中国儿科医师对胸闷变异性哮喘的认知和诊治现状调查

Investigation on cognition,diagnosis and treatment status of chest tightness variant asthma among Chinese pediatricians

目的评价我国儿科医师对胸闷变异性哮喘(CTVA)的认识和诊疗现状。方法采用方便抽样方法,于2021年1月16日至2月4日,通过微信邀请30个省份不同级别医院的主治医师及以上职称儿科医师进行在线问卷调查,儿科医师通过扫描二维码完成小程序中的电子问卷。问卷内容包括对CTVA的认识、诊断以及治疗情况,并且比较二级医院与三级医院儿科医师相关指标的差异。结果共有1529名儿科医师参与调查,1484(97.06%)名儿科医师完整填写问卷并纳入分析,其中男性420名(28.30%)。儿科医师对CTVA的知晓率为77.83%(1155/1484)。与二级医院的儿科医师相比,三级医院的儿科医师知晓率更高[81.86%(898/1097)比66.41%(257/387),P<0.001],对指南推荐的诊断标准遵循情况更好[89.15%(978/1097)比79.59%(308/387),P<0.001]。共有93.06%(1381/1484)的儿科医师一线处方含吸入性糖皮质激素(ICS)治疗CTVA;和二级医院的儿科医师相比,三级医院儿科医师中使用含ICS方案一线治疗CTVA的比例更高[94.90%(1041/1097)比87.86%(340/387),P<0.001]。CTVA良好控制率为32.08%(476/1484),二级医院低于三级医院[17.31%(67/387)比37.28%(409/1097),P<0.001]。结论大多数儿科医师知晓CTVA。二级医院与三级医院的儿科医师之间在CTVA认识、诊断和治疗等临床实践上存在一定差距。

Objective To evaluate the awareness,diagnosis and treatment of chest tightness variant asthma(CTVA)among pediatricians in China.Methods The survey was conducted by convenient sampling method.Pediatricians with professional title of attending physician and above from different grades hospitals in 30 provinces were invited to conduct online questionnaire surveys through WeChat,pediatricians scan QR codes to complete electronic questionnaires in the mini program from January 16th to February 4th,2021.The contents of questionnaire included the awareness,diagnosis and treatment of CTVA,and comparing the differences between pediatricians in secondary hospitals and tertiary hospitals.Results A total of 1529 pediatricians participated in the survey,and 1484(97.06%)pediatricians completed the questionnaire and included in the analysis,including 420 males(28.30%).The awareness rate of CTVA among pediatricians was 77.83%(1155/1484).Pediatricians in tertiary hospitals had higher rates of awareness of CTVA than pediatricians in secondary hospitals[81.86%(898/1097)vs 66.41%(257/387),P<0.001]and had better execution of the guidelines[89.15%(978/1097)vs 79.59%(308/387),P<0.001].A total of 93.06%(1381/1484)of pediatricians′first-line treatment included inhaled corticosteroids(ICS)for CTVA.Among them,a higher proportion of pediatricians in tertiary hospitals used ICS included regimens for first-line treatment of CTVA compared with pediatricians in secondary hospitals[94.90%(1041/1097)vs 87.86%(340/387),P<0.001].The reported well control rate of CTVA was 32.08%(476/1484),which was significantly lower in secondary hospitals than that in tertiary hospitals[17.31%(67/387)vs 37.28%(409/1097),P<0.001].Conclusion Most pediatricians are well aware of CTVA,among which there is a certain gap in clinical practice between pediatricians in secondary hospitals and tertiary hospitals in terms of understanding,diagnosis,and treatment of CTVA.