Ascaris lumbricoides		合计 Total
特征 Feature	检查人数 No. examined	感染人数 No. infected	感染率/% Infection rate/%	感染人数 No. infected	感染率/% Infection rate/%	感染人数 No. infected	感染率/% Infection rate/%	感染人数 No. infected	感染率/% Infection rate/%
母亲 Mothers
年龄/岁 Age/Year
18~29	927	10	1.08	5	0.54	57	6.15	72	7.77
30~35	648	9	1.39	7	1.08	69	10.65	85	13.12
≥ 36	439	22	5.01	11	2.51	100	22.78	133	30.3
文化程度 Education level
小学及以下 Primary school and below	1 203	27	2.24	16	1.33	150	12.47	193	16.04
中学 Middle school	655	13	1.98	7	1.07	69	10.53	89	13.59
大专及以上 College and above	156	1	0.64	0	0	7	4.45	8	5.13
儿童 Children
年龄/岁 Age/Year
3	626	7	1.12	4	0.64	37	5.91	56	8.95
4	894	9	1.01	5	0.56	65	7.27	52	5.82
5~6	494	6	1.21	5	1.01	23	4.66	53	10.73
性别 Gender
男 Male	1 193	8	0.67	6	0.5	73	6.12	87	7.29
女 Female	821	14	1.71	8	0.97	52	6.33	74	9.01

因素 Factor	回归系数 Regression coefficient	标准误差 Standard error	χ²	P	OR	OR 95%CI
常数 Constant	0.100	0.048	4.344	< 0.05	-	-
早产儿 Premature	0.691	0.192	12.907	< 0.05	1.996	1.369~2.909
儿童性别 Gender of children	-0.459	0.201	5.230	< 0.05	0.632	0.426~0.936
母亲有过敏史 Allergy history of mothers	0.768	0.204	14.132	< 0.05	2.156	1.444~3.217
完全母乳喂养 Complete breastfeeding	-0.875	0.300	8.528	< 0.05	0.417	0.232~0.750
家中有人吸烟 Someone smoking at home	0.700	0.288	5.905	< 0.05	2.014	1.145~3.542

因素 Factor	回归系数 Regression coefficient	标准误差 Standard error	χ²	P	OR	OR 95%CI
常数 Constant	-0.044	0.023	3.552	> 0.05	-	-
儿童性别 Gender of children	-0.219	0.091	5.802	< 0.05	0.803	0.672~0.960
母亲有过敏史 Allergy history of mothers	0.767	0.215	12.716	< 0.05	2.153	1.413~3.282
完全母乳喂养 Complete breastfeeding	-0.475	0.177	7.185	< 0.05	0.622	0.439~0.880
家中有人吸烟 Someone smoking at home	0.628	0.168	13.945	< 0.05	1.873	1.348~2.605
家中种植花草 Planting flowers and plants at home	0.461	0.205	5.073	< 0.05	1.585	1.062~2.368

因素 Factor	回归系数 Regression coefficient	标准误差 Standard error	χ²	P	OR	OR 95%CI
常数 Constant	-0.076	0.037	4.156	< 0.05	-	-
儿童性别 Gender of children	-0.282	0.127	4.929	< 0.05	0.754	0.588~0.967
母亲有过敏史 Allergy history of mothers	0.249	0.096	6.788	< 0.05	1.283	1.064~1.547
儿童土源性线虫感染 Children infected by soil borne nematodes	-0.337	0.139	5.873	< 0.05	0.714	0.544~0.938
母亲土源性线虫感染Mothers infected by soil borne nematodes	-0.464	0.120	14.846	< 0.05	0.629	0.497~0.796

土源性线虫感染对农村学龄前儿童喘息、哮喘和皮肤点刺试验阳性的影响

Effects of soil-transmitted nematode infection on wheezing, asthma, and skin prick test positivities in rural preschool children

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