哮喘联盟

   摘要
   背景：有研究报导阻塞性睡眠呼吸暂停（OSA）与哮喘有关。然而，大型人群队列研究受到限制。本研究旨在评估亚洲人群中，成年哮喘患者的阻塞性睡眠呼吸暂停发生风险。
   方法：本文就来源于台湾中央健康保险局（NHI）的数据进行回顾性队列研究。哮喘患者队列包括38840名新近于2000至2010年间诊断为哮喘的患者。诊断日期被定义为索引日期。每名患者根据性别、年龄和索引年随机与4名非哮喘患者匹配以作为对照组。OSA发生率跟踪截止至2011年底。OSA发生风险采用校正性别、年龄、并发症后的Cox比例风险模型进行评估。
   结果：哮喘患者OSA总体发生率高于对照组2.51倍（12.1比4.84/1000人年）。相较于非哮喘患者，每年急诊（ER）次数小于1的哮喘患者的OSA校正风险率(aHR)上升至1.78，每年急诊次数大于1次的哮喘患者校正风险率为23.8。此外，采用吸入性类固醇治疗的哮喘患者相较于不使用吸入性类固醇患者的aHR为1.33 (95% CI = 1.01-1.76)。
   结论：哮喘患者OSA发生风险明显高于普通人群。研究结果提示，OSA风险与哮喘控制情况成正比，采用吸入性类固醇治疗患者OSA风险高于不采用吸入性类固醇治疗的患者。
 

（杨冬 审校）
PLoS One. 2015 Jun 11;10(6):e0128461. doi: 10.1371/journal.pone.0128461.

 

Risk of Obstructive Sleep Apnea in Adult Patients with Asthma: A Population-Based Cohort Study in Taiwan.
 

Shen TC1, Lin CL2, Wei CC3, Chen CH1, Tu CY4, Hsia TC4, Shih CM4, Hsu WH4, Sung FC5, Kao CH6.
 

Abstract
BACKGROUND:There are several publications reported that obstructive sleep apnea (OSA) was associated with asthma. However, large-scaled, population-based cohort study has been limited. We aimed to examine the risk of OSA among adult patients with asthma in an Asian population.
METHODS:We conducted a retrospective cohort study using data from the National Health Insurance (NHI) of Taiwan. The asthma cohort included 38,840 newly diagnosed patients between 2000 and 2010. The date of diagnosis was defined as the index date. Each patient was randomly matched with four people without asthmaaccording to gender, age, and the index year as the comparison cohort. The occurrence of OSA was followed up until the end of 2011. The risk of OSA was estimated using the Cox proportional hazard model after adjusting for gender, age, and comorbidities.
RESULTS:The overall incidence of OSA was 2.51-fold greater in the asthma cohort than in the comparison cohort (12.1 versus 4.84 per 1000 person-years). Compared to non-asthma subjects, the adjusted hazard ratio (aHR) of OSA increased to 1.78 for asthma patients with one or less annual emergency room (ER) visit, and 23.8 for those who visited ER more than once per year. In addition, aHR in patients with inhaled steroid treatment compared to those without steroid treatment was 1.33 (95% CI = 1.01-1.76).
CONCLUSION:Patients with asthma have a significantly higher risk of developing OSA than the general population. The results suggest that the risk of OSA is proportional to asthma control and patients with inhaled steroid treatment have a higher risk for OSA than those without steroid treatment.
 

PLoS One. 2015 Jun 11;10(6):e0128461. doi: 10.1371/journal.pone.0128461.