现实中哮喘治疗现状的前瞻性、多中心研究  

Prospective and multi-center study on the status of asthma management in reality

作　　者：王彦[1] 林科雄[1] 黄英[2] 刘恩梅[2] 熊玮[3] 徐建华[4] 祝纯礼 翁航爱[6] 曹官铭 沈庆[8] 陈昌碧 王长征[1] 

机构地区：[1]第三军医大学新桥医院呼吸科,重庆400037 [2]重庆医科大学儿童医院呼吸科,400014 [3]第三军医大学西南医院呼吸科,重庆400038 [4]重庆市合川区人民医院呼吸科,401520 [5]重庆市江津区人民医院呼吸科,402260 [6]重庆市第五人民医院呼吸科,400062 [7]重庆市急救中心呼吸科,400014 [8]重庆市第三人民医院呼吸科,400014 [9]重庆中山医院呼吸科,400013

出　　处：《国际呼吸杂志》2013年第13期970-973,共4页International Journal of Respiration

摘　　要：目的 过去对支气管哮喘（简称哮喘）现状的研究多采用横断面的回顾性调查,结果有局限性.本研究采用前瞻性的方法对重庆地区哮喘防治的现状进行研究,为改进目前哮喘的防治提供依据.方法 利用统一的调查问卷,采用前瞻性、多中心、非干预性的研究方法,对重庆地区9家教学医院、市区级医院就诊的184例哮喘患者进行6个月的前瞻性调查研究,调查患者的哮喘控制水平、用药和经济负担等情况.结果 入选患者以重度（62.0％）居多,哮喘控制不佳的患者比例较高,哮喘控制评分（ACT）＜20分占82.6％,采用吸入激素为主治疗方法的患者仅占29.6％.6个月后失访率为34.8％.研究结束时与基线数据比较,哮喘控制水平明显改善（P＜0.001）,哮喘加重显著减少（P＜0.001）,而且平均医疗费用减低33.9％.结论 地区哮喘控制现状不佳,规范化治疗的患者比例很低.但经规范治疗和管理后,哮喘控制水平显著改善,急性加重率和治疗费用均显著降低.但仍有约1/3的患者不能接受医师的随访,改善哮喘的管理还需要更多的努力.Objective Previous studies on bronchial asthma （asthma） status with retrospective cross-sectional survey had limitations.To provide the evidence for the improvement of prevention and treatment of asthma,the present prospective study investigated the current status of asthma treatment and control in Chongqing.Methods Using a uniform questionnaire,the six-month,prospective,multicenter and non-interventional study on asthma control,medication,and economic burden was carried out.We surveyed the 184 asthmatic out-patients in nine teaching hospitals and urban-level hospital of Chongqing.Results Severe asthmatic patients accounted for 62.0%.Asthma control in the high proportion of patients was poor,and the patients with asthma control test （ACT） score 〈20 accounted for 82.6%.Only 29.6% of patients used mainly inhaled corticosteroid.The percentage of lost to follow in the six months was 34.8%.Compared with the baseline,the level of asthma control improved significantly （P 〈0.001）,asthma exacerbations significantly reduced （P 〈0.001）,and average medical costs had a 33.9% reduction.Conclusions In Chongqing,the current status of asthma control was poor and the percentage of patients with standardized treatment was very low.After the standardized treatment and management,the level of asthma control significantly improved,acute exacerbation rates and medication costs significantly reduced.However,about 1/3 of the patients rejected to accept the doctor＇s follow-up.Improving asthma management needs more effort.

关 键 词：哮喘 前瞻性 治疗现状 

分 类 号：R562.25[医药卫生—呼吸系统]