体力活动与哮喘发作的相关性：一项针对老年女性哮喘患者的前瞻性研究
2010/01/07
体力活动会加重还是可减少哮喘急性发作尚不清楚。Garcia-Aymerich J 等观察了规律的体力活动与哮喘急性发作之间的相关性。作者对2818例女性哮喘患者进行了为期2年（1998～2000）的监测。基础体力活动情况采用校正问卷进行自我评估，分为5个等级。
随访期间哮喘的急性加重定义为：因哮喘发作住院、急诊就诊或紧急诊所就诊。记录哮喘患者的基本信息，包括哮喘严重度、治疗情况、以往哮喘急性发作情况、社会因素、抽烟情况及其它潜在的混淆信息。
结果：入选者平均年龄63岁，71％有轻中度持续性哮喘，约一半的患者有抽烟史（48％既往抽烟，6％目前仍抽烟），平均体力活动强度为10MET*小时/周（相当于每周3次快步行走20分钟）。研究发现，哮喘急性加重的风险随体力活动的增加而下降，体力活动水平越高，因哮喘急性加重住院的风险就越低（与1级相比，2，3，4，5级的优势比分别为0.85, 0.81, 0.78, and 0.76，趋势P＝0.05）。以上组别在年龄分层、抽烟状况、体重指数（BMI）、既往使用吸入皮质激素情况及以往急性加重情况方面无差异。
因此，作者认为，对女性哮喘患者，规律的体力活动可降低哮喘急性加重的风险。
（王苹莉 浙江医科大学附属第二医院呼吸科 310009 摘译）
（Am J Respir Crit Care Med. 2009 Jun 1;179(11):999-1003.）
Garcia-Aymerich J, Varraso R, Antó JM, Camargo CA Jr. Prospective study of physical activity and risk of asthma exacerbations in older women.
RATIONALE: The potential role of physical activity in preventing asthma exacerbations is unknown. OBJECTIVES: To investigate the longitudinal association between regular physical activity and asthma exacerbations.
METHODS: A total of 2,818 women with asthma from a large U.S. cohort (the Nurses’ Health Study) were monitored from 1998 to 2000. Physical activity was self-reported at baseline, using a validated questionnaire, and categorized in quintiles. Exacerbations during follow-up were defined as a self-report of asthma-related hospitalization, emergency department visit, or urgent office visit. Baseline information about severity of asthma, treatment, previous exacerbations, sociodemographic factors, smoking, and other potential confounders was obtained.
MEASUREMENTS AND MAIN RESULTS: Participants had a mean age of 63 years, and 71% had mild-to-moderate persistent asthma. About half of the women were ever-smokers (48% former, 6% current), and median physical activity was 10 MET x hours/week (equivalent to walking at a brisk pace for 20 minutes three times per week). Risk of exacerbations during follow-up decreased with increasing level of physical activity. In a multivariate logistic regression model, the higher level of physical activity, the lower risk of admission (odds ratio 0.85, 0.81, 0.78, and 0.76, for the 2nd, 3rd, 4th, and 5th quintiles compared with the 1st quintile, P for trend = 0.05). There were no relevant differences on stratifying by age group, smoking status, body mass index, baseline use of inhaled corticosteroids, or previous exacerbations.
CONCLUSIONS: Regular physical activity was associated with reduced risk of exacerbations in women with asthma in this longitudinal study.
Am J Respir Crit Care Med. 2009 ;179(11): 999-1003.
随访期间哮喘的急性加重定义为：因哮喘发作住院、急诊就诊或紧急诊所就诊。记录哮喘患者的基本信息，包括哮喘严重度、治疗情况、以往哮喘急性发作情况、社会因素、抽烟情况及其它潜在的混淆信息。
结果：入选者平均年龄63岁，71％有轻中度持续性哮喘，约一半的患者有抽烟史（48％既往抽烟，6％目前仍抽烟），平均体力活动强度为10MET*小时/周（相当于每周3次快步行走20分钟）。研究发现，哮喘急性加重的风险随体力活动的增加而下降，体力活动水平越高，因哮喘急性加重住院的风险就越低（与1级相比，2，3，4，5级的优势比分别为0.85, 0.81, 0.78, and 0.76，趋势P＝0.05）。以上组别在年龄分层、抽烟状况、体重指数（BMI）、既往使用吸入皮质激素情况及以往急性加重情况方面无差异。
因此，作者认为，对女性哮喘患者，规律的体力活动可降低哮喘急性加重的风险。
（王苹莉 浙江医科大学附属第二医院呼吸科 310009 摘译）
（Am J Respir Crit Care Med. 2009 Jun 1;179(11):999-1003.）
Garcia-Aymerich J, Varraso R, Antó JM, Camargo CA Jr. Prospective study of physical activity and risk of asthma exacerbations in older women.
RATIONALE: The potential role of physical activity in preventing asthma exacerbations is unknown. OBJECTIVES: To investigate the longitudinal association between regular physical activity and asthma exacerbations.
METHODS: A total of 2,818 women with asthma from a large U.S. cohort (the Nurses’ Health Study) were monitored from 1998 to 2000. Physical activity was self-reported at baseline, using a validated questionnaire, and categorized in quintiles. Exacerbations during follow-up were defined as a self-report of asthma-related hospitalization, emergency department visit, or urgent office visit. Baseline information about severity of asthma, treatment, previous exacerbations, sociodemographic factors, smoking, and other potential confounders was obtained.
MEASUREMENTS AND MAIN RESULTS: Participants had a mean age of 63 years, and 71% had mild-to-moderate persistent asthma. About half of the women were ever-smokers (48% former, 6% current), and median physical activity was 10 MET x hours/week (equivalent to walking at a brisk pace for 20 minutes three times per week). Risk of exacerbations during follow-up decreased with increasing level of physical activity. In a multivariate logistic regression model, the higher level of physical activity, the lower risk of admission (odds ratio 0.85, 0.81, 0.78, and 0.76, for the 2nd, 3rd, 4th, and 5th quintiles compared with the 1st quintile, P for trend = 0.05). There were no relevant differences on stratifying by age group, smoking status, body mass index, baseline use of inhaled corticosteroids, or previous exacerbations.
CONCLUSIONS: Regular physical activity was associated with reduced risk of exacerbations in women with asthma in this longitudinal study.
Am J Respir Crit Care Med. 2009 ;179(11): 999-1003.
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肥胖和TNFA变异性对哮喘的联合作用：两个国际队列研究
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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
