哮喘联盟

    哮喘作为美国目前最普遍的慢性疾病之一，曾经在几个世纪前就有人证实其与精神因素有关。现在，对这方面的研究又重新燃起人生的兴奋点。就此，Thomas H. Chun等人在全国范围内对现有人口进行了有关近期哮喘发作与精神健康不佳的群体之间关系的统计。该研究从2006行为危险因素系统调查（Behavioral Risk Factor Surveillance System）中分析一些数据(n = 355,710)，采取多元回归分析精神健康不佳与近期哮喘发作之间是否存在相关性，同时也对既往哮喘发作的患者进行了分析。
    研究结果显示精神健康不佳的人，较心理健康的人近期发生哮喘的机率明显增高。且哮喘发作与精神健康间有明显的“剂量效应”关系，即发现当精神健康不佳，情绪状态不良的日子，其哮喘发作的机率也相应增加。既往曾报道过的哮喘的危险因素，包括年龄、性别、种族、婚姻状态、吸烟情况、整体健康情况、运动、肥胖和社会经济状况。这些因素对哮喘的发作具有协同作用。而对于近期哮喘和精神健康状态间的关系的研究还不明朗。
    这项大型全国性的调查证实了哮喘发作与精神健康状态间的关系。任何程度的精神健康不佳均可成为哮喘的发作的诱因。对于哮喘发作与精神健康之间相关性的机制和生理学分析还有待进一步研究。

（于娜 中国医科大学附属第一医院呼吸科 110001 摘译）
(Chest. 2008; 134:1176-1182)

The Asthma/Mental Health Nexus in a Population-Based Sample of the United States
Thomas H. Chun, MD*; Sherry H. Weitzen, PhD and Gregory K. Fritz, MD 

Abstract 

Background:Asthma is one of the most prevalent chronic medical conditions in the United States. The relationship of asthma with psychological factors has been known for centuries, and recently there has been a resurgence of interest in this topic. This study investigates the relationship between current asthma and poor mental health in a nationally representative sample of the US population.
Methods:This study utilizes data from the 2006 Behavioral Risk Factor Surveillance System survey. A multinomial logistic regression model was constructed to assess the relationship between current asthma and poor mental health. The relationship between formerly having asthma and poor mental health was also investigated. 
Results:Persons reporting poor mental health have increased risk of currently having asthma compared to persons reporting good mental health. Additionally, this asthma/mental health relationship has a "dose-response" relationship. For every incremental increase in days of poor mental health, there is a corresponding increase in risk of currently having asthma. Previously reported risk factors for asthma (ie, age, gender, race, marital, smoking, overall health, exercise, obesity, and socioeconomic status) were all found to be important covariates of asthma. The relationship between former asthma and poor mental health is less clear. 
Conclusions:This large, nationally representative sample confirms the relationship between asthma and mental health symptoms. Any degree of poor mental health appears to increase one’s risk for asthma. Future research is needed to determine the causal and/or physiologic relationship between asthma and mental health symptoms. 
Key Words: asthma • Behavioral Risk Factor Surveillance System • mental health • psychological factors