哮喘患儿检测肺功能与低住院风险有关：丹麦的一项基于人群的随访研究
2010/12/17
摘要
背景：哮喘是儿童最为常见的慢性疾病。不同哮喘患儿的住院比率存在较大差异，其主要原因目前讨论较多的是对哮喘指南的依从性。本文旨在研究哮喘诊断时及治疗开始后1年肺功能检测（对哮喘指南的依从性）是否与住院风险存在相关。
研究设计：本研究为丹麦全国基于人群的队列研究，数据来自于1999年至2004年注册的5个全国性研究。
方法：研究6～14岁哮喘儿童在治疗开始时和随访1年内肺功能检测以及哮喘控制药物与所有药物的比率至少为0.5与住院风险的相关性。采用Cox回归分析，计算性别、年龄、社会经济因素、照护提供者和疾病严重程度校正后的危险比（HRs）。
结果：共计有27,193名儿童开始用药后随访时间超过1年。针对住院，对于治疗开始时即采用肺功能检测，校正后的HR为0.64（95%CI：0.55～0.74），对于随访6个月内进行的肺功能检测，校正后的HR为0.82 (0.68～1.00)，对于用药比率至少为0.5时，HR为0.67 (0.55～0.81)。低收入家庭患儿和6～8岁患儿住院风险增加。
结论：有关哮喘患儿肺功能检测（哮喘指南的依从性）与住院风险下降相关。与此类似，哮喘控制药物与所有药物比率至少为0.5也与住院风险下降相关。
（林江涛 审校）
J Asthma. 2010 Oct 12. [Epub ahead of print]
Use of lung function tests in asthmatic children is associated with lower risk of hospitalization. A Danish population-based follow-up study.
Moth G, Schiotz PO, Parner E, Vedsted P.
Danish Paediatric Asthma Centre, Aarhus University Hospital, Aarhus, Denmark.
Abstract
Background. Asthma is the most common chronic disease in childhood. Large variations in hospitalization rates are observed and adherence to and appropriateness of guidelines are often subject of discussion. The aim was to examine if adherence to guidelines concerning use of lung function tests at time of diagnosis and during the first year after the start of medical treatment was associated with risk of hospitalization. Research Design. A Danish nationwide population-based cohort study was performed for the study period 1999–2004 using data from five nationwide registries linked by a unique personal registration number. Methods. Risk of hospitalization was examined in relation to whether asthmatic children aged 6~14 had a lung function test at the start of treatment and during the first year of follow-up and a medication ratio of controller-to-total medication of at least 0.5. Cox regression analysis was used to calculate hazard ratios (HRs) adjusted for sex, age, socioeconomic factors, care provider, and severity of disease. Results. A total of 27,193 asthmatic children were followed for at least 1 year after the start of medication. The adjusted HR for hospitalization was 0.64 (95% confidence interval: 0.55–0.74) for having had a lung function test at the start of treatment; 0.82 (0.68–1.00) for having had a lung function test during the first 6 months of follow-up; 0.67 (0.55–0.81) for having a medication ratio of at least 0.5. Children from low-income families and children aged 6~8 had an increased risk of hospitalization. Conclusion. Adherence to the guidelines concerning use of lung function test for asthmatic children was associated with a reduced risk of hospitalization. Likewise, a medication ratio of controller-to-total medication of at least 0.5 was associated with a lower risk of hospitalization.
J Asthma. 2010 Oct 12. [Epub ahead of print]
背景：哮喘是儿童最为常见的慢性疾病。不同哮喘患儿的住院比率存在较大差异，其主要原因目前讨论较多的是对哮喘指南的依从性。本文旨在研究哮喘诊断时及治疗开始后1年肺功能检测（对哮喘指南的依从性）是否与住院风险存在相关。
研究设计：本研究为丹麦全国基于人群的队列研究，数据来自于1999年至2004年注册的5个全国性研究。
方法：研究6～14岁哮喘儿童在治疗开始时和随访1年内肺功能检测以及哮喘控制药物与所有药物的比率至少为0.5与住院风险的相关性。采用Cox回归分析，计算性别、年龄、社会经济因素、照护提供者和疾病严重程度校正后的危险比（HRs）。
结果：共计有27,193名儿童开始用药后随访时间超过1年。针对住院，对于治疗开始时即采用肺功能检测，校正后的HR为0.64（95%CI：0.55～0.74），对于随访6个月内进行的肺功能检测，校正后的HR为0.82 (0.68～1.00)，对于用药比率至少为0.5时，HR为0.67 (0.55～0.81)。低收入家庭患儿和6～8岁患儿住院风险增加。
结论：有关哮喘患儿肺功能检测（哮喘指南的依从性）与住院风险下降相关。与此类似，哮喘控制药物与所有药物比率至少为0.5也与住院风险下降相关。
（林江涛 审校）
J Asthma. 2010 Oct 12. [Epub ahead of print]
Use of lung function tests in asthmatic children is associated with lower risk of hospitalization. A Danish population-based follow-up study.
Moth G, Schiotz PO, Parner E, Vedsted P.
Danish Paediatric Asthma Centre, Aarhus University Hospital, Aarhus, Denmark.
Abstract
Background. Asthma is the most common chronic disease in childhood. Large variations in hospitalization rates are observed and adherence to and appropriateness of guidelines are often subject of discussion. The aim was to examine if adherence to guidelines concerning use of lung function tests at time of diagnosis and during the first year after the start of medical treatment was associated with risk of hospitalization. Research Design. A Danish nationwide population-based cohort study was performed for the study period 1999–2004 using data from five nationwide registries linked by a unique personal registration number. Methods. Risk of hospitalization was examined in relation to whether asthmatic children aged 6~14 had a lung function test at the start of treatment and during the first year of follow-up and a medication ratio of controller-to-total medication of at least 0.5. Cox regression analysis was used to calculate hazard ratios (HRs) adjusted for sex, age, socioeconomic factors, care provider, and severity of disease. Results. A total of 27,193 asthmatic children were followed for at least 1 year after the start of medication. The adjusted HR for hospitalization was 0.64 (95% confidence interval: 0.55–0.74) for having had a lung function test at the start of treatment; 0.82 (0.68–1.00) for having had a lung function test during the first 6 months of follow-up; 0.67 (0.55–0.81) for having a medication ratio of at least 0.5. Children from low-income families and children aged 6~8 had an increased risk of hospitalization. Conclusion. Adherence to the guidelines concerning use of lung function test for asthmatic children was associated with a reduced risk of hospitalization. Likewise, a medication ratio of controller-to-total medication of at least 0.5 was associated with a lower risk of hospitalization.
J Asthma. 2010 Oct 12. [Epub ahead of print]
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哮喘青少年的饮食摄入：有待改善
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经医生诊断的变应性鼻炎是否是哮喘发展中的危险因素？
