ISAAC（儿童哮喘和变态反应性疾病全球研究）的第三阶段总结：有关哮喘患病率和严重程度全球性调查
2010/01/07
该研究从97个国家的233个中心中选取798685例13～14岁的儿童，从61个国家的144个中心中选择388811例6～7岁的儿童，进行一项全球性问卷调查，调查时间从2000～2003年。
调查结果显示：自问卷调查时起，在过去的12个月中，13～14岁儿童发生过喘息症状的患病率从0.8%（中国的西藏）到32.6%（纽西兰的惠灵顿），而6～7岁儿童的发生率从2.4%（印度的Jodhpur ）到37.6%（Costa Rica）。重症哮喘的症状（定义为在过去的12个月中喘息发作>4次，或每周有1次以上于夜间出现喘息症状并影响睡眠，或喘息症状影响语言表达），在13～14岁儿童中的发病率从0.1% （印度的Pune）到16%（Costa Rica），在6～7岁的儿童中，发病率从0%～20.3%（与前两个相应的恰为同一地区）。该问卷调查结果联合经济学、生态学等分析得出一个显著的趋势，即对于两个年龄段的儿童，喘息症状发生率较高的地区，相应的收入也较高，然而对于重症哮喘的分析，却呈现相反的趋势，尤其在年长的一组儿童的研究结果中更为明显。
这项全球范围内的流行病学调查研究表明儿童哮喘的症状的发生存在明显的差异。尽管越富足的国家其哮喘发生率越高，然而对于贫困国家，哮喘的症状反而表现的更严重。
调查结果显示：自问卷调查时起，在过去的12个月中，13～14岁儿童发生过喘息症状的患病率从0.8%（中国的西藏）到32.6%（纽西兰的惠灵顿），而6～7岁儿童的发生率从2.4%（印度的Jodhpur ）到37.6%（Costa Rica）。重症哮喘的症状（定义为在过去的12个月中喘息发作>4次，或每周有1次以上于夜间出现喘息症状并影响睡眠，或喘息症状影响语言表达），在13～14岁儿童中的发病率从0.1% （印度的Pune）到16%（Costa Rica），在6～7岁的儿童中，发病率从0%～20.3%（与前两个相应的恰为同一地区）。该问卷调查结果联合经济学、生态学等分析得出一个显著的趋势，即对于两个年龄段的儿童，喘息症状发生率较高的地区，相应的收入也较高，然而对于重症哮喘的分析，却呈现相反的趋势，尤其在年长的一组儿童的研究结果中更为明显。
这项全球范围内的流行病学调查研究表明儿童哮喘的症状的发生存在明显的差异。尽管越富足的国家其哮喘发生率越高，然而对于贫困国家，哮喘的症状反而表现的更严重。
（于娜 中国医科大学附属第一医院呼吸内科 110001 摘译）
（Thorax 2009;64:476-483 ）
Global variation in the prevalence and severity of asthma symptoms: Phase Three of the International Study of Asthma and Allergies in Childhood (ISAAC)
C K W Lai1, R Beasley2, J Crane3, S Foliaki4, J Shah5, S Weiland6 and the ISAAC Phase Three Study Group
Background: Phase Three of the International Study of Asthma and Allergies in Childhood (ISAAC) measured the global prevalence and severity of asthma symptoms in children.
Methods: A cross-sectional questionnaire survey of 798 685 children aged 13–14 years from 233 centres in 97 countries, and 388 811 children aged 6–7 years from 144 centres in 61 countries, was conducted between 2000 and 2003 in >90% of the centres.
Results: The prevalence of wheeze in the past 12 months (current wheeze) ranged from 0.8% in Tibet (China) to 32.6% in Wellington (New Zealand) in the 13–14 year olds, and from 2.4% in Jodhpur (India) to 37.6% in Costa Rica in the 6–7 year olds. The prevalence of symptoms of severe asthma, defined as 
4 attacks of wheeze or 1 night per week sleep disturbance from wheeze or wheeze affecting speech in the past 12 months, ranged from 0.1% in Pune (India) to 16% in Costa Rica in the 13–14 year olds and from 0% to 20.3% in the same two centres, respectively, in the 6–7 year olds. Ecological economic analyses revealed a significant trend towards a higher prevalence of current wheeze in centres in higher income countries in both age groups, but this trend was reversed for the prevalence of severe symptoms among current wheezers, especially in the older age group.
4 attacks of wheeze or 1 night per week sleep disturbance from wheeze or wheeze affecting speech in the past 12 months, ranged from 0.1% in Pune (India) to 16% in Costa Rica in the 13–14 year olds and from 0% to 20.3% in the same two centres, respectively, in the 6–7 year olds. Ecological economic analyses revealed a significant trend towards a higher prevalence of current wheeze in centres in higher income countries in both age groups, but this trend was reversed for the prevalence of severe symptoms among current wheezers, especially in the older age group. Conclusion: Wide variations exist in the symptom prevalence of childhood asthma worldwide. Although asthma symptoms tend to be more prevalent in more affluent countries, they appear to be more severe in less affluent countries.
Thorax 2009;64:476-483
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母乳喂养、亲代过敏史与儿童哮喘之间的关系—--一项对PIAMA受试者随访8年的研究
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美国人群中哮喘和喘息与血清胆固醇之间的新关系
