哮喘联盟

   摘要   
   背景:在基于临床的研究中发现迟发型哮喘比早发型更严重。然而，基于人群的研究缺乏，严重性的预测也很少被研究。
   目的:确定哮喘严重性和根据发病年龄进行严重度预测。
   方法:在2004年台湾94所学校的患儿父母中进行横断面问卷调查研究。哮喘严重程度通过短效β2受体激动剂(SABA)，吸入性皮质类固醇(ICS)和上一年卫生保健的使用情况来判断。采集发病年龄，人口统计资料，遗传和家庭暴露的信息。使用序次logistic或 logistic 回归确定风险因素和严重性之间的关联性。
   结果:纳入年龄在26～50岁的参与者，从而导致21,057 (67.8%) 的参与者。其中449例报告内科确诊哮喘，381例受试者回复了发病年龄的问题。迟发型病例(13～50 岁) 使用SABA,ICS 和卫生保健的风险高于早发型病例 (0～12 岁). 从童年发病，青少年发病，或青年发病到成年发病者，其SABA和卫生保健的使用逐渐升高。在早发型病例中过敏性鼻炎与SABA使用 (OR, 9.08; 95% CI, 1.06-77.99)和ICS 使用(OR, 5.08; 95% CI, 1.47-17.52)成正相关。在迟发型病例中除湿机使用与SABA使用 (OR, 0.50; 95% CI, 0.29-0.87) 及ICS 使用 (OR, 0.38; 95% CI, 0.19-0.78)成负相关。
   结论:在成年人中，迟发型哮喘比早发型哮喘更严重。通过SABA和ICS使用判断的哮喘严重程度，在早发型哮喘中与过敏性鼻炎成正相关，在迟发型哮喘中与除湿机使用成负相关。
 

（苏欣 审校）
Respiration. 2015 Sep 30. [Epub ahead of print]

 

Different Severity and Severity Predictors in Early-Onset and Late-Onset Asthma: A Taiwanese Population-Based Study.
 

Wu TJ1, Chen BY, Lee YL, Hsiue TR, Wu CF, Guo YL.
 

Abstract
BACKGROUND:Late-onset asthma has been shown to be more severe than early-onset asthma in clinic-based studies. However, population-based studies are scarce, and the predictors of severity have been less studied.
OBJECTIVES:To determine asthma severity and severity predictors regarding age at onset.
METHODS:A cross-sectional questionnaire survey was conducted among parents of children from 94 schools in Taiwan in 2004. Asthma severity was defined as short-acting β2-agonist (SABA), inhaled corticosteroid (ICS) and health care use in the last year. Information on age at onset, demographics, heredity and home exposure was collected. Ordered logistic or logistic regression was used for determining the associations between risk factors and severity.
RESULTS:Participants aged 26-50 years were included, resulting in 21,057 (67.8%) participants. Among them, 449 reported ever having had physician-diagnosed asthma, and 381 of those subjects answered the question on age at asthma onset. The risks of rescue SABA, ICS and health care use were generally higher among late-onset (13-50 years) than early-onset (0-12 years) asthmatics. Use of SABA and health care increased from childhood-onset, adolescent- or young adult-onset to adult-onset asthma. Allergic rhinitis was positively associated with SABA use (OR, 9.08; 95% CI, 1.06-77.99) and ICS use (OR, 5.08; 95% CI, 1.47-17.52) in early-onset asthma. Dehumidifier use was negatively associated with SABA use (OR, 0.50; 95% CI, 0.29-0.87) and ICS use (OR, 0.38; 95% CI, 0.19-0.78) in late-onset asthma.
CONCLUSIONS:In adults, late-onset asthma was more severe than early-onset asthma. Severity, as indicated by SABA and ICS use, was positively associated with allergic rhinitis in early-onset asthma and negatively associated with dehumidifier use in late-onset asthma.
 

Respiration. 2015 Sep 30. [Epub ahead of print]