哮喘联盟

   摘要
   背景:很少有研究探索哮喘和焦虑的双向作用；我们旨在于一全地区的大样本中研究哮喘与焦虑的关系。
   方法:病例来源于台湾健康保险研究数据库中2000年到2007年间采用新的初步诊断标准(ICD-9:493)确诊的年龄大于15岁的患者。病例状态定义为哮喘住院病例诊断和（或）至少一年的哮喘门诊服务。共22,797名病例与匹配了性别，年龄，居住环境和保险费用后的22,797 名对照病例相比较，两组均随访至2008年底，焦虑病例定义按照ICD-9 编码 300.0, 300.01, 300.02, 300.2, 300.21, 300.23, 300.3。应用竞争风险校正后的Cox回归模型，校正性别，年龄，居住环境，保险费用，强的松使用情况，Charlson合并症指数，心血管疾病，糖尿病，抑郁症和任意疾病的住院天数。采用竞争风险校正后的Cox回归模型研究哮喘对惊恐性障碍风险的作用和焦虑性障碍对之后哮喘的作用。
   结果: 45,594 名受试者中，2792名在平均随访 5.3 (2.5) 年后确诊患有焦虑。在全调整模型中，哮喘，女性，老年，居住在农村，抑郁症和使用强的松时是焦虑的独立风险因素。在全调整模型中，焦虑，老年，居住在农村和使用强的松是哮喘的独立风险因素。
   局限性:未评价哮喘和焦虑障碍的严重程度，强的松治疗的持续时间和依从性，应激性生活事件，吸烟，家族病史和关系。
   结论:确定了人群中哮喘和焦虑障碍的双向关系，独立于许多潜在的混杂因素。
 

（苏欣 审校）
J Affect Disord.2015 Sep 25;189:98-105. doi: 10.1016/j.jad.2015.09.040. [Epub ahead of print]

 

Association of asthma and anxiety: A nationwide population-based study in Taiwan.
 

Lee YC1, Lee CT2, Lai YR3, Chen VC4, Stewart R5.
 

Abstract
BACKGROUND:Few studies have investigated the bidirectional relationship between asthma and anxiety; we sought to investigate asthma and anxiety in a large national sample.
METHODS:Cases were identified from Taiwan's National Health Insurance Research Database with a new primary diagnosis of asthma (ICD-9:493) aged more than 15 years between 2000 and 2007. Case status required the presence of any inpatient diagnosis of asthma and/or at least one year diagnosis of asthma in outpatient service. These 22,797 cases were compared to 22,797 sex-, age-, residence- and insurance premium-matched controls and both groups were followed until the end of 2008 for instances of anxiety, defined as ICD-9 codes 300.0, 300.01, 300.02, 300.2, 300.21, 300.23, 300.3. Competing risk adjusted Cox regression analyses were applied, adjusting for sex, age, residence, insurance premium, prednisone use, Charlson comorbidity index, cardiovascular disease, diabetes, depression disorder, and hospital admission days for any disorder. The effect of asthma on the risk of panic disorder and the effect of anxiety disorder on the risk of later asthma were also examined as competing risk adjusted Cox regression analyses
RESULTS: Of the 45,594 subjects, 2792 were ascertained as having anxiety during a mean (SD) follow-up period of 5.3 (2.5) years. Asthma, females, older age, rural residence, depression disorder, and prednisone use were independent risks on anxiety in the fully adjusted model. Anxiety, older age, rural residence, and prednisone use were independent risks on asthma in the fully adjusted model.
LIMITATIONS:The severity of asthma and anxiety disorder, the duration of prednisone treatment and adherence, stressful life events, smoking, family history and relationship were not evaluated.
CONCLUSIONS:Bidirectional relationship between asthma and anxiety disorder was confirmed in this population, in dependent of a number of potential confounding factors.
 

J Affect Disord.2015 Sep 25;189:98-105. doi: 10.1016/j.jad.2015.09.040. [Epub ahead of print]