支气管哮喘(简称哮喘)是全球常见的慢性气道疾病。虽然指南推荐了哮喘诊断标准并已经广泛应用于临床实践,但在人群的大型流行病学调查中,常推荐采用标准化的哮喘问卷进行患病率调查,因为标准化的哮喘问卷具有效益高、成本低、应答率高...支气管哮喘(简称哮喘)是全球常见的慢性气道疾病。虽然指南推荐了哮喘诊断标准并已经广泛应用于临床实践,但在人群的大型流行病学调查中,常推荐采用标准化的哮喘问卷进行患病率调查,因为标准化的哮喘问卷具有效益高、成本低、应答率高的特点,所得结果也便于在不同人群或地区之间进行比较。目前全球范围内已开展的4项具有较大影响的哮喘流行病学调查,包括欧盟呼吸健康调查(European Community Respiratory Health Survey,ECRHS)、国际儿童哮喘和过敏研究(International Study of Asthma and Allergies in Childhood,ISAAC)、国际婴儿喘息研究(International Study of Wheezing in Infants,EISL)和世界健康调查(World Health Survey,WHS),上述研究结果也是全球疾病负担研究(Global Burden of Disease Study,GBD)估算全球哮喘患病率的重要数据来源。在中国,曾进行过多次儿童、成人哮喘患病率的调查,但是既往调查多采用临床诊断标准定义人群中的哮喘者,因此,所得结果与国际上采用标准问卷所得哮喘患病率无法比较。在中国20岁以上代表性人群中进行的中国肺部健康研究(China Pulmonary Health Study,CPH),采用了与ECRHS一致的哮喘问卷,结果显示,中国成人中表现有喘息症状的哮喘患病率达4.2%,有近4570万成人哮喘患者,但该数据并不包括20岁以下哮喘患者以及不典型哮喘患者。此外,CPH研究还显示,中国成人哮喘的漏诊率高,规范化治疗率低,亟待社会采取措施提高哮喘的诊治与管理水平。展开更多
Objective: To determine the prevalence of ibuprofen-sensitive asthma in schoo l-aged children with mild ormoderate persistent asthma. Study design: A randomi zed, double-blind, placebocontrolled, crossover bronchoprov...Objective: To determine the prevalence of ibuprofen-sensitive asthma in schoo l-aged children with mild ormoderate persistent asthma. Study design: A randomi zed, double-blind, placebocontrolled, crossover bronchoprovocation challenge st udy in children 6 to 18 years of age with mild or moderate persistent asthma. Pa tients received a single dose of ibuprofen or placebo, per randomization, and th en returned 2 to 7 days later to repeat the procedures after taking that study d rug not received at the first visit. At each visit, patients performed spirometr y before and 1/2, 1, 2, and 4 hours after administration of study drug. We defin ed bronchospasm as a ≥20%decrease from baseline in the forced expired volume i n the first second (FEV1) and ibuprofen sensitivity as bronchospasm following ad ministration of ibuprofen but not placebo. Results: Of the 127 patients screened , 100 (mean age, 11 years) completed the study. Two patients met criteria for ib uprofen-sensitive asthma, resulting in a prevalence of 2%(95%CI: 0.2%-7%). Neither patient was known to have had any exposure to ibuprofen before the stud y. Conclusion: The prevalence of ibuprofen-sensitive asthma was low but non-ze ro in this group of children with mild or moderate asthma. The possibility of ib uprofen-induced bronchospasm should be considered before administering ibuprofen to children with asthma.展开更多
文摘支气管哮喘(简称哮喘)是全球常见的慢性气道疾病。虽然指南推荐了哮喘诊断标准并已经广泛应用于临床实践,但在人群的大型流行病学调查中,常推荐采用标准化的哮喘问卷进行患病率调查,因为标准化的哮喘问卷具有效益高、成本低、应答率高的特点,所得结果也便于在不同人群或地区之间进行比较。目前全球范围内已开展的4项具有较大影响的哮喘流行病学调查,包括欧盟呼吸健康调查(European Community Respiratory Health Survey,ECRHS)、国际儿童哮喘和过敏研究(International Study of Asthma and Allergies in Childhood,ISAAC)、国际婴儿喘息研究(International Study of Wheezing in Infants,EISL)和世界健康调查(World Health Survey,WHS),上述研究结果也是全球疾病负担研究(Global Burden of Disease Study,GBD)估算全球哮喘患病率的重要数据来源。在中国,曾进行过多次儿童、成人哮喘患病率的调查,但是既往调查多采用临床诊断标准定义人群中的哮喘者,因此,所得结果与国际上采用标准问卷所得哮喘患病率无法比较。在中国20岁以上代表性人群中进行的中国肺部健康研究(China Pulmonary Health Study,CPH),采用了与ECRHS一致的哮喘问卷,结果显示,中国成人中表现有喘息症状的哮喘患病率达4.2%,有近4570万成人哮喘患者,但该数据并不包括20岁以下哮喘患者以及不典型哮喘患者。此外,CPH研究还显示,中国成人哮喘的漏诊率高,规范化治疗率低,亟待社会采取措施提高哮喘的诊治与管理水平。
文摘Objective: To determine the prevalence of ibuprofen-sensitive asthma in schoo l-aged children with mild ormoderate persistent asthma. Study design: A randomi zed, double-blind, placebocontrolled, crossover bronchoprovocation challenge st udy in children 6 to 18 years of age with mild or moderate persistent asthma. Pa tients received a single dose of ibuprofen or placebo, per randomization, and th en returned 2 to 7 days later to repeat the procedures after taking that study d rug not received at the first visit. At each visit, patients performed spirometr y before and 1/2, 1, 2, and 4 hours after administration of study drug. We defin ed bronchospasm as a ≥20%decrease from baseline in the forced expired volume i n the first second (FEV1) and ibuprofen sensitivity as bronchospasm following ad ministration of ibuprofen but not placebo. Results: Of the 127 patients screened , 100 (mean age, 11 years) completed the study. Two patients met criteria for ib uprofen-sensitive asthma, resulting in a prevalence of 2%(95%CI: 0.2%-7%). Neither patient was known to have had any exposure to ibuprofen before the stud y. Conclusion: The prevalence of ibuprofen-sensitive asthma was low but non-ze ro in this group of children with mild or moderate asthma. The possibility of ib uprofen-induced bronchospasm should be considered before administering ibuprofen to children with asthma.