中国成人哮喘未控制及其危险因素
2016/11/09
摘要
背景：在中国，哮喘影响大量的患者，但对中国患者的哮喘管理是相对鲜为人知的。本研究的目的是评估在中国成人患者中的哮喘控制率并识别与不受控制的哮喘相关的预测因素。
方法：共有年龄⩾17岁的4125例哮喘患者，代表除西藏以外的中国大陆所有的地区。哮喘的控制状态使用哮喘控制测试（ACT）评分，分为控制（ACT评分⩾20）和不受控制（ACT评分⩿19）。一个多因素的回归模型被用来确定与不受控制的哮喘的预测因素，包括人口因素、鼻炎、过敏性鼻炎、和治疗依从性。
结果：本研究中，可控的哮喘占44.9%，不可控的哮喘占到55.1%。不可控的哮喘在非依从性治疗的 (77.3%)、依从性较差的(66.2%)、低学历的(64.8%)、或者肥胖的(62.9%)的病人中比率较高。不可控哮喘在非依从性治疗组中要比完成依从性治疗组的比例高得多[比值比 (OR) = 4.55 (3.68-5.62), p < 0.001]。其它与不可控哮喘相关的因素包括并发性鼻炎[OR = 1.31 (1.14-1.50), p < 0.001]、肥胖 [OR = 1.31 (1.05-1.64), p = 0.019]、哮喘持续3年以上[OR = 1.22 (1.07-1.39), p = 0.004] 以及年龄45岁及以上[OR = 1.23 (1.07-1.41), p = 0.004]。
结论:半数参与此项研究的病人都有不受控制的哮喘。非依从性治疗是其中一个非常重要的因素，与不受控制的哮喘的发生密切相关。应该优先促进患者治疗的依从性来提高对哮喘的控制，同时也需注意鼻炎或者肥胖的影响。
关键词：成人；哮喘；横断面研究；危险因素
（杨冬 审校）
Ther Adv Respir Dis. 2016 Sep 5. pii: 1753465816663978. [Epub ahead of print]
Uncontrolled asthma and its risk factors in adult Chinese asthma patients.
Zhong N1, Lin J2, Zheng J3, Lai K3, Xie C4, Tang KJ4, Huang M5, Chen P6, Wang C7.
Author information
Abstract
BACKGROUND:Asthma affects a large number of patients in China, but relatively little is known about asthma management among Chinese patients. This study aims to estimate asthma control rate among adult Chinese patients and to identify predictors associated with uncontrolledasthma.
METHODS:A total of 4125 asthma patients aged ⩾17 years and representing all regions of mainland China except Tibet were surveyed. Asthmacontrol status was assessed using the Asthma Control Test (ACT) and classified as controlled (ACT score ⩾ 20) and uncontrolled (ACT score ⩿ 19). A multivariate logistic regression model was used to identify predictors associated with uncontrolled asthma from the factors including demographics, rhinitis, allergic rhinitis, and treatment adherence.
RESULTS:Asthma was controlled in 44.9%, and uncontrolled in 55.1% of the study participants. High rates of uncontrolled asthma were found in patients with treatment nonadherence (77.3%), poor adherence (66.2%), no schooling (64.8%), or obesity (62.9%). The risk of uncontrolled asthmawas much higher in the treatment nonadherence group than the complete adherence group [odds ratio (OR) = 4.55 (3.68-5.62), p < 0.001]. Other predictors for uncontrolled asthma included concomitant rhinitis [OR = 1.31 (1.14-1.50), p < 0.001], obesity [OR = 1.31 (1.05-1.64), p = 0.019],asthma duration > 3 years [OR = 1.22 (1.07-1.39), p = 0.004] and age ⩾ 45 years [OR = 1.23 (1.07-1.41), p = 0.004].
CONCLUSIONS:About half of the participants in this study had uncontrolled asthma. Treatment nonadherence is one of the significant predictors, which is very strongly associated with uncontrolled asthma. Efforts should be prioritized to promote patients' treatment adherence to improveasthma control while attention is needed on rhinitis or obesity.
© The Author(s), 2016.
KEYWORDS:adult; asthma; cross-sectional studies; risk factors
Ther Adv Respir Dis. 2016 Sep 5. pii: 1753465816663978. [Epub ahead of print]
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颈周径与哮喘之间联系的性别差异
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中国儿童未控制哮喘及其危险因素：一项横断面观察研究
