我国八省市重症支气管哮喘患病情况的现状分析

A cross-section study of severe asthma in eight provinces of China

目的分析我国重症支气管哮喘（以下简称哮喘）的患病情况。方法对2009年9月-2010年9月我国8个省市哮喘流行病学调查，按照分层整群不等比随机抽样方法对164215位受访者进行问卷调查，其中确诊的2034例哮喘患者进行重症哮喘的相关分析。结果2034例哮喘患者中，1474例既往确诊为哮喘，占哮喘人群的72．47％（1474／2034）；通过本次问卷调查首次确诊为哮喘者560例，占哮喘人群的27．53％（560／2034）；在既往确诊的哮喘人群中有122例符合本调查设定的重症哮喘判断标准判断为“重症哮喘”，占已确诊哮喘人数的8．28％（122／1474），占哮喘人群的6．00％（122／2034），占所调查人群的0．07％（122／164215）。哮喘人群中男女间重症哮喘患病差异无统计学意义；哮喘人群中21—30岁重症哮喘比例最低（0．85％），而61～70岁重症哮喘比例最高（8．31％），各年龄段间差异有统计学意义（X^2=18．791，P=0．005）；哮喘人群中不同受教育程度者间重症哮喘所占比例差异有统计学意义（x。=24．639，P〈0．0001），小学及小学以下教育程度者重症哮喘比例最高，而大专及大专以上教育程度者重症哮喘比例最低；吸烟哮喘人群（702例）中重症哮喘的比例与非吸烟哮喘人群（1332例）中重症哮喘的比例相比差异有统计学意义（X2=7．447，P〈0．05）。与不吸烟的哮喘患者比，吸烟哮喘者发生重症哮喘的OR值为1．663，95％CI1．150—2．404。结论我国重症哮喘患者在哮喘人群中的比例与其他地区相似，重症哮喘较多发生在老年患者中，吸烟是重症哮喘的危险因素之一。

Objective To analyze the prevalence of severe asthmain China. Methods The epidemiological data was collected from 2 034 asthmatics who were diagnosed in the last epidemiological survey from 2009 to 2010 in 8 provinces. Results According to the questionnaire survey, among the 2 034 patients, the previously diagnosed patients accounted for 72.47% （1 474/2 034 ） and the percentage of newly-diagnosed patients was 27.53 % （560/2 034）. In those 1 474 previously diagnosed asthmatics, 122 （8.28%） were classified into severe asthma, while 6.00% （122/2 034） of all asthmatics and 0.07% （122/164 215 ） of total respondents presented as severe cases. Statistically, there was no difference in the prevalence of severe patients between men and women. The morbidity rate of severe asthma was the lowest in the 21 -30 year old group and the highest in 61 -70 year old group （0.85% and 8.31% respectively）. The difference among ages was statistically significant （ X^2 = 18. 791, P = 0. 005 ）. In addition, the prevalence rates of severe asthma were also significantly diverged among patients with different education background（X^2 = 24. 639, P 〈 0. 000 1 ）. A negative relation was found between education level and the proportion of severe cases. Moreover, the morbidity of severe asthma in smoking patients and non-smoking patients were significantly different as well （ X^2 = 7. 447, P 〈 0.05）. Compared with asthma patients who do not smoke, smokers were more likely to suffer severe asthma （ OR = 1. 663, 95% CI 1. 150 - 2. 404）. Conclusions The prevalence rate of severe asthma in China is similar to that in other countries. Elderly patients have higher risk of severe asthma. Smoking is considered as a risk factor for severe asthma.