1994～2004年欧洲5个主要国家哮喘死亡率与长效β2激动剂应用相关性研究
2009/10/15
目的：过去几十年中，哮喘的药物治疗取得了许多重要进展。然而，对于药物治疗与哮喘死亡之间可能存在的关系一直以来争议不断。
研究设计和数据集：对法国、德国、西班牙、英国和意大利1994～2004年间的相关数据进行统计分析，计算出年龄标准化哮喘死亡率。分别计算儿童和青年（5～34岁）、中年（35～64岁）及老年（≥65岁）人群的哮喘死亡率。采用结合点回归法鉴定死亡率趋势出现显著改变的年龄段。吸入性长效β2受体激动剂（LABA）的使用数据（包括由单一吸入器联合吸入LABA和吸入性糖皮质激素(ICS)）来自对销售量的估计。
结果：在1994年，德国的哮喘死亡率最高（4.7/100,000），意大利和西班牙最低（0.5/100,000）。随后，各国死亡率均呈现稳步下降趋势。其中德国的降幅最大，英国最小。LABA的销售量自1994年后稳步增长，特别是在法国、西班牙和英国，仅2004年销售量已达约14个规定日剂量(DDD)/1,000人。
结论：LABA的使用（联合或不联合ICS）在过去10年中呈逐渐增加趋势，而西欧几个主要国家的哮喘死亡率则呈现下降趋势。
（苏楠 审校）
Chatenoud L, et al. J Asthma. 2009 Aug;46(6):546-551.
Asthma mortality and long-acting beta2-agonists in five major European countries, 1994-2004.
Chatenoud L, Malvezzi M, Pitrelli A, La Vecchia C, Bamfi F.
OBJECTIVES: Over the last few decades, important changes occurred in the pharmacological approach to asthma control. However, the possible link between pharmacologic treatment and asthma death remains controversial.
STUDY DESIGN AND SETTING: Age-standardized asthma mortality rates were computed over the 1994-2004 period for France, Germany, Spain, the UK, and Italy. Rates for children and young adults 5 to 34 years of age, middle age adults 35 to 64 years of age, and elderly adults > or = 65 years. Joinpoint regression was performed to identify years where significant changes in mortality trends occurred. Consumption of inhaled long-acting beta-2-agonists (LABA), including inhaled corticosteroids (ICS) when combined with LABAs in a single inhaler, derived from sales estimates.
RESULTS: In 1994, the highest asthma mortality rates were in Germany (4.7/100,000), and the lowest ones were in Italy and Spain (0.5/100,000). Steady downward trends were observed in all the countries considered. The largest decline was registered in Germany and the smallest one was in the UK. LABA sales increased steadily since 1994, particularly in France, Spain, and the UK, reaching values around 14 Defined Daily Doses (DDD)/1,000 inhabitants in 2004.
CONCLUSION: While the use of LABAs (with or without ICS) increased over the last decade, asthma mortality declined in major western European countries.
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妊娠妇女被动暴露于环境烟草烟雾与儿童哮喘症状的相关性
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成人期哮喘发作的危险因素：一项为期14年的纵向研究
