哮喘发作住院：一项中国大陆29个省份的中国哮喘研究网（CARN）回顾性研究
2020/07/13
摘要
目的：中国大陆哮喘发作住院患者的详细资料是缺失的。对该病患群体进行大样本调查是提高疾病控制水平，减轻经济负担必不可少的。本研究旨在探讨此类患者的临床特点和预后。
方法：本回顾性研究对中国大陆29个地区的29家医院2013-2014年因哮喘发作住院的患者进行了调查。研究总结了患者的人口统计学特征、入院前情况、发作情况和预后情况，并分析了重度发作的危险因素。
结果：研究共纳入3240例哮喘患者（女性占57.7%，男性占42.3%）。只有28.0%的患者使用日常控制药物；1287名（39.7%）患者目前没有使用吸入性皮质类固醇。急性上呼吸道感染是最常见的诱发因素（42.3%）。重度甚至致死性哮喘发作的患者往往病程较长，有吸烟史，有高血压、慢性阻塞性肺病（COPD）和食物过敏等并发症。多因素分析显示，吸烟史，合并有高血压、COPD及食物过敏是重度发作的独立危险因素。因哮喘发作住院的患者数量有季节性差异，在三月和九月达到高峰。8例患者在研究期间死亡（死亡率0.25%）。
结论：尽管近年来中国加强了哮喘自我管理教育，但很少有患者在病情发作前每日使用控制药物，这表明仍需要更多的教育努力和考量。本研究的结果，可增进我们对中国大陆地区因哮喘发作入院的认识，并为决策提供依据。
Hospitalization Due to Asthma Exacerbation: A China Asthma Research Network (CARN) Retrospective Study in 29 Provinces Across Mainland China.
Jiangtao Lin, Bin Xing, Huaping Tang, Lan Yang, Yadong Yuan, Yuhai Gu, Ping Chen, Xiaoju Liu, Jie Zhang, Huiguo Liu, Changzheng Wang, Wei Zhou, Dejun Sun, Yiqiang Chen, Zhuochang Chen, Mao Huang, Qichang Lin, Chengping Hu, Xiaohong Yang, Jianmin Huo, Xianwei Ye, Xin Zhou, Ping Jiang, Wei Zhang, Yijiang Huang, Luming Dai, Rongyu Liu, Shaoxi Cai, Jianying Xu, Jianying Zhou, China Asthma Research Network
Abstract
Purpose: Details of patients hospitalized for asthma exacerbation in mainland China are lacking. To improve disease control and reduce economic burden, a large sample survey among this patient population is indispensable. This study aimed to investigate the clinical characteristics and outcomes of such patients.
Methods: A retrospective study was conducted on patients hospitalized for asthma exacerbation in 29 hospitals of 29 regions in mainland China during the period 2013 to 2014. Demographic features, pre-admission conditions, exacerbation details, and outcomes were summarized. Risk factors for exacerbation severity were analyzed.
Results: There were 3,240 asthmatic patients included in this study (57.7% females, 42.3% males). Only 28.0% used daily controller medications; 1,287 (39.7%) patients were not currently on inhaled corticosteroids. Acute upper airway infection was the most common trigger of exacerbation (42.3%). Patients with severe to life-threatening exacerbation tended to have a longer disease course, a smoking history, and had comorbidities such as hypertension, chronic obstructive pulmonary disease (COPD), and food allergy. The multivariate analysis showed that smoking history, comorbidities of hypertension, COPD, and food allergy were independent risk factors for more severe exacerbation. The number of patients hospitalized for asthma exacerbation varied with seasons, peaking in March and September. Eight patients died during the study period (mortality 0.25%).
Conclusions: Despite enhanced education on asthma self-management in China during recent years, few patients were using daily controller medications before the onset of their exacerbation, indicating that more educational efforts and considerations are needed. The findings of this study may improve our understanding of hospital admission for asthma exacerbation in mainland China and provide evidence for decision-making.
目的：中国大陆哮喘发作住院患者的详细资料是缺失的。对该病患群体进行大样本调查是提高疾病控制水平，减轻经济负担必不可少的。本研究旨在探讨此类患者的临床特点和预后。
方法：本回顾性研究对中国大陆29个地区的29家医院2013-2014年因哮喘发作住院的患者进行了调查。研究总结了患者的人口统计学特征、入院前情况、发作情况和预后情况，并分析了重度发作的危险因素。
结果：研究共纳入3240例哮喘患者（女性占57.7%，男性占42.3%）。只有28.0%的患者使用日常控制药物；1287名（39.7%）患者目前没有使用吸入性皮质类固醇。急性上呼吸道感染是最常见的诱发因素（42.3%）。重度甚至致死性哮喘发作的患者往往病程较长，有吸烟史，有高血压、慢性阻塞性肺病（COPD）和食物过敏等并发症。多因素分析显示，吸烟史，合并有高血压、COPD及食物过敏是重度发作的独立危险因素。因哮喘发作住院的患者数量有季节性差异，在三月和九月达到高峰。8例患者在研究期间死亡（死亡率0.25%）。
结论：尽管近年来中国加强了哮喘自我管理教育，但很少有患者在病情发作前每日使用控制药物，这表明仍需要更多的教育努力和考量。本研究的结果，可增进我们对中国大陆地区因哮喘发作入院的认识，并为决策提供依据。
(中日友好医院呼吸与危重症医学科 顾宪民 摘译 林江涛 审校 )
(Allergy Asthma Immunol Res. 2020 May;12(3):485-495. doi: 10.4168/aair.2020.12.3.485.)
(Allergy Asthma Immunol Res. 2020 May;12(3):485-495. doi: 10.4168/aair.2020.12.3.485.)
Hospitalization Due to Asthma Exacerbation: A China Asthma Research Network (CARN) Retrospective Study in 29 Provinces Across Mainland China.
Jiangtao Lin, Bin Xing, Huaping Tang, Lan Yang, Yadong Yuan, Yuhai Gu, Ping Chen, Xiaoju Liu, Jie Zhang, Huiguo Liu, Changzheng Wang, Wei Zhou, Dejun Sun, Yiqiang Chen, Zhuochang Chen, Mao Huang, Qichang Lin, Chengping Hu, Xiaohong Yang, Jianmin Huo, Xianwei Ye, Xin Zhou, Ping Jiang, Wei Zhang, Yijiang Huang, Luming Dai, Rongyu Liu, Shaoxi Cai, Jianying Xu, Jianying Zhou, China Asthma Research Network
Abstract
Purpose: Details of patients hospitalized for asthma exacerbation in mainland China are lacking. To improve disease control and reduce economic burden, a large sample survey among this patient population is indispensable. This study aimed to investigate the clinical characteristics and outcomes of such patients.
Methods: A retrospective study was conducted on patients hospitalized for asthma exacerbation in 29 hospitals of 29 regions in mainland China during the period 2013 to 2014. Demographic features, pre-admission conditions, exacerbation details, and outcomes were summarized. Risk factors for exacerbation severity were analyzed.
Results: There were 3,240 asthmatic patients included in this study (57.7% females, 42.3% males). Only 28.0% used daily controller medications; 1,287 (39.7%) patients were not currently on inhaled corticosteroids. Acute upper airway infection was the most common trigger of exacerbation (42.3%). Patients with severe to life-threatening exacerbation tended to have a longer disease course, a smoking history, and had comorbidities such as hypertension, chronic obstructive pulmonary disease (COPD), and food allergy. The multivariate analysis showed that smoking history, comorbidities of hypertension, COPD, and food allergy were independent risk factors for more severe exacerbation. The number of patients hospitalized for asthma exacerbation varied with seasons, peaking in March and September. Eight patients died during the study period (mortality 0.25%).
Conclusions: Despite enhanced education on asthma self-management in China during recent years, few patients were using daily controller medications before the onset of their exacerbation, indicating that more educational efforts and considerations are needed. The findings of this study may improve our understanding of hospital admission for asthma exacerbation in mainland China and provide evidence for decision-making.
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INITIAL研究中初始治疗和控制状态的事后分析：一项新诊断哮喘患者的观察性研究
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加工肉制品摄入与哮喘症状的关系：法国健康营养网队列研究
