美国印地安成人哮喘
2007/06/27
研究背景：虽然人们越来越认识到哮喘是影响美国印地安人死亡率的主要原因，目前尚无有关老年人哮喘疾病的系统研究，他们是患哮喘相关并发症的高危人群。鉴于目前美国印地安成人哮喘患病的严峻形势，迫切需要制定出适宜的临床治疗和社区预防的相关措施。
方法：样本取自参加 Strong Heart Study（一项美国印地安人的多中心，大样本，前瞻性心血管疾病研究）的第三次体检患者，他们完成了一份标准化呼吸问卷调查，进行了肺功能测定和皮肤变应原试验。参加者年龄 50岁。
结果:在3,197第三次体检参与者中， 6.3%为医师确诊哮喘，4.3%为疑似哮喘。医师确诊哮喘的患病率，女性高于男性(8.2% vs 3.2%)。哮喘研究亚组的435名参加者，哮喘相关的发病率较高：医师确诊哮喘患者中97%有呼吸困难的症状，52%有重度持续性哮喘。医师确诊哮喘患者的FEV1均值为预计值的61.3%，其中67.2%的患者在过去的一年里有急诊经历有或无住院经历，只有3%规律吸入糖皮质激素治疗。
结论：居住于美国三个不同地区的年长美国印地安人哮喘患病率与美国其他种族患病率无显著差异。哮喘与低肺功能，高患病率和高卫生保健支出有关，而用于这一人群的相关药物治疗也未得到充分使用。
（于娜 沈阳中国医科大学附属一院呼吸科 110001 摘译)
(Chest. 2007;131:1323-1330)
(Chest. 2007;131:1323-1330)
Asthma in American Indian Adults
The Strong Heart Study
Anne E. Dixon, MD, FCCP; Fawn Yeh, MPH, PhD; Thomas K. Welty, MD, MPH; Everett R. Rhoades, MD; Elisa T. Lee, PhD; Barbara V. Howard, PhD; Paul L. Enright, MD; for the Strong Heart Study Research Group
Abstract 摘要
Background: Despite growing recognition that asthma is an important cause of morbidity among American Indians, there has been no systematic study of this disease in older adults who are likely to be at high risk of complications related to asthma. Characterization of the impact of asthma among American Indian adults is necessary in order to design appropriate clinical and preventive measures.
Methods: A sample of participants in the third examination of the Strong Heart Study, a multicenter, population-based, prospective study of cardiovascular disease in American Indians, completed a standardized respiratory questionnaire, performed spirometry, and underwent allergen skin testing. Participants were 50 years old.
Results: Of 3,197 participants in the third examination, 6.3% had physician-diagnosed asthma and 4.3% had probable asthma. Women had a higher prevalence of physician-diagnosed asthma than men (8.2% vs 3.2%). Of the 435 participants reported in the asthma substudy, morbidity related to asthma was high: among those with physician-diagnosed asthma: 97% reported trouble breathing and 52% had severe persistent disease. The mean FEV1 in those with physician-diagnosed asthma was 61.3% of predicted, and 67.2% reported a history of emergency department visits and/or hospitalizations in the last year, yet only 3% were receiving regular inhaled corticosteroids.
Conclusions: The prevalence of asthma among older American Indians residing in three separate geographic areas of the United States was similar to rates in other ethnic groups. Asthma was associated with low lung function, significant morbidity and health-care utilization, yet medications for pulmonary disease were underutilized by this population.
Key Words: American Indian·Arizona·asthma·epidemiology·Native American·North Dakota·Oklahoma·South Dakota·spirometry
