英国儿童及青少年中支气管哮喘诊断、学龄前喘息诊断及哮喘急性发作最新趋势：SABINA Jr研究
2023/08/28
摘要
背景：英国儿童支气管哮喘（以下简称哮喘）相关负担的特征仍不明确。本研究量化了英国基于人群队列（1-17岁）中哮喘患病率和负担的最新趋势。
方法：本研究应用临床实践研究数据链接Aurum数据库（2008-2018），按性别和年龄进行分层，以评估1-17岁儿童的年哮喘发病率和患病率以及1-5岁儿童的学龄前喘息。本研究对诊断为学龄前喘息或哮喘的患者同一时期内的年哮喘急性发作率进行了评估。
结果：研究发现，哮喘年发病率从2008年的1403.4/十万人年（95%CI 1383.7至1423.2）下降到2018年的688.0/十万人年（95%CI 676.3至699.9），下降了51%，其中1-5岁人群的哮喘发病率下降最为明显（从2556.9/十万人年（95%CI 2509.8至2604.7）下降到892.3/十万人年（95%CI 866.9至918.3），降幅达65%）。6-11岁和12-17岁的青少年的相应降幅分别为36%（1139.9/十万人年（95%CI 1110.6至1169.7）至739.9/十万人年（95%CI 720.5至759.8））和20%（572.3/十万人年（95%CI 550.4至594.9）至459.5/十万人年（95%CI 442.9至476.4））。学龄前喘息的发生率随着时间的推移而下降，1-3岁儿童的发病率略高于4岁儿童。哮喘和学龄前喘息的患病率也随着时间的推移下降，从2008年的18.0%下降到2018年的10.2%。随着时间的推移，哮喘急性发作率从2008年的1.33/十人年（95%CI 1.31至1.35）上升到2018年的1.81/十人年（95%CI 1.78至1.83）。
结论：自2008年以来，英国的儿童哮喘发病率有所下降，尤其是1-5岁的儿童；伴随哮喘患病率下降。该年龄组的学龄前喘息发生率也有所下降。然而，哮喘急性发作率持续增加。
Recent trends in asthma diagnosis, preschool wheeze diagnosis and asthma exacerbations in English children and adolescents: a SABINA Jr study
Kallis C, Maslova E, Morgan AD, Sinha I, Roberts G, van der Valk RJP, Quint JK, Tran TN
Abstract
BACKGROUND:Asthma-related burden remains poorly characterised in children in the UK. We quantified recent trends in asthma prevalence and burden in a UK population-based cohort (1‒17-year-olds).
METHODS:The Clinical Practice Research Datalink Aurum database (2008‒2018) was used to assess annual asthma incidence and prevalence in 1‒17-year-olds and preschool wheeze in 1‒5-year-olds, stratified by sex and age. During the same period, annual asthma exacerbation rates were assessed in those with either a diagnosis of preschool wheeze or asthma.
REsults:Annual asthma incidence rates decreased by 51% from 1403.4 (95% CI 1383.7 to 1423.2) in 2008 to 688.0 (95% CI 676.3 to 699.9) per 105 person-years (PYs) in 2018, with the most pronounced decrease observed in 1‒5-year olds (decreasing by 65%, from 2556.9 (95% CI 2509.8 to 2604.7) to 892.3 (95% CI 866.9 to 918.3) per 105 PYs). The corresponding decreases for the 6‒11- and 12‒17-year-olds were 36% (1139.9 (95% CI 1110.6 to 1169.7) to 739.9 (95% CI 720.5 to 759.8)) and 20% (572.3 (95% CI 550.4 to 594.9) to 459.5 (95% CI 442.9 to 476.4)) per 105 PYs, respectively. The incidence of preschool wheeze decreased over time and was slightly more pronounced in the 1‒3 year-olds than in the 4-year-olds. Prevalence of asthma and preschool wheeze also decreased over time, from 18.0% overall in 2008 to 10.2% in 2018 for asthma. Exacerbation rates increased over time from 1.33 (95% CI 1.31 to 1.35) per 10 PYs in 2008 to 1.81 (95% CI 1.78 to 1.83) per 10 PYs in 2018.
conclusions:Paediatric asthma incidence decreased in the UK since 2008, particularly in 1-5-year-olds; this was accompanied by a decline in asthma prevalence. Preschool wheeze incidence also decreased in this age group. However, exacerbation rates have been increasing.
背景：英国儿童支气管哮喘（以下简称哮喘）相关负担的特征仍不明确。本研究量化了英国基于人群队列（1-17岁）中哮喘患病率和负担的最新趋势。
方法：本研究应用临床实践研究数据链接Aurum数据库（2008-2018），按性别和年龄进行分层，以评估1-17岁儿童的年哮喘发病率和患病率以及1-5岁儿童的学龄前喘息。本研究对诊断为学龄前喘息或哮喘的患者同一时期内的年哮喘急性发作率进行了评估。
结果：研究发现，哮喘年发病率从2008年的1403.4/十万人年（95%CI 1383.7至1423.2）下降到2018年的688.0/十万人年（95%CI 676.3至699.9），下降了51%，其中1-5岁人群的哮喘发病率下降最为明显（从2556.9/十万人年（95%CI 2509.8至2604.7）下降到892.3/十万人年（95%CI 866.9至918.3），降幅达65%）。6-11岁和12-17岁的青少年的相应降幅分别为36%（1139.9/十万人年（95%CI 1110.6至1169.7）至739.9/十万人年（95%CI 720.5至759.8））和20%（572.3/十万人年（95%CI 550.4至594.9）至459.5/十万人年（95%CI 442.9至476.4））。学龄前喘息的发生率随着时间的推移而下降，1-3岁儿童的发病率略高于4岁儿童。哮喘和学龄前喘息的患病率也随着时间的推移下降，从2008年的18.0%下降到2018年的10.2%。随着时间的推移，哮喘急性发作率从2008年的1.33/十人年（95%CI 1.31至1.35）上升到2018年的1.81/十人年（95%CI 1.78至1.83）。
结论：自2008年以来，英国的儿童哮喘发病率有所下降，尤其是1-5岁的儿童；伴随哮喘患病率下降。该年龄组的学龄前喘息发生率也有所下降。然而，哮喘急性发作率持续增加。
(中日友好医院呼吸与危重症医学科 张婧媛 摘译 林江涛 审校)
(Thorax. 2023 Jul 31:thorax-2022-219757. doi: 10.1136/thorax-2022-219757.)
(Thorax. 2023 Jul 31:thorax-2022-219757. doi: 10.1136/thorax-2022-219757.)
Recent trends in asthma diagnosis, preschool wheeze diagnosis and asthma exacerbations in English children and adolescents: a SABINA Jr study
Kallis C, Maslova E, Morgan AD, Sinha I, Roberts G, van der Valk RJP, Quint JK, Tran TN
Abstract
BACKGROUND:Asthma-related burden remains poorly characterised in children in the UK. We quantified recent trends in asthma prevalence and burden in a UK population-based cohort (1‒17-year-olds).
METHODS:The Clinical Practice Research Datalink Aurum database (2008‒2018) was used to assess annual asthma incidence and prevalence in 1‒17-year-olds and preschool wheeze in 1‒5-year-olds, stratified by sex and age. During the same period, annual asthma exacerbation rates were assessed in those with either a diagnosis of preschool wheeze or asthma.
REsults:Annual asthma incidence rates decreased by 51% from 1403.4 (95% CI 1383.7 to 1423.2) in 2008 to 688.0 (95% CI 676.3 to 699.9) per 105 person-years (PYs) in 2018, with the most pronounced decrease observed in 1‒5-year olds (decreasing by 65%, from 2556.9 (95% CI 2509.8 to 2604.7) to 892.3 (95% CI 866.9 to 918.3) per 105 PYs). The corresponding decreases for the 6‒11- and 12‒17-year-olds were 36% (1139.9 (95% CI 1110.6 to 1169.7) to 739.9 (95% CI 720.5 to 759.8)) and 20% (572.3 (95% CI 550.4 to 594.9) to 459.5 (95% CI 442.9 to 476.4)) per 105 PYs, respectively. The incidence of preschool wheeze decreased over time and was slightly more pronounced in the 1‒3 year-olds than in the 4-year-olds. Prevalence of asthma and preschool wheeze also decreased over time, from 18.0% overall in 2008 to 10.2% in 2018 for asthma. Exacerbation rates increased over time from 1.33 (95% CI 1.31 to 1.35) per 10 PYs in 2008 to 1.81 (95% CI 1.78 to 1.83) per 10 PYs in 2018.
conclusions:Paediatric asthma incidence decreased in the UK since 2008, particularly in 1-5-year-olds; this was accompanied by a decline in asthma prevalence. Preschool wheeze incidence also decreased in this age group. However, exacerbation rates have been increasing.
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