英国当前哮喘患病率和吸入性皮质类固醇治疗的变化：基于人群2006-2016的队列
2019/03/21
摘要
背景：哮喘是英国最常见的呼吸系统疾病，但我们对当前疾病的患病率、治疗和恶化情况还不完全了解。
方法：我们使用英国电子医疗保健记录（2006-2016年），以每年、性别和年龄（5岁、5-11岁、12-17岁、18-24岁、25-54岁和55岁以上）来估计当前哮喘的患病率，以及针对哮喘恶化和其他哮喘护理标志治疗的吸入皮质类固醇（ICS）和额外哮喘治疗的比例。
结果：2016年哮喘患病率为6.5%（2006年为7.2%）。45岁以下人群的患病率下降。5岁以下儿童患病率最低，绝对下降幅度最大。2016年，80%的当前哮喘患者接受了ICS治疗（2006年为65%），这一增长发生在所有年龄段，主要是由于低剂量ICS的增加。在这段时间内，所有年龄组在额外哮喘治疗比例上都有所增加，这些哮喘治疗是在初级保健机构内进行的，并给出了一份年度哮喘回顾或管理计划。住院病情恶化随时间变化很少。
结论：哮喘患病率高，是一个重要的医疗负担。在那些确诊的患者中，所有年龄组在哮喘急性加重时ICS处方量均有所增加。这可能反映出初级保健中更积极的哮喘治疗的趋势。45岁以下患病率明显下降，特别是5岁以下儿童。
Changing prevalence of current asthma and inhaled corticosteroid treatment in the UK: population based cohort 2006-2016.
Bloom CI, Saglani S, Feary J, Jarvis D, Quint JK.
Abstract
BACKGROUND: Asthma is the most common respiratory disorder in the UK, yet we have incomplete knowledge on the prevalence of current disease, treatment and exacerbations.
METHODS: We used UK electronic healthcare records, 2006-2016, to estimate the prevalence of current asthma by year, gender and age (<5, 5-11, 12-17, 18-24, 25-54 and ≥55 years), and the proportion prescribed inhaled corticosteroids (ICS) and additional asthma-therapy, treated for exacerbations and other asthma care markers.
RESULTS: Overall current asthma prevalence was 6.5% in 2016 (7.2% in 2006). Prevalence fell in those under 45 years. The lowest prevalence and largest absolute decrease was in children under 5-years. In 2016, 80% of current asthma patients were managed on ICS, (65% in 2006); this increase occurred in all ages, primarily due to an increase in low-dose ICS. During this time there was an increase in all age-groups in the proportion prescribed additional asthma-therapy, treated for an exacerbation within primary care, given an annual asthma review or management plan. Hospitalised exacerbations showed minimal change over time.
CONCLUSION: Asthma remains highly prevalent and a significant healthcare burden. In those with a diagnosis, there was an increase in ICS prescriptions and treatment of exacerbations across all age-groups. This may reflect a trend towards more aggressive asthma management within primary care. An apparent decline in prevalence was observed in those aged under 45 years, particularly in children under 5 years.
背景：哮喘是英国最常见的呼吸系统疾病，但我们对当前疾病的患病率、治疗和恶化情况还不完全了解。
方法：我们使用英国电子医疗保健记录（2006-2016年），以每年、性别和年龄（5岁、5-11岁、12-17岁、18-24岁、25-54岁和55岁以上）来估计当前哮喘的患病率，以及针对哮喘恶化和其他哮喘护理标志治疗的吸入皮质类固醇（ICS）和额外哮喘治疗的比例。
结果：2016年哮喘患病率为6.5%（2006年为7.2%）。45岁以下人群的患病率下降。5岁以下儿童患病率最低，绝对下降幅度最大。2016年，80%的当前哮喘患者接受了ICS治疗（2006年为65%），这一增长发生在所有年龄段，主要是由于低剂量ICS的增加。在这段时间内，所有年龄组在额外哮喘治疗比例上都有所增加，这些哮喘治疗是在初级保健机构内进行的，并给出了一份年度哮喘回顾或管理计划。住院病情恶化随时间变化很少。
结论：哮喘患病率高，是一个重要的医疗负担。在那些确诊的患者中，所有年龄组在哮喘急性加重时ICS处方量均有所增加。这可能反映出初级保健中更积极的哮喘治疗的趋势。45岁以下患病率明显下降，特别是5岁以下儿童。
(中日友好医院呼吸与危重症医学科 李红雯 摘译 林江涛 审校)
(Eur Respir J. 2019 Feb 14. pii: 1802130. doi: 10.1183/13993003.02130-2018. )
(Eur Respir J. 2019 Feb 14. pii: 1802130. doi: 10.1183/13993003.02130-2018. )
Changing prevalence of current asthma and inhaled corticosteroid treatment in the UK: population based cohort 2006-2016.
Bloom CI, Saglani S, Feary J, Jarvis D, Quint JK.
Abstract
BACKGROUND: Asthma is the most common respiratory disorder in the UK, yet we have incomplete knowledge on the prevalence of current disease, treatment and exacerbations.
METHODS: We used UK electronic healthcare records, 2006-2016, to estimate the prevalence of current asthma by year, gender and age (<5, 5-11, 12-17, 18-24, 25-54 and ≥55 years), and the proportion prescribed inhaled corticosteroids (ICS) and additional asthma-therapy, treated for exacerbations and other asthma care markers.
RESULTS: Overall current asthma prevalence was 6.5% in 2016 (7.2% in 2006). Prevalence fell in those under 45 years. The lowest prevalence and largest absolute decrease was in children under 5-years. In 2016, 80% of current asthma patients were managed on ICS, (65% in 2006); this increase occurred in all ages, primarily due to an increase in low-dose ICS. During this time there was an increase in all age-groups in the proportion prescribed additional asthma-therapy, treated for an exacerbation within primary care, given an annual asthma review or management plan. Hospitalised exacerbations showed minimal change over time.
CONCLUSION: Asthma remains highly prevalent and a significant healthcare burden. In those with a diagnosis, there was an increase in ICS prescriptions and treatment of exacerbations across all age-groups. This may reflect a trend towards more aggressive asthma management within primary care. An apparent decline in prevalence was observed in those aged under 45 years, particularly in children under 5 years.
上一篇：
按居住地分列的美国儿童哮喘控制，治疗，医疗保健利用和支出趋势：2003-2014
下一篇：
环境超微粒子的时空变化与儿童哮喘发病率的关系
