石家庄城区门诊哮喘患者控制现状及其影响因素的多因素分析  

Assessment of asthma control of Shijiazhuang city and multiplicity of risk factors

作　　者：张洋洋[1,2] 马俊义[1] 鲍洁[3] 丁翠敏[4] 韩靖雯[5] 王瑜玲[6] 袁雅冬[1] 

机构地区：[1]河北医科大学第二医院呼吸科,河北石家庄050000 [2]河北医科大学 [3]河北省胸科医院呼吸科,河北石家庄050041 [4]河北医科大学第四医院呼吸科,河北石家庄050011 [5]河北省人民医院呼吸科,河北石家庄050051 [6]石家庄市第一医院呼吸科,河北石家庄050011

出　　处：《临床荟萃》2009年第7期590-593,共4页Clinical Focus

基　　金：河北省2008年医学科学研究重点课题计划项目(08089)

摘　　要：目的了解石家庄市城区门诊哮喘患者控制现状,并对影响控制水平的相关因素进行多因素分析。方法调查2007年8月1日至2008年6月1日在石家庄市5家三级甲等医院呼吸内科门诊就诊的哮喘患者,采用医生与患者面对面进行问卷调查的方法。结果根据哮喘控制测试(ACT)评分显示,184例哮喘患者中,未得到控制的111例(60.3%),达到良好控制以上的73例(39.7%);过去的近1年内,因哮喘加重住院69例(37.5%),急诊就诊62例(33.7%);将Speaman相关分析中P<0.05的因素选入多因素非条件logistic回归模型,经后退法筛选后显示:吸烟情况(OR=5.202)、过敏史(OR=2.559)、经济负担情况(OR=1.626)、未长期规律吸入糖皮质激素或复合制剂(OR=3.354)、焦虑自评量表(SAS,OR=12.599)及抑郁自评量表(SDS,OR=5.270)评分情况是哮喘控制水平的影响因素(P<0.01或<0.05)。结论对哮喘患者的管理和教育工作有待进一步加强,应积极推广规范化治疗。吸烟情况、过敏史、经济负担情况、没有长期规律吸入糖皮质激素或复合制剂、SAS及SDS评分情况是哮喘控制水平的影响因素。Objective To evaluate asthma control status in asthmatic outpatients of Shijiazhuang city and evaluate the psychologic status. Then the risk factors that influence the control status were analyzed. Methods A questionnaire based investigation was performed from Aug 1 2007 to Jun 1 2008 in asthmatic outpatients of five hospitals of Shijiazhuang city. Results According to the asthma control test（ACT）, there were 111 patients（60.3 %） uncontrolled and 73 patients （39.7%） well controlled. 69 patients （37.5%） had been hospitalized and 62 patients （33.7%） had visited emergency department because of asthma exacerbation in the previous year. Multiple backward regression analysis shows that the control status was significantly correlated with smoking（ OR=5. 202）, allergy history （OR=2. 559）, economic burden （OR=1. 626）, failure in daily control therapy with inhaled corticosteroids （ OR=3. 354）,the Self-Rating Anxiety Scale（SAS, OR=12. 599） and the self-rating Depression Seale（SDS, OR = 5. 270） （P 〈 0.01 or 〈0.05）. Conclusion More work needs to be done about the implementation of patient education program and asthma guideline. Smoking allergy history, economic burden,failure in daily control therapy with inhaled cortieosteriods,scores of SAS and SDS are the influential faetors of asthma control status.

关 键 词：哮喘 问卷调查 危险因素 LOGISTIC模型 

分 类 号：R562.25[医药卫生—呼吸系统]