重庆地区支气管哮喘加重住院的多中心回顾性分析

Hospitalized exacerbation of bronchial asthma in Chongqing, HEAT study

目的通过分析重庆地区支气管哮喘(简称哮喘)加重住院治疗的原因,为今后加强哮喘管理,减少哮喘加重住院提供依据。方法采用多中心、回顾性研究的方法,分析在2007年1～12月期间重庆市14家医院哮喘患者加重住院的情况。结果在此期间共有符合入选标准的住院哮喘患者570例,其中女性61.9%,明显多于男性,年龄4～87岁,平均50.19岁,平均住院8.16d,平均住院费用5711.8元。82.46%(470/570)的患者存在不同的诱因,其中以受凉感冒最多见,占55.26%。78.77%(449/570)的患者在非急性加重期没有规律用药治疗。仅选择氨茶碱或单纯用β受体激动剂进行治疗的占87.17%。虽有16.3%(93/570)的患者曾用吸入性糖皮质激素(ICS)联合长效β2受体激动剂(LABA)治疗,但仅12.81%(73/570)坚持规律用药。全部患者中仅7.89%(45/570)患者是难治性哮喘。绝大部分患者预后良好,97.19%好转出院,2.11%(12/570)自动出院,仅0.70%(4/570)死亡。结论重庆地区大多数哮喘急性加重患者在稳定期没有进行规范的哮喘治疗,这可能是急性加重的重要原因。因此,加强哮喘患者疾病知识宣教、治疗的管理和指导对减少急性加重具有重要意义。

Objective Analysis of hospitalization in acute exacerbation of bronchial asthma (asthma).Methods Using retrospective analysis the reason for hospitalization in acute exacerbation of asthma in Chongqing several teaching hospitals and dimethyl above hospital during January-December 2007.Results In all 570 patients,470 people have different inducing factors, such as catching a cold, inhaled excitant gas (air fumes), weather and seasonal change, allergy source stimulation, etc. 87.19% existing improper treatments,20 patients withdrawal during the no acute phase (3.51%),497 people don′t use in rules, most patients only use aminophylline or LABA, although 93 patients used ICS+LABA treatment, but only 73 people adhere to rules (12.81%).Conclusions The main reason of asthma patients hospitalized with acute aggravate is treatment of acute period of non-standard or withdrawal. The environments factors are also induce asthma acute exacerbation. At the same time, acute exacerbation significantly increased the cost of treatment of asthma. Therefore, strengthening asthma patient knowledge, treatment of management and guiding significance.