北京市郊区支气管哮喘控制情况多中心调查结果初步报告

Preliminary report of a multi-center study of bronchial asthma control in Beijing suburb

目的 了解北京市郊区支气管哮喘控制情况及影响因素.方法 2014年1月15日至5月15日在北京市大兴区、昌平区等11个区域性医疗中心各指定1名呼吸科医生为负责人,对该区域医疗中心门诊就诊并确诊的哮喘患者进行面对面问卷调查,问卷内容包括哮喘患者的一般情况、哮喘诊断依据（由呼吸科医生确认）、用药情况、哮喘控制情况及未控制的可能原因,计算哮喘控制率、患者哮喘控制测试（ACT）评分,并分析影响哮喘控制情况的因素.结果 调查患者321例,完成调查问卷321份,剔除资料不全的调查问卷6份,应答合格率为98％.哮喘患者临床用药含有吸入糖皮质激素（ICS）和长效β2受体激动剂（LABA）方案的占72.4％（228/315）,含有ICS者为84.1％（265/315）.治疗后,16.8％ （53/315）的患者哮喘完全控制,65.1％（205/315）的患者哮喘部分控制,18.1％（57/315）的患者哮喘未控制.ACT评分＜20的115例患者中,影响哮喘控制的原因包括依从性差（92例,80.0％）、合并其他并发症（32例,27.8％）及治疗方案不合理（28例,24.3％）等.结论 北京市郊区支气管哮喘患者用药以ICS加LABA为主;哮喘部分控制率比较高,但完全控制率较低;影响哮喘控制的主要因素为患者治疗依从性、治疗方案的合理性.

Objective To investigate the control level of bronchial asthma and related factors in Beijing suburb.Methods A face-to-face questionnaire survey with patients with bronchial asthma was conducted by 11 Beijing regional medical centers from January 15th to May 15th 2014.The contents of survey included the demographic data,diagnosis,treatment,control level,asthma control test （ACT） scores and the related factors.Results Total 321 patients with bronchial asthma participated in the questionnaire survey and 315 completed survey with a response rate of 98%.In the aspect of treatment,inhaled corticosteroids （ICS） combined with long-term beta 2 receptor agonist （LABA） accounted for 72.4% （228/315）,and medication containing ICS （265/315） for 84.1%.After treatment,the rates of complete control,partial control and no control were 16.8% （53/315）,65.1% （205/315）and 18.1% （57/ 315）,respectively.Among 115 patients with ACT 〈 20,the main affecting factors of asthma control are poor adherence（92 cases,80.0%）,concomitant diseases （32 cases,27.8%）and unreasonable treatment plan （28 cases,24.3%）.Conclutions ICS and LABA are the main drugs in treatment of bronchial asthma.The complete control rate plus partial control rate of bronchial asthma in Beijing suburb is satisfactory,but the complete control rate is still low.The main factors affecting asthma control are treatment compliance and rationality of the treatment plan.