哮喘联盟

    背景：国家指南推荐哮喘患者每周需有3～5天，每天20～30分钟的运动。然而，达到上述要求对于哮喘患者来说是一个很大的挑战，因为运动时哮喘症状有可能加重。
    目的：本文旨在研究成年哮喘患者的运动习惯、体重与哮喘严重程度和哮喘控制情况之间的关系。
    方法：采用Paffenbarger体力活动和运动指数表获得258名哮喘症状稳定期患者的运动习惯。采用哮喘控制问卷和哮喘严重程度量表检测患者疾病状态。将年龄、性别、教育、体重指数和哮喘控制情况及哮喘严重程度作为独立变量，采用多变量分析方法评价患者的运动习惯。
    结果：患者平均年龄42岁，75％为女性，62％为大学毕业生，40％患者存在肥胖。仅44％患者有运动的习惯。双变量分析显示，哮喘控制较好的患者更倾向于运动；但多变量分析显示，哮喘控制和哮喘严重程度与运动习惯无相关性，而男性(P＝0.01)、受教育程度高(P＝0.04)及非肥胖状态(P<0.001)与运动习惯具有相关性。多变量分析显示，哮喘控制情况和严重程度也与运动类型、运动持续时间和运动频率无相关性，但非肥胖状态与上述运动特征相关。全部患者中有22％(其中49％的运动患者)满足国家指南推荐的每周运动要求。多变量分析中非肥胖状态是唯一与达到指南要求相关的变量(P＝0.02)。
    结论：与普通人群相比，哮喘患者进行常规的运动并达到国家运动指南要求的比例较低。医生有必要控制患者的哮喘和肥胖，以帮助哮喘患者达到运动目标。

（刘国梁 审校）
Westermann H, et al. Ann Allergy Asthma Immunol. 2008 Nov;101(5):488-494.

Obesity and exercise habits of asthmatic patients.

Westermann H, Choi TN, Briggs WM, Charlson ME, Mancuso CA.
Weill Cornell Medical College, New York, New York, USA.

BACKGROUND: National guidelines recommend 20 to 30 minutes of exercise 3 to 5 days a week. However, achieving these goals may be challenging for asthmatic patients whose symptoms are exacerbated by exercise.
OBJECTIVE: To describe relationships among exercise habits, weight, and asthma severity and control in adults with asthma.
METHODS: Self-reported exercise habits were obtained from 258 stable patients by using the Paffenbarger Physical Activity and Exercise Index. Disease status was measured by using the Asthma Control Questionnaire and the Severity of Asthma Scale. Exercise habits were evaluated in multivariate analyses with age, sex, education, body mass index, and asthma control and severity as independent variables.

RESULTS: The mean patient age was 42 years; 75% were women, 62% were college graduates, and 40% were obese. Only 44% of patients did any exercise. In bivariate analysis, patients with well-controlled asthma were more likely to exercise; however, in multivariate analysis, asthma control and severity were not associated, but male sex (P = .01), having more education (P = .04), and not being obese (P < .001) were associated. Asthma control and severity also were not associated with type, duration, or frequency of exercise, but not being obese was associated in multivariate analyses. Only 22% of all patients (49% of those who exercised) met national guidelines for weekly exercise. Not being obese was the only variable associated with meeting guidelines in multivariate analysis (P = .02).

CONCLUSIONS: Compared with the general population, a lower proportion of asthmatic patients did any routine exercise and met national exercise guidelines. Physicians need to manage asthma and obesity to help asthmatic patients meet exercise goals.