我国>14岁重症哮喘患者的临床特征和患病危险因素  

A survey on clinical characteristics and risk factors of severe asthma in China

作　　者：王文雅[1] 林江涛[1] 周新[2] 陈萍 万欢英[4] 殷凯生 马利军[6] 吴昌归 李靖[8] 刘春涛[9] 谢华 汤葳 黄茂 陈燕[8] 刘媛华[9] 宋立强 陈献亮[6] 刘国梁[1] 张永明[1] 李雯[1] 孙力超[1] Wang Wenya;Lin Jiangtao;Zhou Xin;Chen Ping;Wan Huanying;Yin Kaisheng;Ma Lijun;Wu Changgui;Li Jing;Liu Chuntao;Xie Hua;Tang Wei;Huang Mao;Chen Yan;Liu Yuanhua;Song Liqiang;Chen Xianliang;Liu Guoliang;Zhang Yongming;Li Wen;Sun Lichao(Department of Pulmonary and Critical Care Medicine,China-Japan Friendship Hospital,Beijing 100029,China;Department of Respiratory Diseases,Shanghai General Hospital of Shanghai Jiaotong University,Shanghai 201315,China;Department of Pulmonary and Critical Care Medicine,General Hospital of Northen Theater Shenyang Command,Shenyang 110016,China;Department of Pulmonary and Critical Care Medicine,Ruijin Hospital of Shanghai Jiaotong University,Shanghai 200025,China;Department of Respiratory and Critical Care Medicine,the First Affiliated Hospital of Nanjing Medical University,Nanjing 210029,China;Department of Pulmonary and Critical Care Medicine,Henan Provincial People′s Hospital,Zhengzhou 450003,China;Department of Pulmonary and Critical Care Medicine,Chest Hospital of Xi′an International Medical Center,Xi′an 710100,China;Guangzhou Institute of Respiratory Disease,Department of Respiratory Diseases,First Affiliated Hospital of Guangzhou Medical University,Guangzhou 510120,China;Department of Pulmonary and Critical Care Medicine,West China Hospital of Sichuan University,Chengdu 610041,China;Department of Pulmonary and Critical Care Medicine,Xijing Hospital of Air Force Military Medical University,Xi′an 710032,China)

机构地区：[1]中日友好医院呼吸与危重症医学科,北京100029 [2]上海交通大学第一人民医院呼吸科,上海201315 [3]北部战区总医院呼吸与危重症医学科,沈阳110016 [4]上海交通大学附属瑞金医院呼吸与危重症医学科,上海200025 [5]南京医科大学第一附属医院呼吸与危重症医学科,南京210029 [6]河南省人民医院呼吸与危重症医学科,郑州450003 [7]西安国际医学中心胸科医院呼吸与危重症医学科,西安710100 [8]广州呼吸疾病研究所广州医科大学附属第一医院呼吸内科,广东510120 [9]四川大学华西医院呼吸与危重症医学科,成都610041 [10]空军军医大学西京医院呼吸与危重症医学科,西安710032

出　　处：《中华医学杂志》2020年第14期1106-1111,共6页National Medical Journal of China

基　　金：首都卫生发展科研专项重点攻关项目(2016-1-4061)。

摘　　要：目的调查分析我国>14岁人群重症哮喘患者的临床特征和患病危险因素。方法于2010年2月至2012年8月,在我国华北地区的北京市、东北地区的辽宁省、华东地区的上海市和江苏省、华中地区的河南省、华南地区的广东省、西南地区的四川省和西北地区的陕西省共7个大区8个省市,按照多阶整群随机抽样方法对164215名受访者进行问卷调查。其中确诊2034例哮喘患者,对其中符合重症哮喘入选标准的哮喘患者进一步分析,了解我国重症哮喘患者的临床特征和患病危险因素。结果2034例哮喘患者中,首次确诊者560例(27.5%),既往确诊者1474例(72.5%);其中145例符合重症哮喘,占既往确诊者的9.8%(145/1474),占全部哮喘的7.1%(145/2034)。83.5%(121/145)重症哮喘患者至少存在一种触发因素。相关危险因素分析显示:吸烟(OR=1.543,95%CI:1.250~1.814)、肥胖(OR=2.186,95%CI:1.972~2.354)、饲养宠物(OR=2.135,95%CI:1.904~2.283)、合并过敏性鼻炎(OR=3.456,95%CI:2.721~4.326)、胃食管反流(OR=1.842,95%CI:1.682~2.140)、支气管扩张(OR=1.665,95%CI:1.347~1.912)、慢性阻塞性肺疾病(OR=1.312,95%CI:1.171~1.694)是重症哮喘患病的危险因素。结论我国>14岁人群重症哮喘合并症以过敏性鼻炎、胃食管反流最常见,患病危险因素包括肥胖、过敏性鼻炎、胃食管反流、慢性阻塞性肺疾病、支气管扩张、吸烟、饲养宠物等。Objective To investigate the clinical characteristics and risk factors of severe bronchial asthma in Chinese people over 14 years old.Methods According to the multi-stage random cluster sampling methods, a total of 164 215 subjects were visited by a questionnaire in the epidemiology survey from eight provinces (Beijing, Shanghai, Guangdong, Liaoning, Henan, Shanxi, Jiangsu, Sichuan provinces) located in seven regions (north, northeast, east, central China, south, southwest and northwest) of China from February 2010 to August 2012. A total of 2 034 were diagnosed as asthma. The clinical characteristics and related risk factors of patients with severe asthma in China were analyzed.Results Among all asthma patients, 560 were newly diagnosed, accounting for 27.5% (560/2 034) and the percentage of previously confirmed patients was 72.5% (1 474/2 034). A total of 145 were eligible for severe asthma, accounting for 9.8% (145/1 474) of previously confirmed asthmatics and 7.1% (145/2 034) of all asthmatics. 83.5% (121/145) severe asthmatics had at least one trigger factor. Correlation analysis showed that the risk factors of severe asthma were: smoking (OR=1.543, 95%CI: 1.250-1.814), obesity (OR=2.186, 95%CI: 1.972-2.354), petting (OR=2.135, 95%CI: 1.904-2.283), combined with allergic rhinitis (OR=3.456, 95%CI: 2.721-4.326), gastroesophageal reflux disease (OR=1.842, 95%CI: 1.682-2.140), bronchiectasis (OR=1.665, 95%CI: 1.347-1.912) or chronic obstructive pulmonary disease (OR=1.312, 95%CI: 1.171-1.694).Conclusions The most common comorbidities in severe asthmatics in China are allergic rhinitis and gastroesophageal reflux disease. The risk factors of severe asthma include obesity, allergic rhinitis, gastroesophageal reflux disease, chronic obstructive pulmonary disease, bronchiectasis, smoking and petting.

关 键 词：哮喘 疾病特征 危险因素 疾病严重程度 流行病学 

分 类 号：R5[医药卫生—内科学]