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我国8省市支气管哮喘患者控制水平的流行病学调查

An epidemiological survey of current asthma control status in China

摘要:

目的 通过全国支气管哮喘(以下简称哮喘)患病情况及相关危险因素的流行病学调查,了解我国哮喘患者的控制水平.方法 2010年2月-2011年8月采用多级随机整群抽样方法,以全国8个省(市)年龄> 14岁的常住居民为研究对象进行入户问卷调查,根据病史、体征和肺功能检查确诊哮喘.医生和患者对哮喘控制水平进行评估,记录患者急诊就诊与住院情况,药物治疗情况,分析吸烟对哮喘控制的影响.结果 (1)8省市共调查有效人数164 215人,其中哮喘患者2 034例,患病率为1.24%.(2)医生评估哮喘患者控制水平,控制率为40.51%(824/2 034),部分控制率为42.58%(866/2 034),未控制率为16.91%(344/2 034).患者自行评估控制水平,完全控制者占15.63%(318/2034),良好控制者占49.46%(1 006/2 034),未控制者占34.91% (710/2 034).(3)在过去1年中,每例哮喘患者平均住院次数0.45次/年,住院率为22.62%(460/2 034),平均急诊就诊次数为0.67次/年,急诊率为26.99% (549/2 034).(4)维持治疗的哮喘患者中,茶碱治疗占29.11%(592/2034),吸入糖皮质激素治疗占14.75%(300/2 034),口服糖皮质激素治疗占9.49%(193/2 034),口服白三烯调节剂治疗占3.10% (63/2 034),吸入糖皮质激素联用长效β2受体激动剂治疗占6.39%(130/2 034).(5)有吸烟史的哮喘患者占34.51% (702/2 034).非吸烟哮喘者达到哮喘控制率高于有吸烟史的哮喘患者[43.24%(576/1 332)比35.33% (248/702)].有吸烟史的哮喘者在过去1年中,住院率[27.35%(192/702)]和急诊率[31.77%(223/702)]明显高于非吸烟哮喘者(20.12%、24.47%).结论 我国哮喘患者的控制水平较前有了一定程度的提高,但与全球哮喘防治创议(GINA)的要求还有较大差距.吸烟是影响哮喘控制的重要因素.

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abstracts:

Objective Base on the China asthma and risk factors epidemiologic investigation (CARE study),we analyzed the current status of asthma control in China.Methods With the multi-stage random cluster sampling method,epidemiological survey was performed among Chinese residents who aged over 14 years in 8 provinces(cities) from 2010 to 2011.Detailed clinic data of 2 034 asthma patients were collected via face-to-face home visit.Asthma was diagnosed based upon the history,clinical signs and lung function tests.The SPSS 12.0 was conducted for statistics analysis.Results This survey found that the prevalence rate of asthma in China was 1.24% (2 034/164 215),including 973 male and 1 061 female patients,with a mean age of (56 ± 18) years old.Consistent with the Global Initiative for Asthma (GINA) guidelines,40.51% (824/2 034) and 42.58% (866/2 034) of our patients achieved control and partial control,respectively.According to the asthma control test (ACT) estimates,15.63% (318/2 034) and 49.46% (1 006/2 034) of patients achieved full control (ACT 25) and well control (ACT 20-24),respectively.In the past year,22.62% (460/2 034) of patients reported hospitalized and 26.99% (549/2 034)of patients reported emergency room visit at least one time due to asthma exacerbation.61.80% (1 257/2 034)of patients were on daily us of medication.Inhaled corticosteroids (ICS) plus a long-acting β2 agonist (LABA) or solely ICS were used in 6.39% and 14.75% of patients,respectively.Theophylline treatment accounted for 29.11% (592/2 034).Oral glucocorticoid and oral leukotriene modifier (LTRA) treatment accounted for 9.49% (193/2 034) and 3.10% (63/2 034),respectively.According to the survey,34.51% (702/2 034) of asthma patients reported a history of smoking.The percentage of asthma control in non smoking patients was higher than in smoking patients [43.24% (576/1 332)and 35.33% (248/702),respectively].Meanwhile,the rates of both hospitalization and emergency due to asthma exacerbation in smoking asthma patients were significantly higher than nonsmoking asthma patients (27.35% and 31.77%,20.12% and 24.47%,respectively).Conclusions The situation of asthma control has been improved in China.However,compared with GINA guidelines,there is still a considerable gap.Smoking is one of the crucial factors that affect asthma control.

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