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Article(id=1240950907408536499, tenantId=1146029695717560320, journalId=1227665162245664772, issueId=1240950898113966774, articleNumber=null, orderNo=null, doi=10.20043/j.cnki.MPM.202312476, pmid=null, cstr=null, oa=null, hot=null, price=null, onlineType=0, articleFormat=0, articleType=null, articleTypeStr=null, receivedDate=1703347200000, receivedDateStr=2023-12-24, revisedDate=null, revisedDateStr=null, acceptedDate=null, acceptedDateStr=null, onlineDate=1773795352078, onlineDateStr=2026-03-18, pubDate=1712678400000, pubDateStr=2024-04-10, doiRegisterDate=null, doiRegisterDateStr=null, onlineIssueDate=1773795352078, onlineIssueDateStr=2026-03-18, onlineJustAcceptDate=null, onlineJustAcceptDateStr=null, onlineFirstDate=null, onlineFirstDateStr=null, sourceXml=null, magXml=null, createTime=1773795352078, creator=13701087609, updateTime=1773795352078, updator=13701087609, issue=Issue{id=1240950898113966774, tenantId=1146029695717560320, journalId=1227665162245664772, year='2024', volume='51', issue='7', pageStart='1153', pageEnd='1344', issueExtLink='null', onlineDate='null', pubDate='null', beforeIssueId=null, nextIssueId=null, price=null, status=1, issueComplete=1, articleOrder=1, issueType=-1, specialIssue=null, createTime=1773795349862, creator=13701087609, updateTime=1773795519367, updator=13701087609, preIssue=null, nextIssue=null, ext={EN=IssueExt(id=1240951609136567133, tenantId=1146029695717560320, journalId=1227665162245664772, issueId=1240950898113966774, language=EN, specialIssueTitle=, coverIllustrator=null, specialIssueEditor=, specialIssueAbout=), CN=IssueExt(id=1240951609136567134, tenantId=1146029695717560320, journalId=1227665162245664772, issueId=1240950898113966774, language=CN, specialIssueTitle=, coverIllustrator=null, specialIssueEditor=, specialIssueAbout=)}, issueFiles=null}, startPage=1175, endPage=1180, ext={EN=ArticleExt(id=1240950907718915008, articleId=1240950907408536499, tenantId=1146029695717560320, journalId=1227665162245664772, language=EN, title=Analysis on epidemiological characteristics and multiple diseases of allergic diseases in children born from 2017 to 2022 in Yichang city, columnId=1240413921954295836, journalTitle=Modern Preventive Medicine, columnName=Epidemiology and Statistical Methods, runingTitle=null, highlight=null, articleAbstract=
Objective

Based on the health big data platform of Yichang city, to analyze the characteristics of allergic diseases of children born in medical institutions from 2017 to 2022 in Yichang city, and to clarify the distribution of allergic diseases among children in Yichang city.

Methods

Statistical analysis was conducted based on the records of born children with allergic diseases in the outpatient clinic of urban comprehensive medical institutions from 2017 to 2022 in the big data cloud platform of Yichang city.

Results

The number of visits of male children was 68 707, more than that of female children, and the number of visits had been increasing since 2017. The highest number of hospital visits was 46 190 (37.86%) among children of 0-1 year old, of which the highest number of visits was 3 331(13.74%) among children of two months. Atopic dermatitis/eczema and allergic rhinitis had a higher number of visits with 46 156 and 14 388 visits, respectively. The age of onset of atopic dermatitis was earlier, with the age of first consultation being 0.42 years, and the age of onset was earlier in males than in females. Atopic dermatitis/eczema and allergic rhinitis were the most common multimorbidities.

Conclusion

For children with atopic dermatitis/eczema and/or allergic rhinitis, the focus is on the development of concomitant diseases to further interrupt the allergic process and promote early detection, prevention and treatment of the disease.

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目的

基于宜昌市健康大数据平台，分析宜昌市2017—2022年期间出生的儿童在医疗机构就诊的过敏性疾病特征，明确宜昌市儿童过敏性疾病的多病分布。

方法

对宜昌市健康大数据云平台中2017—2022年城区综合医疗机构门诊就诊为过敏性疾病的出生儿童患者记录进行统计分析。

结果

男性儿童就诊68 707人次多于女性儿童的53 292人次，2017年以来就诊人次不断增加，0～1岁医院就诊人次最多，为46 190人次(37.86%)，其中二月龄就诊人次最多，为3 331人次(13.74%)。特应性皮炎/湿疹与过敏性鼻炎的就诊人次较高，分别为46 156和14 388人次。特应性皮炎的发病年龄较早，首次就诊年龄为0.42岁,男性的发病年龄要早于女性，特应性皮炎/湿疹与过敏性鼻炎是最常见的多病。

结论

对于患有特应性皮炎/湿疹和（或）过敏性鼻炎的儿童，重点关注其伴随疾病的发生，进一步阻断过敏进程，促进疾病早期发现、预防及治疗。

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孙谨芳，E-mail:
, copyrightStatement=本刊刊出的所有文章不代表中华预防医学会和本刊编委会的观点，除非特别声明。, copyrightOwner=中华预防医学会和四川大学华西公共卫生学院, extLink=null, articleAbsUrl=null, sourceXml=ffJYZwridhNRIShSiYVRNw==, magXml=ipAWd6B4w9Q9cYTelQk+Ng==, pdfUrl=null, pdf=Q4EDQDvI2VNEToJOh6PRDg==, pdfFileSize=775203, pdfExtLink=null, richHtmlUrl=null, mobilePdfUrl=null, reviewReport=null, pdfFirstPage=null, abstractGraph=AB2PuPgMrLUjqSG5cRHa2g==, abstractGraphContent=null, abstractVideo=null, citation=null, cebUrl=null, magXmlContent=afTbgkaIZR6ICmtiPqhvvg==, mapNumber=null, authorCompany=null, fund=null, authors=

孙明伟（1997—），男，硕士，研究方向；儿童过敏性疾病流行病学

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孙明伟（1997—），男，硕士，研究方向；儿童过敏性疾病流行病学

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孙明伟（1997—），男，硕士，研究方向；儿童过敏性疾病流行病学

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Placing food allergy risk in sub-Saharan Africa, refAbstract=null)], funds=[Fund(id=1240972168075473519, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1240950907408536499, awardId=ZNSA-2021035, language=CN, fundingSource=广东省钟南山医学基金会(ZNSA-2021035), fundOrder=null, country=null)], companyList=[AuthorCompany(id=1240972159963689147, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1240950907408536499, xref=1., ext=[AuthorCompanyExt(id=1240972159976272059, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1240950907408536499, companyId=1240972159963689147, language=EN, country=null, province=null, city=null, postcode=null, companyName=null, departmentName=null, remark=Office of Epidemiology, Chinese Center for Disease Control and Prevention, Beijing 100050, China), AuthorCompanyExt(id=1240972159997243580, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1240950907408536499, companyId=1240972159963689147, language=CN, country=null, province=null, city=null, postcode=null, companyName=null, departmentName=null, remark=1.中国疾病预防控制中心流行病学办公室，北京 100050)]), AuthorCompany(id=1240972160114684099, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1240950907408536499, xref=2., ext=[AuthorCompanyExt(id=1240972160127267013, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1240950907408536499, companyId=1240972160114684099, language=CN, country=null, province=null, city=null, postcode=null, companyName=null, departmentName=null, remark=2.北京大学医学部)]), AuthorCompany(id=1240972160219541708, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1240950907408536499, xref=3., ext=[AuthorCompanyExt(id=1240972160227930317, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1240950907408536499, companyId=1240972160219541708, language=CN, country=null, province=null, city=null, postcode=null, companyName=null, departmentName=null, remark=3.宜昌市疾病预防控制中心)])], figs=[ArticleFig(id=1240972164627755437, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1240950907408536499, language=EN, label=Figure 1, caption=Monthly medical visits for allergic diseases among children aged 0-1 in Yichang city from 2017 to 2022, figureFileSmall=hnyzDVabqk0NPu6Fmg65PA==, figureFileBig=WCW+P8P6T4SamOgiPJRU9A==, tableContent=null), ArticleFig(id=1240972164850053561, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1240950907408536499, language=CN, label=图1, caption=2017—2022年宜昌市0～1岁儿童过敏性疾病分月龄就诊情况, figureFileSmall=hnyzDVabqk0NPu6Fmg65PA==, figureFileBig=WCW+P8P6T4SamOgiPJRU9A==, tableContent=null), ArticleFig(id=1240972166439694788, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1240950907408536499, language=EN, label=Figure 2, caption=Composition chart of multiple allergic diseases among children in Yichang city from 2017 to 2022, figureFileSmall=5epYqqQa2HmwPAgjVUeFPw==, figureFileBig=+pTM3rEiguzujUiplhDHlA==, tableContent=null), ArticleFig(id=1240972166557135312, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1240950907408536499, language=CN, label=图2, caption=2017—2022年宜昌市儿童过敏性疾病的多病构成图, figureFileSmall=5epYqqQa2HmwPAgjVUeFPw==, figureFileBig=+pTM3rEiguzujUiplhDHlA==, tableContent=null), ArticleFig(id=1240972166691353055, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1240950907408536499, language=EN, label=Table 1, caption=

Gender-specific medical visits for allergic diseases among newborns in Yichang city from 2017 to 2022

, figureFileSmall=null, figureFileBig=null, tableContent=
出生年份
（年）		总人群男性女性
就诊人次(次)就诊人数年均人均就诊次数(次)就诊人次(次)就诊人数年均人均就诊次数(次)就诊人次(次)就诊人数年均人均就诊次数(次)
201738 34810 4150.6121 9825 7940.6316 3664 6210.59
201829 6289 1870.6516 5834 9670.6713 0454 2200.62
201924 2438 8640.6813 3184 7590.7010 9254 1050.67
202016 6227 0740.789 2363 7870.817 3863 2870.75
202110 0524 9631.015 7852 7881.044 2672 1750.98
20223 1061 8671.661 8031 0451.731 3038221.59
合计121 99942 370—68 70723 140—53 29219 230—
), ArticleFig(id=1240972166817182189, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1240950907408536499, language=CN, label=表1, caption=

2017—2022年宜昌市分年度出生儿童过敏性疾病的分性别就诊情况

, figureFileSmall=null, figureFileBig=null, tableContent=
出生年份
（年）		总人群男性女性
就诊人次(次)就诊人数年均人均就诊次数(次)就诊人次(次)就诊人数年均人均就诊次数(次)就诊人次(次)就诊人数年均人均就诊次数(次)
201738 34810 4150.6121 9825 7940.6316 3664 6210.59
201829 6289 1870.6516 5834 9670.6713 0454 2200.62
201924 2438 8640.6813 3184 7590.7010 9254 1050.67
202016 6227 0740.789 2363 7870.817 3863 2870.75
202110 0524 9631.015 7852 7881.044 2672 1750.98
20223 1061 8671.661 8031 0451.731 3038221.59
合计121 99942 370—68 70723 140—53 29219 230—
), ArticleFig(id=1240972166913651191, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1240950907408536499, language=EN, label=Table 2, caption=

Top 15 allergic diseases among infants in Yichang from 2017 to 2022

, figureFileSmall=null, figureFileBig=null, tableContent=
疾病名称合计男性女性
人次顺位人次顺位人次顺位
特应性皮炎/湿疹46 156125 807120 3491
皮炎15 52227 97437 5482
过敏性鼻炎14 38839 02725 3614
荨麻疹14 00447 76146 2433
慢性单纯苔藓和痒疹6 32653 34862 9785
哮喘6 28563 98852 2976
其它皮炎4 47172 52271 9497
接触过敏性皮炎3 81682 05881 7588
非化脓性中耳炎2 84491 70791 1379
过敏性结膜炎1 418109341048411
尿布性皮炎1 125115461157910
过敏性皮疹990125431244712
刺激物接触性皮炎746133891335713
血管神经性水肿338141691410914
外耳湿疹207151061510115
), ArticleFig(id=1240972167014314498, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1240950907408536499, language=CN, label=表2, caption=

2017—2022年宜昌出生儿童就诊前15位过敏性疾病情况

, figureFileSmall=null, figureFileBig=null, tableContent=
疾病名称合计男性女性
人次顺位人次顺位人次顺位
特应性皮炎/湿疹46 156125 807120 3491
皮炎15 52227 97437 5482
过敏性鼻炎14 38839 02725 3614
荨麻疹14 00447 76146 2433
慢性单纯苔藓和痒疹6 32653 34862 9785
哮喘6 28563 98852 2976
其它皮炎4 47172 52271 9497
接触过敏性皮炎3 81682 05881 7588
非化脓性中耳炎2 84491 70791 1379
过敏性结膜炎1 418109341048411
尿布性皮炎1 125115461157910
过敏性皮疹990125431244712
刺激物接触性皮炎746133891335713
血管神经性水肿338141691410914
外耳湿疹207151061510115
), ArticleFig(id=1240972167131755023, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1240950907408536499, language=EN, label=Table 3, caption=

Age of initial diagnosis for the top 15 allergic diseases among infants born in Yichang in 2017 and 2022 [M(Q1,Q3)]

, figureFileSmall=null, figureFileBig=null, tableContent=
疾病名称男性首次就诊年龄（岁）女性首次就诊年龄（岁）检验统计量P值
特应性皮炎/湿疹0.42(0.18,1.10)0.46(0.16,1.35)2 309 490.00<0.001
尿布性皮炎0.47(0.10,0.99)0.61(0.13,1.01)110 112.00<0.001
外耳湿疹0.58(0.26,0.93)0.33(0.17,0.62)3 766.500.003
其它皮炎1.08(0.42,2.29)1.36(0.48,2.51)705 751.00<0.001
刺激物接触性皮炎1.24(0.55,2.72)1.20(0.49,2.60)-0.470.596
皮炎1.41(0.72,2.64)1.52(0.77,2.59)1 692 381.00<0.001
慢性单纯苔藓和痒疹1.49(0.88,2.41)1.54(0.92,2.42)2.260.691
接触过敏性皮炎1.60(0.79,3.03)1.75(0.80,3.26)56 620.500.031
过敏性皮疹1.63(0.84,3.00)1.75(0.80,3.26)0.880.459
荨麻疹1.63(0.91,2.77)1.73(0.98,2.91)1 394 534<0.001
血管神经性水肿1.89(1.32,3.23)2.67(1.65,3.49)7 342.500.016
哮喘3.07(1.85,3.88)3.33(2.18,4.05)447 680.50<0.001
过敏性鼻炎3.24(2.17,4.04)3.29(2.18,4.05)103 689.000.449
过敏性结膜炎3.26(2.39,4.03)3.35(2.53,4.16)-0.230.086
非化脓性中耳炎3.91(3.29,4.46)3.87(3.32,4.49)1.120.792
), ArticleFig(id=1240972167232418330, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1240950907408536499, language=CN, label=表3, caption=

2017—2022年宜昌出生儿童就诊前15位过敏性疾病首次就诊年龄[M(Q1,Q3)]

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疾病名称男性首次就诊年龄（岁）女性首次就诊年龄（岁）检验统计量P值
特应性皮炎/湿疹0.42(0.18,1.10)0.46(0.16,1.35)2 309 490.00<0.001
尿布性皮炎0.47(0.10,0.99)0.61(0.13,1.01)110 112.00<0.001
外耳湿疹0.58(0.26,0.93)0.33(0.17,0.62)3 766.500.003
其它皮炎1.08(0.42,2.29)1.36(0.48,2.51)705 751.00<0.001
刺激物接触性皮炎1.24(0.55,2.72)1.20(0.49,2.60)-0.470.596
皮炎1.41(0.72,2.64)1.52(0.77,2.59)1 692 381.00<0.001
慢性单纯苔藓和痒疹1.49(0.88,2.41)1.54(0.92,2.42)2.260.691
接触过敏性皮炎1.60(0.79,3.03)1.75(0.80,3.26)56 620.500.031
过敏性皮疹1.63(0.84,3.00)1.75(0.80,3.26)0.880.459
荨麻疹1.63(0.91,2.77)1.73(0.98,2.91)1 394 534<0.001
血管神经性水肿1.89(1.32,3.23)2.67(1.65,3.49)7 342.500.016
哮喘3.07(1.85,3.88)3.33(2.18,4.05)447 680.50<0.001
过敏性鼻炎3.24(2.17,4.04)3.29(2.18,4.05)103 689.000.449
过敏性结膜炎3.26(2.39,4.03)3.35(2.53,4.16)-0.230.086
非化脓性中耳炎3.91(3.29,4.46)3.87(3.32,4.49)1.120.792
), ArticleFig(id=1240972167337275948, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1240950907408536499, language=EN, label=Table 4, caption=

Distribution of the number of allergic diseases among infants born in Yichang from 2017 to 2022

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系统过敏性疾病系统疾病名称人数占比(%)
一种35 26883.24
皮肤粘膜过敏30 57886.70
呼吸系统过敏3 89811.05
其它过敏4061.15
眼部过敏2910.83
两种6 31314.90
皮肤粘膜过敏+呼吸系统过敏5 10280.82
皮肤粘膜过敏+眼部过敏4056.42
皮肤粘膜过敏+其它过敏3996.32
呼吸系统过敏+其它过敏1782.82
三种7551.78
皮肤粘膜过敏+呼吸系统过敏+其它过敏34045.03
皮肤粘膜过敏+呼吸系统过敏+眼部过敏33644.50
), ArticleFig(id=1240972167496659515, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1240950907408536499, language=CN, label=表4, caption=

2017—2022年宜昌市出生儿童患有过敏性疾病所在系统的数量分布

, figureFileSmall=null, figureFileBig=null, tableContent=
系统过敏性疾病系统疾病名称人数占比(%)
一种35 26883.24
皮肤粘膜过敏30 57886.70
呼吸系统过敏3 89811.05
其它过敏4061.15
眼部过敏2910.83
两种6 31314.90
皮肤粘膜过敏+呼吸系统过敏5 10280.82
皮肤粘膜过敏+眼部过敏4056.42
皮肤粘膜过敏+其它过敏3996.32
呼吸系统过敏+其它过敏1782.82
三种7551.78
皮肤粘膜过敏+呼吸系统过敏+其它过敏34045.03
皮肤粘膜过敏+呼吸系统过敏+眼部过敏33644.50
), ArticleFig(id=1240972167660237382, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1240950907408536499, language=EN, label=Table 5, caption=

Distribution of the number of multiple allergic diseases among infants born in Yichang from 2017 to 2022

, figureFileSmall=null, figureFileBig=null, tableContent=
多病种类顺位人数占比(%)
特应性皮炎+皮炎11 77210.04
特应性皮炎+荨麻疹21 0796.12
特应性皮炎+过敏性鼻炎37234.10
特应性皮炎+其他皮炎45793.28
特应性皮炎+慢性单纯苔藓和痒疹55072.87
特应性皮炎+荨麻疹+皮炎64302.44
荨麻疹+皮炎74232.40
特应性皮炎+接触过敏性皮炎83381.92
特应性皮炎+慢性单纯苔藓和痒疹+皮炎92831.60
特应性皮炎+过敏性鼻炎+皮炎102761.56
过敏性鼻炎+皮炎112731.55
慢性单纯苔藓和痒疹+皮炎122521.43
哮喘+过敏性鼻炎132461.39
哮喘+特应性皮炎142231.26
特应性皮炎+其它皮炎+皮炎152181.24
), ArticleFig(id=1240972167786066515, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1240950907408536499, language=CN, label=表5, caption=

2017—2022年宜昌市出生儿童患有过敏性疾病多病的数量分布

, figureFileSmall=null, figureFileBig=null, tableContent=
多病种类顺位人数占比(%)
特应性皮炎+皮炎11 77210.04
特应性皮炎+荨麻疹21 0796.12
特应性皮炎+过敏性鼻炎37234.10
特应性皮炎+其他皮炎45793.28
特应性皮炎+慢性单纯苔藓和痒疹55072.87
特应性皮炎+荨麻疹+皮炎64302.44
荨麻疹+皮炎74232.40
特应性皮炎+接触过敏性皮炎83381.92
特应性皮炎+慢性单纯苔藓和痒疹+皮炎92831.60
特应性皮炎+过敏性鼻炎+皮炎102761.56
过敏性鼻炎+皮炎112731.55
慢性单纯苔藓和痒疹+皮炎122521.43
哮喘+过敏性鼻炎132461.39
哮喘+特应性皮炎142231.26
特应性皮炎+其它皮炎+皮炎152181.24
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宜昌市2017—2022年出生儿童过敏性疾病流行病学特征及多病分析
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孙明伟 1 , 刘钦 1 , 王琦琦 1 , 李国星 2 , 张艳丽 3 , 孙谨芳 1
现代预防医学 | 流行病与统计方法 2024,51(7): 1175-1180
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现代预防医学 | 流行病与统计方法 2024, 51(7): 1175-1180
宜昌市2017—2022年出生儿童过敏性疾病流行病学特征及多病分析
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孙明伟1, 刘钦1, 王琦琦1, 李国星2, 张艳丽3, 孙谨芳1
作者信息
  • 1.中国疾病预防控制中心流行病学办公室，北京 100050
  • 2.北京大学医学部
  • 3.宜昌市疾病预防控制中心

    • 孙明伟（1997—），男，硕士，研究方向；儿童过敏性疾病流行病学

通讯作者:

孙谨芳，E-mail:
Analysis on epidemiological characteristics and multiple diseases of allergic diseases in children born from 2017 to 2022 in Yichang city
Ming-wei SUN1, Qin LIU1, Qi-qi WANG1, Guo-xing LI2, Yan-li ZHANG3, Jin-fang SUN1
Affiliations
  • Office of Epidemiology, Chinese Center for Disease Control and Prevention, Beijing 100050, China
出版时间: 2024-04-10 doi: 10.20043/j.cnki.MPM.202312476
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目的

基于宜昌市健康大数据平台，分析宜昌市2017—2022年期间出生的儿童在医疗机构就诊的过敏性疾病特征，明确宜昌市儿童过敏性疾病的多病分布。

方法

对宜昌市健康大数据云平台中2017—2022年城区综合医疗机构门诊就诊为过敏性疾病的出生儿童患者记录进行统计分析。

结果

男性儿童就诊68 707人次多于女性儿童的53 292人次，2017年以来就诊人次不断增加，0～1岁医院就诊人次最多，为46 190人次(37.86%)，其中二月龄就诊人次最多，为3 331人次(13.74%)。特应性皮炎/湿疹与过敏性鼻炎的就诊人次较高，分别为46 156和14 388人次。特应性皮炎的发病年龄较早，首次就诊年龄为0.42岁,男性的发病年龄要早于女性，特应性皮炎/湿疹与过敏性鼻炎是最常见的多病。

结论

对于患有特应性皮炎/湿疹和（或）过敏性鼻炎的儿童，重点关注其伴随疾病的发生，进一步阻断过敏进程，促进疾病早期发现、预防及治疗。

过敏性疾病  /  儿童  /  多病
Objective

Based on the health big data platform of Yichang city, to analyze the characteristics of allergic diseases of children born in medical institutions from 2017 to 2022 in Yichang city, and to clarify the distribution of allergic diseases among children in Yichang city.

Methods

Statistical analysis was conducted based on the records of born children with allergic diseases in the outpatient clinic of urban comprehensive medical institutions from 2017 to 2022 in the big data cloud platform of Yichang city.

Results

The number of visits of male children was 68 707, more than that of female children, and the number of visits had been increasing since 2017. The highest number of hospital visits was 46 190 (37.86%) among children of 0-1 year old, of which the highest number of visits was 3 331(13.74%) among children of two months. Atopic dermatitis/eczema and allergic rhinitis had a higher number of visits with 46 156 and 14 388 visits, respectively. The age of onset of atopic dermatitis was earlier, with the age of first consultation being 0.42 years, and the age of onset was earlier in males than in females. Atopic dermatitis/eczema and allergic rhinitis were the most common multimorbidities.

Conclusion

For children with atopic dermatitis/eczema and/or allergic rhinitis, the focus is on the development of concomitant diseases to further interrupt the allergic process and promote early detection, prevention and treatment of the disease.

Allergic disease  /  Children  /  Multiple diseasess
孙明伟, 刘钦, 王琦琦, 李国星, 张艳丽, 孙谨芳. 宜昌市2017—2022年出生儿童过敏性疾病流行病学特征及多病分析. 现代预防医学, 2024 , 51 (7) : 1175 -1180 . DOI: 10.20043/j.cnki.MPM.202312476
Ming-wei SUN, Qin LIU, Qi-qi WANG, Guo-xing LI, Yan-li ZHANG, Jin-fang SUN. Analysis on epidemiological characteristics and multiple diseases of allergic diseases in children born from 2017 to 2022 in Yichang city[J]. Modern Preventive Medicine, 2024 , 51 (7) : 1175 -1180 . DOI: 10.20043/j.cnki.MPM.202312476
正文
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过敏性疾病又称变态反应性疾病，是机体受过敏原（如花粉、食物和药物等）刺激后引起的组织损伤或生理功能紊乱，常见的儿童过敏性疾病主要包括特应性皮炎（atopic dermatitis, AD）、过敏性哮喘（allergic asthma，AA）、食物过敏（food allergy, FA）、过敏性鼻炎（allergic rhinitis,AR）[1-2]。过敏性疾病被世界卫生组织（WHO）列为21世纪需要预防和控制的三大疾病之一。根据WHO的统计，全球患有过敏性疾病的人数已经超过3亿，儿童过敏性疾病患病比例在全球呈逐年上升趋势，严重危害婴幼儿的健康成长[3]。
根据病变位置的不同，过敏性疾病可以进一步划分为呼吸系统过敏、皮肤粘膜过敏、眼部过敏、消化道过敏、严重过敏反应以及其他过敏。过敏性疾病表现出多病并存共发的常见现象，严重影响患者生活质量，增加了医疗费用，延长了治疗周期，整体影响了疾病控制，近年来引起广泛关注[3]。不同过敏性疾病在时间长轴上表现出的一定前后顺序的现象被称为特应性进程或过敏进程（atopic march）[4]。特应性进程严格的定义指从婴儿时期的AD开始，逐渐发展为儿童期的哮喘、AR，后来再逐渐扩展到包括嗜酸性食管炎（eosinophilic esophagitis，EoE）、过敏性结膜炎（allergic conjunctivitis，AC）等在内的多种Th2型过敏性疾病的范畴[5]。Lowe AJ等人[5]在澳大利亚的研究发现男性儿童更容易出现特应性进程的发展，而女性儿童则进展较慢。这表明性别在特应性进程的发展中可能有一定的影响。本研究采用的多病定义为同一患者同时及相继罹患两种及以上疾病，包括具有共同致病机制的过敏相关疾病，例如过敏性鼻炎、过敏性哮喘、过敏性结膜炎、荨麻疹（urticaria,Ur）、慢性单纯苔藓和痒疹(chronic simple lichen and prurigo,CSP)等[6]。
本研究基于宜昌市健康大数据平台，分析宜昌市2017—2022年期间出生的儿童在医疗机构就诊的过敏性疾病特征，明确宜昌市儿童过敏性疾病的多病分布，有助于初步理解儿童过敏性疾病的流行特征及病理生理形成过程，对促进疾病早期发现、预防及治疗有重要意义。
1　对象与方法
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1.1　数据来源
本研究的数据来源于2015年建立的宜昌健康大数据云平台，大数据平台打通宜昌网格人口信息库、医疗卫生机构基本业务信息系统等基础数据，涵盖医疗、网格人口、户籍、教育、社保、环保、气象等多源数据。其中，医疗数据收集自医院信息系统（HIS），2017年全面覆盖了宜昌市城区（包括西陵区、伍家岗区、点军区、猇亭区、夷陵区）全部综合性医疗机构以及社区卫生服务中心，具体包括8家三级医院、2家二级医院以及18家社区卫生服务机构，但对县级区域的医疗机构尚未实现全部覆盖。2017—2022年出生人口数据来源于宜昌市统计年鉴。
数据的纳入标准：（1）出生日期为2017年1月1日—2022年12月31日期间的儿童；（2）就诊时间为2017—2022年且主诊断为过敏性疾病（ICD—10编码见附录1）；（3）就诊单位为宜昌市城区的所有医疗机构的门诊就诊记录。包括患者的个人基本信息和诊疗信息，诸如加密的身份证号、性别、出生日期、疾病ICD-10编码、疾病诊断名称、伴随诊断以及诊断时间。排除标准为性别缺失、首次就诊年龄<0岁的记录。
数据清理：加密的身份证号相同为同一患者，对加密的身份证号缺失的记录，先以出生日期、性别、家庭住址标识完全相同者判定，未匹配上的再以出生日期、性别为标识判定为同一患者。
1.2　本研究涉及的指标定义如下：
（1）就诊人次：指患者就诊后，由医师诊断或处理的诊疗人次数。一天内同一患者多次挂号就诊，按实际诊疗次数统计；单次诊疗中如存在多个疾病诊断，每种疾病被诊断1次就记录为就诊1人次。
（2）人均就诊人次：平均每位患者的就诊次数，为就诊总人次/就诊总人数。
（3）首次就诊年龄：宜昌健康大数据云平台首次被诊断为过敏性疾病的年龄。
1.3　统计学方法
用R 4.3.1软件进行数据分析。使用描述流行病学，描述2017—2022年宜昌市出生儿童过敏性疾病就诊时间和人群（性别，年龄）分布特征以及过敏性疾病病种构成；通过过敏性疾病首次就诊年龄对过敏性疾病的进程进行分析。其中，符合正态分布的计量资料采用（）表示,不符合正态分布的计量资料采用M(Q1,Q3)表示,计量资料的组间比较采用t检验或Mann-Whitney U检验；计数资料采用频数及构成比进行描述。采用R软件的TraMineR包进行时间顺序上的就诊疾病病种提取。检验水准α=0.05。
2　结果
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2.1　2017—2022年宜昌市出生儿童过敏性疾病就诊时间、人群分布特征
2017—2022年间宜昌市城区出生的儿童数为61 409人，过敏性疾病就诊患者42 370人，就诊121 999人次，过敏性疾病报告发病率为70.43%。其中男性23 140人，就诊68 707人次，女性19 230人，就诊53 292人次。除2017—2022年间出生女童的就诊人数呈现逐年上升趋势外，男童的就诊人次和就诊人数以及女童的就诊人次都在2020年出现了下降。分出生年份来看，年均人均就诊次数随着出生年份的升高而升高，2022年出生的儿童年均人均就诊次数最高，为1.66次，2017年最低为0.61次（Mann-Kendall趋势检验，z=2.63, P=0.008）。同年出生男童的就诊人次、就诊人数、年均人均就诊次数均高于女童。见表1。
2017—2022年宜昌市出生儿童就诊的121 999人次过敏性疾病中，0～1岁组为46 190人次，占比37.86%，其中2月龄内就诊人次最高，为3 331人次，占比13.74%，1月龄最低，占比5.32%，5月以后呈下降趋势。分年度来看2018年的就诊人次最多，为9 242人次，其次为2020年，8 803人次，2022年就诊人次最低，为3 106人次。见图1。
2.2　2017—2022年宜昌市出生儿童过敏性疾病重点病种及首次就诊年龄情况
2017—2022年宜昌市出生儿童就诊过敏性疾病主要包括特应性皮炎/湿疹、皮炎、过敏性鼻炎、荨麻疹、慢性单纯苔藓和痒疹、哮喘、其它皮炎等，分别为46 156、15 522、14 388、14 004、6 326、6 285和4 471人次。其中男性就诊人次排名前五位分别是特应性皮炎/湿疹、过敏性鼻炎、皮炎、荨麻疹、哮喘;女性就诊人次排名前五位分别是特应性皮炎/湿疹、皮炎、荨麻疹、过敏性鼻炎、慢性单纯苔藓和痒疹。见表2。
2017—2022年宜昌市出生儿童首次过敏性疾病就诊的中位数年龄由小到大排序，男性依次为特应性皮炎/湿疹、尿布性皮炎、外耳湿疹等;女性依次为外耳湿疹、特应性皮炎/湿疹、尿布性皮炎等;除外耳湿疹外，女性儿童特应性皮炎/湿疹、尿布性皮炎、接触过敏性皮炎、荨麻疹、血管神经性水肿、哮喘的就诊中位数年龄均较男性晚，且存在统计学差异。见表3。
2.3　2017—2022年宜昌市出生儿童过敏性疾病多病情况
2017—2022年宜昌市出生儿童就诊患者中，有35 268位患者患有一种系统过敏性疾病，占比83.238%，其中皮肤粘膜过敏占比最多，为86.702%。6 313位儿童患有两种系统过敏性疾病，占比14.900%，其中皮肤粘膜过敏与呼吸系统过敏占比最多，为80.817%，755位儿童患有三种系统过敏性疾病，占比1.782%。见表4。
2017—2022年宜昌市出生儿童就诊患者的多病种类中，AD与AR是最常见的过敏性疾病共病，AD合并最多的疾病为皮炎、荨麻疹、过敏性鼻炎。AR合并最多的疾病为特应性皮炎、皮炎、哮喘。见表5。
图2显示特应性皮炎/湿疹与荨麻疹、慢性单纯苔藓和痒疹共病率最高，46%的荨麻疹患者和44%的慢性单纯苔藓和痒疹患者患有AD;特应性皮炎/湿疹与呼吸系统过敏(过敏性鼻炎和哮喘)明显共病，40%的AR患者和37%的AA患者均患有AD。此外，呼吸系统过敏性疾病中，有30%的AR儿童患有AA。
3　讨论
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了解儿童过敏性疾病的就诊情况，包括所患过敏性疾病的种类、首次就诊年龄、多种过敏性疾病患病情况，对理解过敏性疾病的发病机制、了解过敏性疾病在儿童人群中的现况并采取进一步预防措施有着重要意义。2017—2022年宜昌市诊断为过敏性疾病的就诊儿童数量不断增加，且宜昌市男性出生儿童过敏性疾病就诊人次要高于女性。这与之前的研究一致，男孩在儿童时期患哮喘的风险要高于女性[7]。在英国的儿童中，Deliu等人[6]发现，男性儿童出现哮喘症状的年龄比女性更早，风险明显更高。之前的相关研究也表明，宜昌市皮肤病门诊男性儿童人数要高于女性[8]。我们的研究发现，男性儿童的哮喘就诊人次是女性儿童的1.7倍，发病人数为女性的1.6倍，发病年龄的中位数比女性早3个月。男童的就诊人次和就诊人数以及女童的就诊人次都在2020年出现了下降，与之前的研究一致，宜昌市疫情防控阶段18岁以下儿童过敏性疾病的月均就诊人次均显著低于防控前阶段[9]。
在本研究中，男性出生儿童首次患过敏性疾病（除外耳湿疹）的中位数年龄均较女性早。特应性皮炎/湿疹的发病年龄的中位数最小。流行病学研究[10]表明，45%的儿童在6个月前发生AD，60%在1岁前发生，85%的儿童在5岁前发生AD。一项儿童的队列研究[11]显示，AD儿童的致敏使哮喘和AR的患病率分别增加了11倍和7倍以上。有研究表明在生命的第一年，男性过敏原致敏率（特异性免疫球蛋白E，IgE的产生）明显高于女性，总IgE血清水平也较高。在本研究中，宜昌出生儿童过敏性疾病首次就诊的年龄分布中，皮肤粘膜系统首次就诊年龄明显早于呼吸系统，大部分的皮肤粘膜疾病大部分在2岁以内，过敏性鼻炎与哮喘的首次就诊年龄均在3岁以后。与之前的研究一致，在时间顺序上，过敏进程表现为特应性皮炎、食物过敏、哮喘、过敏性鼻炎随着年龄增长此起彼伏的出现；而在解剖结构上，它也遵循着皮肤-胃肠道-呼吸道的空间演化[12]。这与身体各部位的微生物种群密切相关。大量研究表明，皮肤微生物种群在特应性皮炎发病过程中起关键作用，在儿科特应性皮炎患者的疾病进展过程中观察到皮肤微生物组群发生了改变；此外，生命早期气道微生物群的形成能影响哮喘的发病[13]。此外，Belgrave等人[14]在个体水平而不是大规模人群水平上证明，只有3.1%的儿童遵循特应性进程（首先是AD，其次是AA，然后是AR）。总而言之，与个体共生的各类微生物可抵御外源性病原体的入侵，是构成皮肤屏障的一个重要组成部分，影响着身体的免疫反应，且身体各系统各部位间的微生物种群改变不止在局部发挥作用，也存在相互作用，从而导致过敏进程的发生和发展。值得注意的是，宜昌市过敏性疾病首次就诊年龄最早的为特应性皮炎/湿疹，特应性皮炎发病后早期实施相应的干预措施，可以减轻症状并阻断过敏进程的发展，提高患者的生活质量。关于EDEN母子队列[15]的研究发现怀孕期间不经常食用豆类与合并多种过敏的较高风险之间有关系，并且儿童在没有过敏性疾病的情况下患哮喘的风险更高。
本研究中过敏性疾病中存在常见的多病情况，其中特应性皮炎/湿疹和过敏性鼻炎是最常见的多病。罹患AD可能增加多病风险，Dharmage等[16]研究发现，在2岁以内患有AD的婴儿中，在3～7岁期间与AA和AR的多病率显著增加。这可能是共同的遗传和（或）环境危险因素，以及共同的Th2型免疫炎症的结果。在重庆进行的前瞻性纳入医院门诊就诊并诊断为过敏性疾病的600例儿童研究[17]发现年龄（<6岁）是AR和AD同时发生的独立危险因素，但对哮喘没有影响。EuroPrevall-iFAAM[18]研究发现，年龄、家庭过敏评分、早期生活过敏症状和剖宫产术是导致患者过敏性多病的危险因素。
医疗大数据可利用大型患者队列，识别疾病模式，并探索与疾病相关的风险因素，以指导临床和公共卫生干预措施。本研究的优势在于利用宜昌大数据平台首次确定了在宜昌市医院就诊的0～5岁出生儿童过敏性疾病分布;利用过敏性疾病患儿队列，可以准确获得过敏性疾病患者的就诊时间、疾病发展模式等信息。我们的研究最大限度地减少了基于调查的分析所固有的偏倚（如回忆偏倚）。局限性在于我们将首次就诊的年龄作为发病年龄可能存在偏倚。另外在本研究中，不同级别的医疗机构对疾病的诊断能力可能存在差异，有疾病错分的可能性，但相对于患者自我报告的患病情况来说，要更加准确。此外，本研究只针对已就诊的过敏性疾病患者进行了分析，但过敏性疾病患者的就诊行为受到其知识水平、重视程度和经济状况等因素的影响[19]。
基金
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  • 广东省钟南山医学基金会(ZNSA-2021035)
文献
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参考文献 引证文献
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2024年第51卷第7期
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doi: 10.20043/j.cnki.MPM.202312476
  • 接收时间：2023-12-24
  • 首发时间：2026-03-18
  • 出版时间：2024-04-10
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  • 收稿日期：2023-12-24
基金
广东省钟南山医学基金会(ZNSA-2021035)
作者信息
    1.中国疾病预防控制中心流行病学办公室，北京 100050
    2.北京大学医学部
    3.宜昌市疾病预防控制中心

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孙谨芳，E-mail:
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2种不同金属材料的力学参数
科
Family		 属数
Number of
genus		 种数
Number of
species		 占总种数比例
Percentage of
total species (%)		 属
Genus		 种数
Number of
species		 占总种数比例
Percentage of total
species (%)
鹅膏菌科Amanitaceae 2 11 5.26 鹅膏菌属 Amanita 10 4.78
小菇科 Mycenaceae 2 12 5.74 丝盖伞属 Inocybe 5 2.39
多孔菌科 Polyporaceae 8 14 6.70 蜡蘑属 Laccaria 5 2.39
红菇科 Russulaceae 3 23 11.00 小皮伞属 Marasmius 6 2.87
小菇属 Mycena 11 5.26
光柄菇属 Pluteus 5 2.39
红菇属 Russula 17 8.13
栓菌属 Trametes 5 2.39
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