中华内科杂志
中華內科雜誌
중화내과잡지
CHINESE JOURNAL OF INTERNAL MEDICINE
2014年
8期
601-606
,共6页
苏楠%林江涛%刘国梁%陈萍%周新%万欢英%殷凯生%马利军%吴昌归
囌楠%林江濤%劉國樑%陳萍%週新%萬歡英%慇凱生%馬利軍%吳昌歸
소남%림강도%류국량%진평%주신%만환영%은개생%마리군%오창귀
哮喘%控制现状%治疗药物%流行病学
哮喘%控製現狀%治療藥物%流行病學
효천%공제현상%치료약물%류행병학
Asthma%Asthma control%Drug therapy%Epidemiology
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.
目的 通過全國支氣管哮喘(以下簡稱哮喘)患病情況及相關危險因素的流行病學調查,瞭解我國哮喘患者的控製水平.方法 2010年2月-2011年8月採用多級隨機整群抽樣方法,以全國8箇省(市)年齡＞ 14歲的常住居民為研究對象進行入戶問捲調查,根據病史、體徵和肺功能檢查確診哮喘.醫生和患者對哮喘控製水平進行評估,記錄患者急診就診與住院情況,藥物治療情況,分析吸煙對哮喘控製的影響.結果 (1)8省市共調查有效人數164 215人,其中哮喘患者2 034例,患病率為1.24％.(2)醫生評估哮喘患者控製水平,控製率為40.51％(824/2 034),部分控製率為42.58％(866/2 034),未控製率為16.91％(344/2 034).患者自行評估控製水平,完全控製者佔15.63％(318/2034),良好控製者佔49.46％(1 006/2 034),未控製者佔34.91％ (710/2 034).(3)在過去1年中,每例哮喘患者平均住院次數0.45次/年,住院率為22.62％(460/2 034),平均急診就診次數為0.67次/年,急診率為26.99％ (549/2 034).(4)維持治療的哮喘患者中,茶堿治療佔29.11％(592/2034),吸入糖皮質激素治療佔14.75％(300/2 034),口服糖皮質激素治療佔9.49％(193/2 034),口服白三烯調節劑治療佔3.10％ (63/2 034),吸入糖皮質激素聯用長效β2受體激動劑治療佔6.39％(130/2 034).(5)有吸煙史的哮喘患者佔34.51％ (702/2 034).非吸煙哮喘者達到哮喘控製率高于有吸煙史的哮喘患者[43.24％(576/1 332)比35.33％ (248/702)].有吸煙史的哮喘者在過去1年中,住院率[27.35％(192/702)]和急診率[31.77％(223/702)]明顯高于非吸煙哮喘者(20.12％、24.47％).結論 我國哮喘患者的控製水平較前有瞭一定程度的提高,但與全毬哮喘防治創議(GINA)的要求還有較大差距.吸煙是影響哮喘控製的重要因素.
목적 통과전국지기관효천(이하간칭효천)환병정황급상관위험인소적류행병학조사,료해아국효천환자적공제수평.방법 2010년2월-2011년8월채용다급수궤정군추양방법,이전국8개성(시)년령＞ 14세적상주거민위연구대상진행입호문권조사,근거병사、체정화폐공능검사학진효천.의생화환자대효천공제수평진행평고,기록환자급진취진여주원정황,약물치료정황,분석흡연대효천공제적영향.결과 (1)8성시공조사유효인수164 215인,기중효천환자2 034례,환병솔위1.24％.(2)의생평고효천환자공제수평,공제솔위40.51％(824/2 034),부분공제솔위42.58％(866/2 034),미공제솔위16.91％(344/2 034).환자자행평고공제수평,완전공제자점15.63％(318/2034),량호공제자점49.46％(1 006/2 034),미공제자점34.91％ (710/2 034).(3)재과거1년중,매례효천환자평균주원차수0.45차/년,주원솔위22.62％(460/2 034),평균급진취진차수위0.67차/년,급진솔위26.99％ (549/2 034).(4)유지치료적효천환자중,다감치료점29.11％(592/2034),흡입당피질격소치료점14.75％(300/2 034),구복당피질격소치료점9.49％(193/2 034),구복백삼희조절제치료점3.10％ (63/2 034),흡입당피질격소련용장효β2수체격동제치료점6.39％(130/2 034).(5)유흡연사적효천환자점34.51％ (702/2 034).비흡연효천자체도효천공제솔고우유흡연사적효천환자[43.24％(576/1 332)비35.33％ (248/702)].유흡연사적효천자재과거1년중,주원솔[27.35％(192/702)]화급진솔[31.77％(223/702)]명현고우비흡연효천자(20.12％、24.47％).결론 아국효천환자적공제수평교전유료일정정도적제고,단여전구효천방치창의(GINA)적요구환유교대차거.흡연시영향효천공제적중요인소.
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.
