我国30个省市城区门诊支气管哮喘患者控制水平的调查结果

The level of asthma control in China from a national asthma control survey

目的全面评估我国城区支气管哮喘（哮喘）患者控制水平。方法本研究为多中心横断面研究，采用面对面问卷调查，覆盖我国大陆地区（除西藏外）30个省市。2015年10月至2016年5月于30家分中心门诊就诊的符合入选标准的哮喘患者依次入组本研究。问卷内容包括一般资料、控制水平、哮喘管理、哮喘发作的征兆和自我管理、疾病的认知程度。结果共纳入3 875例门诊哮喘患者。根据GINA定义的哮喘控制水平分级，我国城区哮喘总体控制率为28.5%（1 099/3 854）；其中，曾参与2008年哮喘控制调查的10个城市在本次调查中哮喘控制率为39.2%（533/1 361），与2008年（控制率28.7%）比较，有较大程度提高。26.4%（1 017例/3 858例）的患者在过去的一年中因哮喘急性发作住院，22.4%（864/3 858）的患者在过去的一年中因哮喘发作急诊就诊。在职工作人员中，18.4%（568/3 092）的患者在过去的一年中因哮喘发作误工；在校学生中，63.6%（63/99）的患者在过去的一年中因哮喘发作误学。结论目前我国哮喘总体控制水平尚不理想，但部分城市的哮喘控制水平有明显改善。哮喘控制不佳导致急诊就诊、住院和误工误学增加。

Objective To assess the overall asthma control level in urban China. Methods A multi-center, cross-sectional, questionnaire-based survey was carried out in 30 provinces in China （except Tibet ）. Asthmatic outpatients who met the inclusion criteria were recruited consecutively from 30 sub-centers from October 2015 to May 2016. Data of demographic characteristics, asthma control, asthma management, asthma exacerbations and self-management, and disease perception were collected by face-to-face interviews. Results Totally 3 875 asthmatic outpatients were recruited. Asthma control level was assessed according to GINA 2015. The prevalence of asthma control was 28.5% （1 099/3 854）. Among 10 cities, which were also involved in the asthma control survey in 2008, the level of asthma control improved from 28. 7% in 2008 to 39. 2% （533/1 361 ） in 2016. The rate of hospitalizations due to asthma exacerbations was 26. 4% （1 017/3 858） and the rate of emergency visits was 22. 4% （864/3 858）. Among adult patients, 18.4% （568/3 092 ） of them had been absent from work while 63.6% （63/99） adolescent patients had been absent from school because of asthma attacks in the previous year. Conclusion Although the level of asthma control in China is still far from ideal at present, the status has been improved in some cities. Poorly controlled asthma resulted in increase of hospitalizations, emergency department visits and work/school absences.