青海省哮喘儿童的哮喘控制及治疗情况  

Status of asthma control and treatment of asthmatic children in Qinghai Province

作　　者：雷娇 张祖豪 李帅[1] 杨卉[1] 景亮[1] LEI Jiao;ZHANG Zu-hao;LI Shuai;YANG Hui;JING Liang(Department of Clinical Pharmacy,Affiliated Hospital of Qinghai University,Xining 810000,China)

机构地区：[1]青海大学附属医院临床药学科,西宁市810000

出　　处：《广西医学》2022年第6期635-639,共5页Guangxi Medical Journal

基　　金：青海大学中青年科研基金(2019-QYY-6)。

摘　　要：目的调查青海省哮喘儿童的哮喘控制情况及治疗情况。方法采用分层随机整群抽样调查方法,纳入368例哮喘儿童。调查患儿家长/监护人对哮喘治疗和用药的认知、患儿哮喘控制情况、治疗依从性、患儿哮喘的诱发因素、患儿用药情况、药物不良反应发生情况。结果(1)哮喘完全控制、部分控制、未控制的患儿分别有36例(9.78%)、194例(52.72%)、138例(37.5%),其中居住在农村的哮喘患儿哮喘控制水平差于居住在城市的患儿(P<0.05)。(2)接受过用药教育129例(35.05%),未接受过用药教育239例(64.95%);缓解期患儿接受规范治疗134例(36.41%)。(3)治疗依从性好占35.87%(132/368),治疗依从性差占64.13%(236/368),家长/监护人接受过用药教育、家长/监护人为高中及以上文化程度、缓解期患儿接受规范治疗者的治疗依从性更好(均P<0.05)。治疗依从性差的主要原因为家长/监护人担心长期使用吸入性糖皮质激素(ICS)产生副作用、自认为痊愈而停药、治疗方案烦琐。(4)多数哮喘患儿发病于秋冬季节(占57.07%)及季节更替(占22.01%)之时,部分患儿有吸入过敏原(占15.76%)或摄入过敏食物(占25.82%)史。(5)在急性期,ICS、β_(2)肾上腺素受体激动剂的使用率分别为81.25%(299/368)、95.11%(350/368);在缓解期,ICS、β_(2)肾上腺素受体激动剂的使用率均为34.24%(126/368)。(6)总不良反应发生率为7.88%(29/368),其中β_(2)肾上腺素受体激动剂的不良反应发生率最高,其次为糖皮质激素。结论青海省哮喘儿童在急性期接受一线治疗的方案较合理,但缓解期接受规范治疗的患儿比例偏低,哮喘整体控制水平不高,治疗依从性欠佳,ICS的应用需进一步推广。Objective To investigate the status of asthma control and treatment of asthmatic children in Qinghai Province.Methods The investigation method of stratified random cluster sampling was used to enroll 368 children with asthma.A survey was conducted on the awareness of asthma treatment and medication of the children′s parents/guardians,children′s asthma control status,treatment adherence,precipitating factors for asthma in the children,children′s medication status,and the occurrence of adverse drug reactions.Results(1)There were 36(9.78%)asthmatic children with well-controlled symptoms,194(52.72%)with partly controlled symptoms and 138(37.5%)with no controlled symptoms,wherein asthmatic children living in rural areas exhibited a poorer asthma control level than asthmatic children living in urban areas(P<0.05).(2)Totally 129(35.05%)cases had received medication education,whereas 239(64.95%)cases had not;134(36.41%)children in the remission phase received the standard treatment.(3)Children with favorable treatment adherence accounted for 35.87%(132/368),and children with poor treatment adherence accounted for 64.13%(236/368).Better treatment adherence was observed in the children whose parents/guardians had received medication education,children whose parents/guardians graduated from high schools or above,and children in the remission phase who received standard treatment(all P<0.05).The major reasons for poor treatment adherence were parents′/guardians′worries about the side effects resulting from a long-term use of inhaled glucocorticosteroid(ICS),drug withdrawal due to their ideas that their children were cured,and cumbersome treatment regimens.(4)The majority of asthmatic children sustained asthma attacks in autumn and winter(57.07%)as well as when the seasons changed(22.01%),and some children had a history of inhaling allergens(15.76%)or consuming allergenic food(25.82%).(5)The utilization rates of ICS and β_(2) adrenergic agonist in the acute phase were 81.25%(299/368)and 95.11%(350/368),respectively

关 键 词：哮喘 儿童 哮喘控制 药物治疗 依从性 用药认知 青海省 

分 类 号：R562.25[医药卫生—呼吸系统]