支气管哮喘

支气管哮喘是一种常见的呼吸道疾病，全球约有1．7亿人患此病。近年来，我国各地对哮喘患也作了流行病学调查：1988-1990年全国27省(市)对90万0～14岁儿童的哮喘进行抽样调查，发现各地区的哮喘患病率相差很大：福建省的患病率最高为2．03％，西藏高原最低为0．11％，平均为1％；山东省调查了98万名城乡人群的哮喘患病率为0．59%，其中14岁以下儿童的患病率为0．80％，显高于成人的0．49％。     

近十年我国高血压患病率概况

我国自 50年代以来对人群高血压进行过三次普查 ,结果显示 :高血压 (定义为收缩压≥1 4 0mmHg及 /或舒张压≥ 90mmHg)患病率 1 959年为 5 1 1 % ,1 979年为 7 73 % ,1 991年为 1 1 88% ,呈明显上升趋势 ,并且北方高血压患病率高于南方。近十年来随着经济的发展及生活水平的提高 ,人们的生活方式发生了很大的变化 ,各地流行病学研究明确提示人群高血压患病率较十年前明显增高。本文就 1 995年以后我国各地高血压流行病学调查结果作一综述。1　高血压流行趋势近年来 ,各地的高血压流行病学调查显示 ,人群高血压患病率明显高于 1 991第三次全…     

鲁中地区猪带绦/囊虫病流行病学调查研究

为摸清鲁中地区猪带绦 /囊虫病流行情况 ,1997年对平阴等 5县 (区 ) 2 2处乡 (镇 ) 5 6个自然村的 35 5 12人进行了调查。人群绦虫病患病率为 0 .10 1% ,囊虫病患病率为 0 .10 7%。 5县 (区 )均有不同程度的流行。男女之间绦/囊虫病患病率无显著性差异 ,但患病率随年龄增加而升高 ,二者呈正相关。另外 ,发现其分布有明显的职业特征。人群抗囊尾蚴特异性 Ig G4抗体阳性率平均为 2 .2 4%。猪囊虫感染率在 0 .12 %～ 0 .48%之间 ;5县 (区 )共采集 2 0 4份猪血标本 ,血清学检测抗体阳性率为 4.41%。同时 ,对居民饮食、卫生习惯、养猪情况等进行了调查分析     

高脂血症与胆石症关系的相关性调查

研究高脂血症与胆石症的关系 ,通过对两组不同饮食习惯 (高脂与低脂饮食 )的相关调查 ,显示两组高脂血症患病率分别为 2 8 81% (1197/ 4 15 4 ) ,2 18% (16 / 732 ) ,P <0 0 0 5 ,RR =13 2 1。胆石症患病率分别为 12 2 8%(5 10 / 4 15 4 ) ,1 6 4 % (12 / 732 ) ,P <0 0 0 5 ,RR =7 4 9。说明了高脂血症与胆石症患病率之间存在着非常明显的相关性。     

辽宁省大中城市及郊区老年人支气管哮喘患病率调查

目的　调查辽宁省大、中城市及其郊区老年人支气管哮喘 (哮喘 )的患病情况 ,为老年人哮喘的防治提供依据。　方法　以分层整群不等比随机抽样对照方法 ,抽取全省人口的 2 5‰以上人口共 1162 76人 ,对其中≥ 60岁的 12 73 5名老年人哮喘患病情况进行分析。　结果　确诊老年哮喘患者 52 2例 ,患病率为 4 0 9% ,显著高于我省同期现患病率的 1 2 5% ,其中男 2 0 7例、女 3 15例 ,女性显著高于男性 (P <0 0 1)。农村老年人哮喘患病率显著高于城市 (患病率分别为 5 2 4%和3 0 1% ,P <0 0 1)。城市工业区老年人哮喘患病率高于文化区 (患病率分别为 3 85%和 2 44% ,P<0 0 5) ,起病年龄在 60岁以上者 50例 ,占 9 58%。本次调查确诊为哮喘者 2 13例 ,漏诊率为40 80 %。　结论　哮喘是老年人的常见疾病 ,加强其防治极为重要     

门冬胰岛素50的临床应用

正糖尿病及其并发症的高患病率,给居民造成严重的家庭和社会负担,已经成为严重威胁公共卫生健康的社会问题。中华医学会糖尿病学分会(CDS)组织的流行病学调查数据显示,以口服葡萄糖耐量试验(OGTT)测定的空腹血糖(FPG)和餐后2h血糖(2h PG)值为诊断标准,推测我国20岁以上人群糖尿病患病率约为9.7%。2013年发表的流行病学调查数据以糖化血红蛋白(Hb A1c)水平7.0%为血糖控制标准,估测我国     

脑蛋白水解物注射液治疗老年痴呆的疗效观察

流行病学调查显示,在欧美等西方国家,60岁以上人群痴呆的患病率为10%,80岁以上为20%～30%[1].我国老年痴呆的总患病人数已经达老年人口的4%～5%[2].     

上海市宝山区支气管哮喘患病率和危险因素调查

目的:了解上海市宝山区哮喘患病率情况及其危险因素的分布,为开展哮喘防治工作提供依据。方法:按照分层整群不等比随机抽样对照方法对上海宝山区进行哮喘流行病学问卷调查,采取入户问卷填写方式,调查人群年龄≥4岁。结果:共调查4 956人,哮喘患者95例,总患病率为1.92%。儿童患病率为3.89%,成人患病率为1.81%。男、女患病率分别为1.5%和2.3%,男女之比为0.7∶1。相关因素分析显示,哮喘患者中精神紧张[比值比(OR)=12.474,95%可信区间(CI):8.019～19.405]、冷空气(OR=3.43,95%CI:2.41～4.90)、刺激性气体(OR=12.47,95%CI:8.015～19.40)、接触粉尘(OR=20.311,95%CI:12.52～32.97)为主要诱因;哮喘伴有过敏性鼻炎者为45.26%(OR=16.425,95%CI:10.739～25.12),有哮喘家族史者46.32%(OR=19.496,95%CI:12.724～29.872)。回归分析显示哮喘家族史和过敏性鼻炎对哮喘的发生影响最大。结论:本次流行病学调查获得了上海市宝山区哮喘患病率及相关危险因素的资料,为今后开展上海地区支气管哮喘的防治工作提供了依据。     

哮喘与肺结核的关系探讨

目的 探讨哮喘与肺结核关系。方法 在河南省结核病流行病学调查的同时进行河南省哮喘流行病学调查。结果 肺结核病人的哮喘患病率为2.3%，非肺结核组的哮喘患病率为1.0%；肺结核病人中的哮喘患病是非肺结核组的2倍。哮喘病人中的肺结核患病率为1.2%，非哮喘组的肺结核患病率为0.5%；哮喘病人的肺结核患病率为非哮喘的2倍多。结论 肺结核易并发哮喘，哮喘亦易并发肺结核，二者互为促发因素。     

基于标准问卷的支气管哮喘流行病学

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, ...     

Occupational and environmental risk factors for respiratory symptoms in rural Beijing, China.

The aim of the present study was to determine the effects of occupational and environmental exposure on respiratory symptoms in adults in rural Beijing, China. Thirty randomly selected villages in the counties of Shunyi and Tongxian, 50 km north and east, respectively, of the city of Beijing, China, participated in this study. Village doctors interviewed all residents aged > or = 15 yrs and completed the International Union Against Tuberculosis and Lung Disease Questionnaire on Bronchial Symptoms translated into Chinese with added questions on smoking and occupational and environmental exposure. Of the eligible population, 22,528 adults (98%) took part. The prevalence of all respiratory symptoms, i.e. asthma-like symptoms, asthma attacks in the last 12 months, chronic cough and chronic phlegm, was low. Significant determinants for respiratory symptoms were age, sex, smoking and county of residence. A dose-dependent relationship was found between cumulative cigarette consumption and prevalence of respiratory symptoms. After adjusting for these variables, exposure to insecticides and fertilisers significantly increased the risk of most of the respiratory symptoms, whereas exposure to indoor air pollution from domestic fuels did not. Exposure to chemicals such as insecticides and fertilisers contributed independently to the risk of respiratory symptoms in rural Beijing, China.     

Prevalence and risk factors for asthma in Poland: results from the PMSEAD study.

BACKGROUND: The prevalence of asthma depends on both hereditary and environmental factors. Knowledge of the effects of environmental and congenital factors on the frequency of occurrence of asthma may provide important clues to its pathogenesis and prevention. OBJECTIVES: The Polish Multicentre Study of Epidemiology of Allergic Diseases was designed to obtain estimates representative of the entire Polish population to assess asthma prevalence and risk factors. METHODS: Thirty-three areas were selected in 11 regions of Poland. Epidemiologic diagnoses of asthma were verified by a single recognized expert in each region on the basis of collected data as well as available medical documentation, in accordance with the 1997 guidelines of the Global Initiative for Asthma. Ambient air concentrations of sulfur dioxide and suspended particulates (black smoke) were measured directly or estimated by statistical modelling. RESULTS: Results were obtained for asthma in 16 238 subjects, including 3268 children (aged 3 to 16 years) and 12 970 adults (17 to 80 years). The overall prevalence of asthma was 8.6% (95% confidence interval [CI], 7.7%-9.6%) among children and 5.4% (95% CI, 5.0%-5.8%) among adults. Several risk factors for asthma were identified: family history of asthma, black smoke, residential exposure to traffic-related air pollution in both children and adults, and damp or overcrowded housing in adults. No statistically significant association was observed for passive smoking in the home, use of gas stoves, pet ownership, or exposure to ambient air pollution with sulfur dioxide. CONCLUSION: Our results show that the prevalence of asthma is associated with several host and environmental factors in the Polish population.     

Effect of respiratory protective devices on development of antibody and occupational asthma to an acid anhydride

STUDY OBJECTIVES: To determine whether the use of respiratory protective equipment would reduce the incidence of occupational asthma due to exposure to hexahydrophthalic anhydride (HHPA). DESIGN: Prospective cohort study. SETTING: A facility that makes an epoxy resin product requiring HHPA for its manufacture. PARTICIPANTS: Sixty-six individuals newly hired at a facility that makes an epoxy resin product requiring HHPA for its manufacture. INTERVENTION: Employees who wished to use respiratory protective equipment could choose from three types of masks: dust mask, half-face organic vapor respirator, or full-face organic vapor respirator. MEASUREMENTS: Workers were evaluated annually for development of positive antibody to HHPA and occupational, immunologic respiratory disease, including occupational asthma. RESULTS: With use of respiratory protective equipment, the rate of developing an occupational immunologic respiratory disease was reduced from approximately 10 to 2% per year. Occupational asthma developed in only three individuals, and they were all in the higher exposure category. Statistically, one respirator was not superior to the others. CONCLUSION: Respiratory protective equipment can reduce the incidence of occupational immunologic respiratory disease, including occupational asthma, in employees exposed to HHPA.     

Adult-onset asthma in west Sweden--incidence, sex differences and impact of occupational exposures

The aim was to estimate the incidence rate of adult-onset asthma in relation to age, sex, smoking and occupational exposures.A random sample of 18,087 subjects aged 16–75 years was investigated using a respiratory questionnaire. Adult-onset asthma was defined as "physician-diagnosed" asthma with onset at or after 16 years of age. The subjects were asked about year of asthma diagnosis and year of starting and stopping smoking. Subjects with onset of asthma before 16 years of age and physician-diagnosed chronic obstructive pulmonary disease were excluded resulting in a study population of 15,761 subjects. Incidence-rates of adult-onset asthma were calculated and relative risks were assessed using Cox-regression models.During the observation period 1990–2008, 359 new cases of asthma occurred and the cumulative incidence for adult-onset asthma was 2.3%. The crude incidence rate was 1.4/1000 person-years (95% confidence interval 1.3/1000–1.6/1000), with significantly higher incidence rate among women than among men. The incidence rate of asthma during never-smoking years was similar to that during smoking years. The rate of asthma incidence decreased with increasing age. Occupational dust and fume exposure and being female were associated with increased risk of asthma. The attributable fraction for occupational exposure to gas, dust and fumes was 9.4% in the total group, 17.3% among men and 5.1% among women.The incidence rate of asthma was higher among women than among men, and the rate declined with increasing age. A substantial proportion of the new-onset asthma cases could be attributed to occupational exposures.     

Occupational asthma in France: a 1-yr report of the observatoire National de Asthmes Professionnels project.

Observatoire National des Asthmes Professionnels (ONAP) was created in 1996 by two French professional societies to estimate the incidence of occupational asthma and to promote preventive measures against it. Occupational and chest physicians were asked to report newly diagnosed cases of work-related asthma and reactive airway dysfunction syndrome (RADS), the information collected included age, sex, occupation, suspected causal agents and diagnostic methods. In 1997, 82.3% of 559 cases reported (64% males, mean age 36 +/- 13 yrs) involved occupational asthma, 4.7% RADS and 12.7% atypical asthma syndromes. Incidence rates (expressed as number of cases per million workers) showed a regional variation that ranged from 4 to 73 (national mean: 25.7). The most frequently suspected agents were flour (23.3%), followed by isocyanates (16.6%), latex (7.5%), aldehydes (5.5%), and persulphates (4.1%). Occupations at risk were bakers (23.9%), healthcare workers (12%), painters (9.1%), hairdressers (5.2%), wood industry workers (4.8%) and cleaners (3.5%). These results are compared to those of other systems set up in Europe and North America. Because of the considerable bias inherent in a surveillance system based on voluntary, reporting, the number of occupational asthma cases reported is probably lower than the real incidence. Nevertheless, the French National Observatory for Occupational Asthma encourages physician awareness of occupational asthma and provides an estimate of its incidence and aetiologies in France.     

Association between traffic volume and health care use for asthma among residents at a U.S.-Canadian border crossing point.

Little information is available about health impacts of the North American Free Trade Agreement (NAFTA) traffic-related pollution on residents near the major traffic corridors along the U.S.-Canadian border. Here we report on a 10 year (1991-2000) retrospective study of commercial traffic volumes across the Peace Bridge and health care use for asthma in a residential community, which serves as a conduit for traffic crossing between Fort Erie, Ontario, Canada, and Buffalo, New York. We hypothesized that commercial traffic pollution was impacting on residents in close proximity to the trade corridor. Commercial traffic volumes, hospital discharges for asthma, and outpatient visits to area hospitals and clinics were analyzed before and after implementation of NAFTA. Results showed a positive association between increased commercial traffic volume and increased health care use for asthma. Zip codes 14201 and 14213, which surround the Peace Bridge Plaza Complex (PBC), had the highest prevalence rates and health care use rates for asthma. Statistical analysis showed the findings to be significant (p < 0.05) in that residential proximity to the PBC was associated with greater hospital discharge rates for asthma. The findings were strongest (p < 0.000) in the zip codes where the PBC was located (14213) and the major highway I-190 passed through (14201). A yearly excess of 230.2 adult asthma hospital discharges was associated with an increase in traffic volume during the period from 1991 to 1996 in the study area. This is in contrast to an overall decrease in the national rate of hospitalizations for asthma by 7.5% in the same period. The results suggest that NAFTA-related commercial traffic has a negative health impact on asthmatics living in close proximity to the trade corridor. Health and social costs due to traffic pollution need to be included in cost estimates of transport decisions related to the NAFTA corridors. Similar health effects due to NAFTA traffic need to be studied at other U.S.-Canada border crossing points.     

Risk of asthma among Finnish patients with occupational rhinitis

STUDY OBJECTIVES: To determine the risk of asthma among patients with occupationally induced rhinitis. DESIGN: Patients with confirmed occupational rhinitis were followed for asthma incidence through register linkage. Patients with other occupational diseases were used as a reference population. SUBJECTS: Patients entered into the Finnish Register of Occupational Diseases in from 1988 to 1999 for occupational rhinitis (n = 3,637) or other occupational disease (n = 31,457) were observed until December 31, 2000, through two national registers of individuals who were eligible for the reimbursement of asthma medication and the Population Register Center. METHODS: Incidence rates of asthma were calculated, and a log-linear model, adjusted for age, gender, and occupation, was used to estimate the relative risks (RRs) of asthma among those with occupational rhinitis compared to those with other occupational diseases. RESULTS: There were 420 and 972 incident cases of asthma, respectively, among those with occupational rhinitis and the reference population. The crude RR of asthma was 4.8 (95% confidence interval [CI], 4.3 to 5.4) for all patients with occupational rhinitis, 5.4 (95% CI, 4.8 to 6.2) for those with occupational rhinitis accepted for compensation, and 3.7 (95% CI, 3.1 to 4.5) for patients with unaccepted occupational rhinitis. The RR varied according to occupation and was the highest among farmers and wood workers, both groups having a sevenfold risk. The risk was especially high during the year following notification, but a roughly threefold risk persisted several years thereafter. CONCLUSIONS: Patients with occupationally induced rhinitis have a high risk of asthma, but further studies are needed to establish the effect of preventive interventions.     

Occupational asthma in a highly industrialized region of UK: report from a local surveillance scheme

Estimates of the incidence of occupational asthma may be derived from surveillance schemes established in several countries. SHIELD is a voluntary surveillance scheme for occupational asthma in the West Midlands, a highly industrialized region of UK. The aim of this study was to estimate the general and specific incidence of occupational asthma in the West Midlands in 1990-97. The annual incidence was 41.2/million. There was a two fold difference in the incidence by sex (male 59.6/million/yr; female 27.4/million/yr). The highest annual incidence (53.2/million) was observed in the age group 45-64 yr (male) and 45-59 yr (female). Spray painters were the occupation at the highest risk of developing occupational asthma, followed by electroplaters, rubber and plastic workers, bakery workers and moulders. Although the percentage of reported cases was low among healthcare workers, there was a raising trend. Isocyanates still remained the most common causative agents with 190 (17.3%) out of the total 1097 cases reported to the surveillance scheme in seven years. There was a decrease in the reported cases due to colophony (9.5% to 4.6%), flour & wheat (8.9% to 4.9%). There was an increase of reported cases due to latex (0.4% to 4.9%) and glutaraldehyde (1.3% to 5.6%). The serial mesurement of peak expiratory flow at and away from work was the most used method of diagnosis to confirm the occupational cause of asthma. Specific bronchial challenge test with the occupational agents were used when the serial measurement of peak expiratory flow was not able to confirm undoubtdely the diagnostic suspicion or when it was difficult to identify the possible causative agent due to multiple exposures in the workplace. Following diagnosis, 24% of the patients were moved away from exposure within the same workplace in 1997, compared to 15.8% in the previous years. Those remaining exposed to the causative agent in the same workplace decreased from 28.3% to 17.7% between 1990-97. The surveillance of occupational asthma trough this voluntary scheme has allowed to monitor the incidence of the disease in the region and to identify clusters of cases, where control measures are a priority.     

Aerosolized red-tide toxins (brevetoxins) and asthma

BACKGROUND: With the increasing incidence of asthma, there is increasing concern over environmental exposures that may trigger asthma exacerbations. Blooms of the marine microalgae, Karenia brevis, cause red tides (or harmful algal blooms) annually throughout the Gulf of Mexico. K brevis produces highly potent natural polyether toxins, called brevetoxins, which are sodium channel blockers, and possibly histamine activators. In experimental animals, brevetoxins cause significant bronchoconstriction. In humans, a significant increase in self-reported respiratory symptoms has been described after recreational and occupational exposures to Florida red-tide aerosols, particularly among individuals with asthma. METHODS: Before and after 1 h spent on beaches with and without an active K brevis red-tide exposure, 97 persons >or= 12 years of age with physician-diagnosed asthma were evaluated by questionnaire and spirometry. Concomitant environmental monitoring, water and air sampling, and personal monitoring for brevetoxins were performed. RESULTS: Participants were significantly more likely to report respiratory symptoms after K brevis red-tide aerosol exposure than before exposure. Participants demonstrated small, but statistically significant, decreases in FEV(1), midexpiratory phase of forced expiratory flow, and peak expiratory flow after exposure, particularly among those participants regularly using asthma medications. No significant differences were detected when there was no Florida red tide (ie, during nonexposure periods). CONCLUSIONS: This study demonstrated objectively measurable adverse changes in lung function from exposure to aerosolized Florida red-tide toxins in asthmatic subjects, particularly among those requiring regular therapy with asthma medications. Future studies will assess these susceptible subpopulations in more depth, as well as the possible long-term effects of these toxins.