哮喘联盟

   摘要
   目的：确定黑人儿童与白人儿童相比是否存在较高的哮喘患病率，以作为依据或寻求哮喘个性化治疗。
   方法：对最初儿童常规门诊哮喘咨询注册数据进行二级分析。当提供者认为合适时，父母进行标准化肺活量测定。
   结果：Wilcoxon秩和检验表明黑人父母的住院次数是白人父母的两倍，进入重症监护病房或气管插管的几率是白人父母的1½倍。t检验提示黑人父母的第1秒用力呼气容积(FEV1)占预计值百分比显著低于白人父母，但是两者在FEV1/最大肺活量方面无显著差异。t检验表明在最初呼吸内科医生就诊时，黑人父母的哮喘控制显著差于白人父母，但是在哮喘严重程度类型分布方面两者无显著差异。多变量回归模型表明父母受教育的种族差异不能解释哮喘患病率的差异。
   结论：黑人父母的哮喘患病率明显高于白人父母，包括高住院率、高重症监护入住率和更差的肺功能。考虑到接受哮喘个性化治疗可以改善黑人儿童哮喘控制的结果差异，有必要去发展增加他们接受和使用哮喘个性化治疗的方法。

（杨冬 审校）
AcadPediatr. 2015Aug29.pii:S1876-2859(15)00218-1.doi:10.1016/j.acap.2015.06.010. [Epub ahead of print]

 

Racial Disparities in Asthma Morbidity Among Pediatric Patients Seeking Asthma Specialist Care.
 

Mitchell SJ1, Bilderback AL2, Okelo SO3.
 

Abstract
OBJECTIVE:To elucidate whether there may be a higher morbidity threshold for African American versus white children to be referred to or seek asthma specialist care.
METHODS:Secondary analysis of registry data captured from children presenting for an initial routine outpatient asthma consultation. Parents completed standard survey instruments, and spirometry was conducted when deemed appropriate by the provider.
RESULTS:Wilcoxon rank sum tests revealed that African American patients had been hospitalized twice as often and admitted to the intensive care unit or intubated significantly more than 1½ times more frequently than their white patient counterparts. t tests indicated African American patients' forced expiratory volume in 1 second (FEV1) percentage predicted was significantly worse than that of whites, but there was no significant difference for FEV1/forced vital capacity ratio. t tests suggested that African American patients had statistically worse asthma control than did white patients at the time of initial presentation to the pulmonologist, but there was no difference in the distribution of asthma severity categories. Multivariate regression models indicated that racial differences in parent education did not explain the disparities in asthma morbidity.
CONCLUSIONS:African American patients had significantly worse asthma morbidity than their white counterparts, including higher rates of hospitalization and intensive care unit admission and poorer lung functioning. Given that receipt of asthma specialist care can improve those outcomes that are disparately experienced by African American children, methods of increasing their access to and use of asthma specialist care need to be developed.
 

AcadPediatr. 2015Aug29.pii:S1876-2859(15)00218-1.doi:10.1016/j.acap.2015.06.010. [Epub ahead of print]