中国儿童未控制哮喘及其危险因素：一项横断面观察研究
2016/11/09
摘要
目的：在中国，许多孩子受到哮喘折磨，但有关中国小儿哮喘患者的哮喘管理的信息非常有限。本研究的目的是评估中国小儿哮喘患者的哮喘控制，并识别与不控制的哮喘相关的危险因素。
方法：对从除了西藏以外的中国大陆的42个三级医院的年龄在2-16岁的4223名持续哮喘患者进行了调查。哮喘控制测试（ACT）、儿童哮喘控制测试（C-ACT）和全球哮喘防治创议（GINA）标准被用于评估12-16岁、4-11岁、2-3岁儿童的哮喘控制。不控制的哮喘指ACT或者C-ACT评分≤19或GINA定义的哮喘不控制。使用多因素逻辑回归模型确定与不受控制的哮喘相关的危险因素。
结果：哮喘在19.9%的受试者中是不控制的。高的哮喘非控制率在不坚持治疗（44.1%）、并发过敏性鼻炎（AR）（23.3%）、病程≥1.5年（22.8%），以及一级亲属并发过敏性鼻炎（21.5%）的患者中出现。不受控制的哮喘的风险在不坚持治疗的患者组中要高得多（OR= 5.79，P＜0.001）。并发过敏性鼻炎，病程≥1.5年，与一级亲属并发过敏性鼻炎也被证实为哮喘不控制的相关的危险因素。
结论：约20%的中国儿童哮喘患者有不受控制的哮喘。治疗依从性和并发过敏性鼻炎是最重要的危险因素。提高治疗依从性和诊断以及治疗过敏性鼻炎这些措施应该被采纳以提高中国儿童哮喘控制水平。
关键词：哮喘控制；儿童；持续哮喘
（杨冬 审校）
JAsthma.2016Sep;53(7):699-706.doi:10.3109/02770903.2016.1144199. Epub 2016 May 17.
Uncontrolled asthma and its risk factors in Chinese children: A cross-sectional observational study.
Xiang L1, Zhao J2, Zheng Y3, Liu H4, Hong J5, Bao Y6, Chen A7, Deng L8, Ji W9, Zhong N10, Shen K1.
Author information
Abstract
OBJECTIVE:Asthma afflicts many children in China but information about asthma management among Chinese pediatric asthma patients is limited. This study aims to evaluate asthma control among Chinese pediatric patients and identify risk factors associated with uncontrolledasthma.
METHODS:A total of 4223 patients with persistent asthma aged 2-16 years from 42 tertiary hospitals across all regions of mainland China except Tibet were surveyed. Asthma Control Test (ACT), Childhood Asthma Control Test (C-ACT) and Global Initiative for Asthma (GINA) criteria were used to assess asthma control for children aged 12-16 years, 4-11 years and 2-3 years, respectively. Uncontrolled asthma was defined as ACT or C-ACT score ≤19 or GINA-defined uncontrolled asthma. Risk factors associated with uncontrolled asthma were identified using multivariate logistic regression models.
RESULTS:Asthma was uncontrolled in 19.9% of the subjects. High rates of uncontrolled asthma were found in subjects with treatment non-adherence (44.1%), concomitant allergic rhinitis (AR) (23.3%), disease duration ≥ 1.5 years (22.8%), and first-degree relatives with AR (21.5%). The risk of uncontrolled asthma was much higher in the treatment non-adherence group compared to the complete adherence group (OR = 5.79, p < 0.001). Concomitant AR, disease duration ≥ 1.5 years, and first-degree relatives with AR were also confirmed as risk factors associated with uncontrolled asthma.
CONCLUSIONS:About 20% of Chinese pediatric asthma patients had uncontrolled asthma. Treatment adherence and AR were the most significant risk factors. Tailored measures aimed at improving treatment adherence and diagnosis and treatment of AR should be adopted to improve the level of asthma control in Chinese children.
KEYWORDS:Asthma control; children; persistent asthma
JAsthma.2016Sep;53(7):699-706.doi:10.3109/02770903.2016.1144199. Epub 2016 May 17.
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中国成人哮喘未控制及其危险因素
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产前和产后的压力和儿童哮喘：时间和性别的关系
