哮喘患儿更想上学？--有关数据真实性的调查
2009/05/18
众所周知，哮喘患儿较没有哮喘的儿童更想上学。之前美国的一项调查（1998年）结果显示49%哮喘患儿想念校园生活，但其中只有一些研究曾经尝试把所调查患儿想念的学校的总数进行量化。考虑缺少真实有效的数据，并且具体了解哮喘对学校出勤的影响有助于将有限的保健资源更好的用到那些真正更需要它们帮助的患儿身上。
就此，Mark W. Millard等人对Dallas Independent 学区 (DISD)的19所城区内学校的学生进行调查，调查第4～6学期的出勤情况。调查纳入了353个认定可能患有哮喘的学生，他们通过在儿科医生不知情情况下进行肺功能测定，和/或进行运动激发（EC）试验，来诊断哮喘。
结果25个学生因FEV1 < 70%且没有支气管舒张试验被排除诊断。157个学生EC试验阳性，171个EC试验阴性。在这19个学校中，Mark等人在第四到第六学期范围内逐年单个比较这些学生的缺勤情况，并且额外取得了曾经由校方注册护士诊断（RN）的哮喘患儿的一组数据进行制表分析。2002～2003学年度学区内的所有学校的学期缺勤情况由校方提供。
结果显示缺勤率分别为2.54% (EC阳性组), 2.12% (EC阴性组), 2.59% (FEV1异常组), 2.86% (RN 诊断哮喘组), 2.85% (所研究学校中第4到6学期的所有学生组), 2.95% (所研究学区DISD中第4到6学期的所有学生组). 可见各组间缺勤率无统计学差异，该调查显示了，在DISD学区，哮喘患儿并未比无哮喘儿童更想上学，两组间缺勤率无明显差别。
（于娜 中国医科大学附属第一医院呼吸科 110001 摘译）
（Chest February 2009 135:303-306; doi:10.1378/chest.08-1642）
Children With Asthma Miss More SchoolFact or Fiction?
Keywords: asthma、pediatric、school absenteeism
Mark W. Millard, MD, FCCP*,
Pauline T. Johnson, PhD, RN,
Anna Hilton, MSN, RN and
Mary Hart, RRT, RCP
Abstract
Background: It is widely believed that children with asthma miss considerably more school than children without asthma. Previous surveys have indicated that 49% of children with asthma miss school (Asthma in America, 1998), but only a few studies have attempted to quantify the amount of school missed. Understanding the role of asthma in school attendance will help direct limited health-care resources to the children who need them most.
Methods: We investigated school absence rates in fourth- through sixth-grade students in 19 inner-city schools in the Dallas Independent School District (DISD). The sample consisted of 353 students who were identified as possibly having asthma based on responses to a modified Brief Pediatric Screen instrument and who underwent spirometry and/or exercise challenge (EC) testing to confirm the diagnosis of asthma: 25 students were excluded for FEV1 < 70% and without bronchodilator response, while 157 students had EC-positive test results, and 171 students had EC-negative test results. We compared yearly absences for these students with each other, with all fourth- through sixth-grade students in the 19 study schools, and with all fourth- through sixth-grade students in the district. We also tabulated data from a separate database that included asthma patients identified by the school registered nurse (RN). Absence data by school and by grade level were provided by the school district for the 2002–2003 school year.
Results: Absence rates were as follows: 2.54% (EC positive), 2.12% (EC negative), 2.59% (abnormal FEV1), 2.86% (RN identified), 2.85% (all fourth- through sixth-grade students in study schools), and 2.95% (all fourth- through sixth-grade students in the DISD).
Conclusion: Students with asthma in the DISD miss no more school their classmates without asthma.
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学前儿童喘鸣的远期预后： 纵向邮寄问卷研究1993～2004.
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加拿大Alberta省急诊室的成人哮喘表现
