中国城区儿童哮喘患病率调查

A nationwide survey in China on prevalence of asthma in urban children

目的 调查中国城区儿童哮喘患病率、哮喘相关因素及对儿童、家庭和社会的影响。方法 采用整群抽样调查方法 ,调查全国 3 1省 43个城市 ,在 2 0 0 0年 6月～ 10月 ,由全国儿科哮喘防治协作组完成 ,对象为所在调查区域 0～ 15岁儿童 ( 1985年 7月 1日～ 2 0 0 0年 6月 3 0日出生 )。结果共调查 3 1省 43个城市儿童 43 783 7名 ,实查 43 2 5 0 0名。最后确定 3岁以上儿童哮喘 740 1例( 73 5 3 % ) ,婴幼儿哮喘 110 9例 ( 11 0 2 % ) ,咳嗽变异性哮喘 785例 ( 7 80 % ) ,可疑哮喘 770例( 7 65 % )。 0～ 15岁儿童哮喘累计患儿 85 10例 ,平均累计患病率为 1 97%。儿童哮喘和婴幼儿哮喘2年内发作现患 6672例 ,现患率 1 5 4%。与 10年前比较有明显增加。各城市儿童哮喘患病率不同 ,最低是青海 ,累计患病率 0 2 5 % ,现患率 0 12 % ;最高为重庆和上海 ,累计患病率分别为 4 63 %和4 5 2 % ,现患率均为 3 3 4%。 4670例 ( 70 0 0 % )患儿首次喘息发作在 3岁内。以呼吸道感染和过敏为诱因致哮喘发病和发作者 63 13例 ( 94 62 % )。治疗中有 2 477例 ( 3 7 13 % )哮喘现患儿童使用吸入激素治疗 ,5 987例 ( 89 74% )应用支气管扩张剂治疗喘息。有 673 0例 ( 95 47% )患儿因哮喘致家庭成员工作受影响。结论 ?

Objective Asthma is one of the most common chronic disorders in childhood. The prevalence rate of asthma and other atopic diseases have increased steadily in many countries. The present survey was conducted to find out the prevalence of childhood asthma in urban areas in China, and to assess the influence of asthma on patients′ social life and their families. Methods A nationwide randomized survey, covering 43 cities in 31 provinces, on the prevalence of childhood asthma was carried out by the National Pediatric Cooperative Group on Asthma Research from June to October 2000, including a population of 437 873 children aged 0-14 years. Patients who had asthma, infantile asthma, cough variant asthma and questionable asthma (including asthmatic bronchitis) were chosen as subjects. Results Totally 10 065 subjects were screened out as asthma associated children by means of questionnaire to the parents, physical examination and case history review. Among them 7 401 (73.53%) children, aged 3 years or more, were diagnosed as asthma of children; 1 109 (11.02%) infants and young children, aged less than 3 years, as asthma of infants and young children; 785 (7.80%) as cough variant asthma; and 770 (7.65%) as questionable asthma. The prevalence of the average accumulated asthma of all the 0-14 years old asthma population (including asthma of older children and of infants) in the 31 provinces, 43 cities was 1.97%. Male/female ratio was 1.75∶1. There was statistically significant difference in asthma prevalence among the 43 cities, with the highest rate in Chongqing (4.63%) and the lowest in Xining (0.25%). Overall, within China, the prevalence rate in North China was relatively lower (0.99%) and was higher in South China (1.54%), the highest was seen in eastern areas of China (2.37%), 4 670 patients (70.00%) of the children had their onset before three years of age. The current 2 years prevalence of Chinese urban children was 1.54%. Thirty-six of the 43 cities had received the same kind of asthma prevalence survey 10 years ago, which made a longitudinal comparison of the two surveys available. For 6 370 patients (95.47%) the family members′ work was affected because of their asthma attacks. One third of the patients had used inhaler corticosteroids. In about 2/3 of patients the diagnosis of asthma was correct, while only 1/3 patients′ cough variant asthma was correct compared with their early diagnosis. Sixteen percent of patients were never diagnosed to have asthmatic diseases previously. Conclusions There has been a significantly increasing trend of asthma prevalence during the ten years, especially in the older age group. From the data of present survey it was inferred that there has been certain improvement, although not ideal, in the accuracy of diagnosis and in the practice of steroid inhalation therapy by the pediatricians in different cities.