1～8岁儿童期哮喘的治疗：PIAMA队列研究
2010/07/06
目的：诸多横断面研究都对儿童患者的哮喘用药进行了评价，但关于哮喘用药模式的纵向研究较少。本试验旨在纵向研究儿童患者的哮喘用药，首次对哮喘药物治疗的频率进行分析。
方法：PIAMA（哮喘和尘螨过敏的发病率与预防研究）为一项前瞻性队列研究，有3963名荷兰儿童参与本项研究。患者入选于1996～1997年。PIAMA研究数据还得到药房数据的补充。采用家庭成员处方信息评价儿童出生后至8岁之间的用药史是否完整。对于用药史完整的儿童研究其哮喘药物治疗频率。
结果：8岁以前首次采用药物治疗的儿童有280名（36％），其中88％的治疗开始于5岁，在所有开始治疗的患者中，91.1％的患者采用短效β2激动剂，61.1％的患者采用吸入糖皮质激素治疗。
结论：共计有777名哮喘患儿在其8岁以前有明确的哮喘药物治疗史。这些资料有助于纵向研究哮喘用药模式。结果显示，儿童具有较高比例的哮喘药物治疗史，用药开始于哮喘未完全确诊前。
（林江涛 审校）
Zuidgeest MG, et al. J Asthma. 2010 Mar;47(2):209-213.Asthma therapy during the first 8 years of life: a PIAMA cohort study.
Zuidgeest MG, Koster ES, Maitland-van der Zee AH, Smit HA, Brunekreef B, Leufkens HG, Koppelman GH, Postma DS, de Jongste JC, Hoekstra MO; PIAMA-Study Group.
Division of Pharmacoepidemiology and Pharmacotherapy, Utrecht Institute for Pharmaceutical Sciences (UIPS), Faculty of Science, Utrecht University, 3508 TB Utrecht, The Netherlands.
OBJECTIVE: Many studies evaluated asthma medication use in children in a cross-sectional manner, yet little is known about longitudinal use patterns. This study describes the formation of a longitudinal data set on asthma medication use and shows first results regarding the prevalence and incidence of medication use.
METHODS: The PIAMA (Prevention and Incidence of Asthma and Mite Allergy) study is a prospective birth cohort study among 3963 Dutch children. Recruitment took place in 1996-1997. The data of the PIAMA birth cohort study were complemented with pharmacy data. Prescription information of family members was used to determine whether medication histories were complete from birth until age 8. The prevalence and incidence of asthma medication use was studied in children for whom complete medication histories were available.
RESULTS: A first prescription for asthma medication was filled before age 8 by 280 (36%) children, with 88% starting therapy before age 5. Of all children who started therapy, 91.1% received short-acting beta(2)-agonists and 61.1% inhaled corticosteroids.
CONCLUSION: The applied method of data collection rendered a data set including 777 children with complete medication histories for their first 8 years of life. This data set provides the opportunity to study longitudinal medication use patterns. First analyses show that asthma medication is initiated in a rather high percentage of children in this cohort and mainly at an age at which an asthma diagnosis cannot yet be firmly established.
