慈溪市乡镇医师支气管哮喘认知状况的调查分析

目的了解乡镇医师对支气管哮喘（简称哮喘）基本概念、治疗及管理的认知状况,为基层医师的培训提供依据。方法对慈溪市25家不同级别医院共198名内科医师进行有关哮喘相关知识问卷调查,其中,三级医院1家,内科医师24名;二级医院5家,内科医师70名;一级医院19家,内科医师104名。问题涉及：哮喘定义、一线控制药物、预后、治疗中抗菌药物应用情况、GINA知晓率及医院是否备有吸入激素药物等。结果对哮喘属气道慢性炎症及可控制性疾病,回答正确率分别为85．4％与96％,上述两问题在三级与一、二级医院间差异无统计学意义。对吸入糖皮质激素者为哮喘一线控制性用药、发作时是否应用抗菌药物、GINA知晓率方面,正确率分别为68．7％、29．3％和58．6％。三级医院与一、二级医院间存在显著差异（P〈0．05）。关于医院备有吸入糖皮质激素方面,全市共4家医院备有（1家三级医院、3家二级医院）,一级医院均无吸入激素的备药。结论基层医院,尤其是一、二级乡镇医院对哮喘的防治管理认知方面尚存在较多问题,知识较陈旧,对GINA知晓率较低,不利于基层大量哮喘患者的治疗及管理,规范培训基层医务人员,使其掌握哮喘防治指南,从而有效指导哮喘患者是基层哮喘管理亟待解决的问题。     

新疆和田地区内科医师支气管哮喘认知状况的调查分析

目的 了解新疆和田地区内科医师对支气管哮喘(简称哮喘)基本概念、治疗及管理的认知状况,为基层少数民族医师的培训提供依据.方法 对和田地区26家不同级别医院共246名内科医师进行有关哮喘相关知识问卷调查,其中二级甲等医院1家,内科医师68名;二级乙等医院7家,内科医师122名;一级医院18家,内科医师56名.问题涉及:哮喘定义及哮喘炎症本质、哮喘的症状和诊断、哮喘的药物治疗和首选治疗方法、哮喘防治中存在的误区、全球哮喘防治创议(GINA)知晓情况及医院是否备有吸入激素药物等.结果 对哮喘属气道慢性炎症及哮喘治疗方面如首选治疗方法、治疗目标及控制水平分级,回答正确率仅分别为11.8％、21.5％、8.5％和2.0％,且上述问题在二级与一级医院间差异有统计学意义(P＜0.05).对哮喘GINA知晓率、吸入方法的掌握及慢性疾病理念方面正确率分别为9.3％、13.8％和9.8％.二级甲等医院与二级乙等医院及一级乡镇医院相互间差异有统计学意义(P＜0.05).关于医院备有吸入支气管扩张剂或糖皮质激素方面,全地区七县一市共8家二级医院均备有药物(1家二级甲等地区医院、7家二级乙等县医院).一级乡镇医院均无短效支气管扩张剂和糖皮质激素吸入剂的备药.结论 我国边疆基层医院,尤其是新疆南疆一、二级县乡镇医院对哮喘的认知防治管理方面存在较多问题,知识陈旧,对GINA知晓率低,不利于基层大量哮喘患者的治疗及管理,规范培训基层少数民族医务人员,使其掌握哮喘防治指南,从而有效指导哮喘患者是基层哮喘管理亟待解决的问题.     

慈溪市乡镇医师支气管哮喘认知状况的调查分析

目的 了解乡镇医师对支气管哮喘(简称哮喘)基本概念、治疗及管理的认知状况,为基层医师的培训提供依据.方法 对慈溪市25家不同级别医院共198名内科医师进行有关哮喘相关知识问卷调查,其中.三级医院1家,内科医师24名;二级医院5家,内科医师70名;一级医院19家,内科医师104名.问题涉及:哮喘定义、一线控制药物、预后、治疗中抗菌药物应用情况、GINA知晓率及医院是否备有吸入激素药物等.结果 对哮喘属气道慢性炎症及可控制性疾病,回答正确率分别为85.4%与96%,上述两问题在三级与一、二级医院间差异无统计学意义.对吸入糖皮质激素者为哮喘一线控制性用药、发作时是否应用抗菌药物、GINA知晓率方面.正确率分别为68.7%、29.3%和58.6%.三级医院与一、二级医院间存在显著差异(P<0.05).关于医院备有吸入糖皮质激素方面.全市共4家医院备有(1家三级医院、3家二级医院).一级医院均无吸入激素的备药.结论 基层医院,尤其是一、二级乡镇医院对哮喘的防治管理认知方面尚存在较多问题,知识较陈旧,对GINA知晓率较低,不利于基层大量哮喘患者的治疗及管理,规范培训基层医务人员,使其掌握哮喘防治指南,从而有效指导哮喘患者是基层哮喘管理亟待解决的问题.     

北京市各级医院呼吸系病专业医师哮喘基本知识问卷调查结果分析

目的了解各级医院呼吸系病专业医师对哮喘基本知识的掌握情况，作为哮喘防治学组制定工作计划的依据。方法采用问卷调查方式，共调查市级或以上医院、市内区级医院和郊区县医院５５家，对象为呼吸内科或内科呼吸专业组的住院医师和主治医师，总计４３６人。结果无论是哮喘的基本概念，还是吸入治疗、抗炎治疗在哮喘治疗中的地位、峰流速仪的使用价值等，各级医院呼吸系病专业医师均存在不同程度的模糊认识，市级或以上医院医师回答问题情况明显优于市内区级医院和郊区县医院。结论哮喘的医师教育问题是一项非常重要的工作，工作的重点应放在基层医院。     

北京市各级医院呼吸系病专业医师哮喘基本知识问卷调查结…

目的 了解各级医院呼吸系病专业医师对哮喘基本知识的掌握情况，作为哮喘防治学组制定工作计划的依据。方法 采用问卷调查方式，共调查市级或以上医院、市内区级医院和郊区县医院５５家，对象为呼吸内科或内科呼吸专业组的住院医师和主治医师，总计４３６人。结果 无论是哮喘的基本概念，还是吸入治疗、抗炎治疗在哮喘治疗中的地位，峰流速仪的使用价值等，各级医院呼吸系病专业医师均存在没程度的模糊认识，市级或以上医院医师回     

天津市16家医院哮喘患者问卷调查

目的了解天津地区支气管哮喘的危险因素和诊治情况。方法采用天津市哮喘联盟制定的统一问卷．由天津市哮喘联盟16家医院的呼吸科医生对门诊和住院确诊的793例哮喘患者进行问卷调查。结果被调查哮喘患者成年以后发病者占78．56％．病史在10年以上者44.39％。合并变应性鼻炎者39．97％。哮喘患者幼时呼吸道感染以病毒、细菌感染为主，占25．48％。某些环境因素及食物和药物均可诱发哮喘，尤其是刺激气体，有48．42％的患者不能耐受。精神因素对哮喘的发病也具有一定的作用。本次调查还显示哮喘患者对寒冷和干燥的环境更不耐受。被调查患者多数就诊于正规医院，53．22％的患者进行了肺功能检查；64．06％的患者使用哮喘指南推荐的吸入激素治疗．但仍有49．05％的患者使用不符合治疗规范的抗生素治疗。结论哮喘是一种具有众多诱发因素的可防可治的疾病，临床上要贯彻防重于治的原则。积极寻找和避免触发和诱发因素，制定以糖皮质激素吸人为核心的个体化治疗方案。同时，应利用各种方法和手段加强哮喘知识的宣传普及，提高基层医务工作者对哮喘的诊治水平，加强哮喘患者的自我监测意识。     

不同医院内科医生对糖皮质激素在哮喘治疗中作用认识的调查

糖皮质激素在支气管哮喘治疗中的作用和地位已取得共识。但有报道显示，哮喘治疗中糖皮质激素的使用，尤其是吸入表面激素的使用仍很不普遍。近两年，我们在我市三级甲等医院、城区医院、郊区县医院医生及部分社区医生中进行了有关糖皮质激素在哮喘治疗中作用认识的问卷调查。现将调查结果报道如下。 临床资料 一、测验对象：来自以下几个层次的医院或卫生保健机构：（１）某医科大学教学医院内科医师３５人（甲组）；（２）某市区级医院内科医师３５人；（乙组）（３）某市县医院内科医师３５人（丙组）；（４）某市区社区保健科、家庭病床…     

咳嗽变异性哮喘的组织胺支气管激发试验结果分析

目的探讨咳嗽变异性哮喘患者（CVA）组织胺支气管激发试验的结果。方法对269例拟诊CVA用肺功能仪测定基础肺功能及吸入不同剂量组织胺后的肺功能，对照激发前后结果。结果269例患者支气管激发试验阳性173例（64．31％），阴性86例（31．97％），可疑阳性10例（3．72％）。173例支气管激发试验阳性患者按支气管哮喘予吸入糖皮质激素及支气管舒张剂治疗，症状缓解。结论组织胺支气管激发试验对咳嗽变异性哮喘的诊断具有临床意义，此方法安全适用。     

支气管哮喘30例诊治常见误区分析

目的调查基层医院支气管哮喘诊治现状。方法通过对本组30例支气管哮喘患者诊治情况的调查,了解我国支气管哮喘防治指南在当地的执行情况。结果本组30例患者中曾经行肺功能检查或能用峰速仪监测气喘情况者占13．3％,按要求分级治疗为20％,哮喘急性发作时抗生素使用率93．3％,患者依从性较差。结论按支气管哮喘防治指南治疗部分患者明显受益,大部分患的诊治有待进一步改善。     

经鼻吸入布地奈德及特布他林治疗支气管哮喘急性发作并变应性鼻炎患者的临床疗效观察

目的观察经鼻吸入布地奈德及特布他林治疗支气管哮喘急性发作并变应性鼻炎患者的临床疗效。方法选取2013年9月—2015年5月淮安市淮阴医院收治的支气管哮喘急性发作并变应性鼻炎患者96例,采用随机数字表法分为对照组和观察组,每组48例。两组患者入院后均给予支气管哮喘常规干预,对照组患者在此基础上经口吸入布地奈德和特布他林,观察组患者在此基础上经鼻吸入布地奈德和特布他林。比较两组患者治疗前、治疗后3 d、出院前视觉模拟量表(VAS)评分、哮喘控制问卷(ACT)评分,住院时间及住院期间糖皮质激素静脉给药量。结果治疗前两组患者VAS、ACT评分比较,差异无统计学意义(P0.05);治疗3 d后、出院前观察组患者VAS评分低于对照组,ACT评分高于对照组(P0.05)。观察组患者住院时间短于对照组,住院期间糖皮质激素静脉给药量少于对照组(P0.05)。结论经鼻吸入布地奈德及特布他林治疗支气管哮喘急性发作并变应性鼻炎患者的临床疗效确切,可有效控制鼻炎及哮喘症状,缩短住院时间并减少糖皮质激素用量。     

1997年12月至2009年12月成人接种卡介苗对支气管哮喘防控作用监测研究

目的 探讨成人接种卡介苗能否预防支气管哮喘（简称哮喘）发生和控制已患哮喘急性发作.方法 以分层整群随机抽样确定科研点的县、乡,以乡辖村为单位分为研究组和对照组,对村中20～55岁非肿瘤、结核病现症患者的自愿村民按性别、年龄分别配对,对研究组人群进行卡介苗接种,每6个月1次连续3次;依靠县、乡、村三级防疫网络,对哮喘的发生和已患哮喘的发作进行监测.结果 抽得4个乡、83个村,共有哮喘患者1 406例,患病率为1.3% （1 406/108 189）;纳入监测的20～55岁村民共24 830人,哮喘患者149例,患病率0.6%,其中研究组81例,对照组68例;在1997年12月至2009年12月监测期间研究组死亡3例,尚存的78例急性发作35例,共计233次;对照组死亡7例,尚存的61例发作59例,共计2 131次.哮喘患者的急性发作率比较及发作次数（人次）比较研究组与对照组间的差异均有统计学意义（χ2=42.07,P＜0.01;t=9.46,P＜0.01）;研究组原非哮喘患者12 334人中已经死亡432人,新发哮喘13例,哮喘发生、发作共计167次;对照组原非哮喘患者12 347人中已经死亡511人,新发哮喘39例,哮喘发生、发作共计1 907次.哮喘发病率比较及发生、发作的次数（人次）比较研究组与对照组间的差异亦均有统计学意义（χ2=13.17,P＜0.01;t=6.31,P＜0.01）.结论 成人接种卡介苗对哮喘的发生有一定预防作用,对哮喘急性发作有一定治疗、控制作用.     

Prevalence of Asthma, Rhinitis, and Eczema from ISAAC Survey of Schoolchildren in Central Taiwan

Asthma is a common disease among schoolchildren in Taiwan. It is clearly a trend that the prevalence of asthma, rhinitis, and eczema has been increasing in developed countries such as Taiwan, but the data remain limited. This study is part of an effort to evaluate the epidemiology of asthma, rhinitis and eczema in Taiwan and to assess the prevalence and severity of those disorders among school age in central Taiwan. The International Study of Asthma and Allergies in Childhood (ISAAC, phase III) standard written questionnaire was administered to 7,873 first grade schoolchildren, 6 to 8 years of age from 47 different elementary schools in Changhwa county, which is located in central Taiwan. The overall cumulative and 12-month prevalence of wheezing is 10.4% and 5.0%, respectively. The prevalence of diagnosed asthma by doctor is 7.0%. Rhinitis is 24.6% and eczema 18.0%. Multiple logic regression analysis shows that a higher prevalence of wheezing and rhinitis is associated with males. Among these school-age children, the peak incidence of asthma and rhinitis is in the winter months, especially in December and January.

We also compared the prevalence of asthma, rhinitis, and eczema in two severely polluted areas in Changhwa County with the prevalence in less polluted parts of the county. One is the area near a huge petrochemical company, TaiHao Petroleum Company, located in the central area of the county. The other is XiZhao, a rural area located near an incinerator. These were compared with the less-polluted Coast-Area and with the rest Changhwa County area. The school-age children living near the TaiHao Company have a higher prevalence of wheezing, diagnosed asthma, and diagnosed eczema, but there are no differences for rhinitis. As for XiZhao and Coast areas, those children have significantly higher rates of nasal problems, diagnosed rhinitis, and eczema than the rest of the area, but we did not find a significant difference in the prevalence of asthma. Among school-age children who lived in the Coast area, we found a higher prevalence of rhinitis and nasal problems with associated itchy eyes than among children in other areas of the county.     

Prevalence of Asthma,Rhinitis, and Eczema from ISAAC Survey of Schoolchildren in Central Taiwan

Asthma is a common disease among schoolchildren in Taiwan. It is clearly a trend that the prevalence of asthma, rhinitis, and eczema has been increasing in developed countries such as Taiwan, but the data remain limited. This study is part of an effort to evaluate the epidemiology of asthma, rhinitis and eczema in Taiwan and to assess the prevalence and severity of those disorders among school age in central Taiwan. The International Study of Asthma and Allergies in Childhood (ISAAC, phase III) standard written questionnaire was administered to 7,873 first grade schoolchildren, 6 to 8 years of age from 47 different elementary schools in Changhwa county, which is located in central Taiwan. The overall cumulative and 12-month prevalence of wheezing is 10.4% and 5.0%, respectively. The prevalence of diagnosed asthma by doctor is 7.0%. Rhinitis is 24.6% and eczema 18.0%. Multiple logic regression analysis shows that a higher prevalence of wheezing and rhinitis is associated with males. Among these school-age children, the peak incidence of asthma and rhinitis is in the winter months, especially in December and January.

We also compared the prevalence of asthma, rhinitis, and eczema in two severely polluted areas in Changhwa County with the prevalence in less polluted parts of the county. One is the area near a huge petrochemical company, TaiHao Petroleum Company, located in the central area of the county. The other is XiZhao, a rural area located near an incinerator. These were compared with the less-polluted Coast-Area and with the rest Changhwa County area. The school-age children living near the TaiHao Company have a higher prevalence of wheezing, diagnosed asthma, and diagnosed eczema, but there are no differences for rhinitis. As for XiZhao and Coast areas, those children have significantly higher rates of nasal problems, diagnosed rhinitis, and eczema than the rest of the area, but we did not find a significant difference in the prevalence of asthma. Among school-age children who lived in the Coast area, we found a higher prevalence of rhinitis and nasal problems with associated itchy eyes than among children in other areas of the county.     

Socioeconomical conditions as risk factors for bronchial asthma in children aged 4-5 yrs.

A number of factors are associated with the development of childhood asthma. The purpose of this study was to establish the prevalence of childhood asthma and to explore the socioeconomic background factors associated with childhood asthma in a Norwegian cohort of children aged 4-5 yrs. A questionnaire was given to parents in connection with the ordinary child control of 4-5-yr-old children in Vestfold county, Norway. In addition to the question "Has the child at present or ever had asthma?", a number of medical and socioeconomical background factors were registered. Of the 2,430 parents, 1,913 (79%) responded. Of the 163 (cumulative prevalence 8.7%) children with confirmed asthma, 19 did not use any medication and were regarded as having outgrown their asthma. Several background factors were significantly associated with asthma in a logistic regression analysis: few rooms at home, psychosocial problems, fever more than three times during the last year, hay fever, reaction to food and mother or father with chronic disease. The findings indicate that socioeconomic background factors are associated with asthma in childhood, in addition to other known risk factors.     

Patterns of Inpatient and Outpatient Care for Asthma in Erie and Niagara Counties, Western New York State

The prevalence of asthma, as well as the morbidity and mortality due to asthma, has increased in the United States, especially among poor minority subpopulations. The causes of these increases are complex and not well understood. Our findings from an analysis of emergency room (ER) visits and hospitalizations for Erie and Niagara Counties in western New York State for the period 1984-1991 provides important background to this problem. Of all respiratory disorders, asthma was the most frequent reason for ER visits and was second only to pneumonia as a reason for hospital admissions. In Erie County the hospitalization rates for asthma in two inner-city communities with predominantly minority populations were 1.48 and 2.09 times higher than those in the rest of the county. Furthermore, the hospitalization rates for these communities showed an increasing trend over the study period. Gender differences were also found. Boys age 0 to 9 years were hospitalized for asthma twice as often as girls. However, over 15 years of age, females had admission rates that were twice those of males. In contrast, hospitalization rates for pneumonia were equal for males and females, which would suggest gender differences particular to asthma. Hospitalizations for asthma in the western New York region cost an estimated $6,000,000 in 1990. We conclude that asthma is a major cause of morbidity in this region with excessive and increasing impact on inner-city communities.     

Differences in utilization of asthma drugs between two neighbouring Swedish provinces: relation to treatment in individuals with airway disease

Abstract. Objective . To assess the extent to which drugs were used by individuals found to have asthma in a population survey. To assess the relative influence of the proportion of patients treated and doses reported on the sales of drugs. To study if observed differences in sales of asthma drugs between the county of Jämtland (with high sales) and Gävleborg (with lower sales) correlated to a difference in the control of the disease. Design . A cross-sectional population study with a postal questionnaire followed by an interview and examination of symptomatic individuals. Asthma was diagnosed in subjects reporting a typical history of asthma or repeated episodes of dyspnoea and wheezing, or dry cough combined with reversibility in FEV₁. PEF-variability or PC₂₀ ≤ 4 mg ml^-1. Setting . The county of Jämtland, and Gästrikland, a southern part of the county of Gävleborg in central Sweden. Subjects . All 16 year olds, and 13% (randomly selected) of 30–39 and of 60–69 year olds (totalling 12732 individuals). Subjects reporting airway symptoms in the questionnaire (n = 2100) and 450 asymptomatic controls were further investigated. Main outcome measures . Drug use and symptoms reported by individuals found to have asthma or chronic obstructive pulmonary disease (COPD). Results . Inhaled β₂ agonists and inhaled steroids were used more often by individuals with asthma and COPD in Jämtland. However, regular use was more common in Gävleborg. Most of the asthmatics did not use any medication in spite of the fact that symptoms were commonly reported. The drug combinations most often used were inhaled β₂ agonists alone or in combination with inhaled steroids. There were only minor differences in the prevalence of symptoms reported by individuals with asthma treated in different ways. Conclusion . Differences in the way anti-asthma drugs were used contributed to the observed difference in the sales of drugs. However, this difference was mainly caused by differences in the prevalence of asthma. The goals of asthma management plans were fulfilled only in a minority of patients despite the sales of asthma drugs being high.     

A National Survey of Adult Asthma Prevalence by Urban-Rural Residence U.S. 2005

Objectives. We analyzed national data to estimate asthma prevalence among U.S. adults by urban-rural residence and to determine the relative contributions of sociodemographic and health behavior characteristics on the probability of reporting asthma. Methods. We linked the 2005 Behavioral Risk Factor Surveillance System (BRFSS) to Urban Influence Codes (UICs), categorizing respondents into four urban-rural groups: metropolitan, adjacent metropolitan, micropolitan, and remote. BRFSS collects health data from all 50 states. UICs classify respondent's county as urban or rural based on population size and proximity to metropolitan areas. We calculated asthma prevalence estimates and generated odds ratios (ORs) for the probability of reporting asthma. Results. Overall asthma prevalence (7.9%; 95%CI = 7.73–8.08) was not statistically different (p = 0.28) by urban-rural residence. After adjusting for selected characteristics, adjacent metropolitan (OR = 0.96; 95%CI = 0.90–1.02) and remote (OR = 0.95; 95%CI = 0.85–1.05) residents were less likely—and micropolitan (OR = 1.04; 95%CI = 0.93–1.16) residents were more likely—to report asthma compared with metropolitan residents; but confidence intervals included null. Conclusions. Asthma prevalence is as high in rural as in urban areas. Certain demographic, behavioral, and health care characteristics unique to place of residence might affect asthma prevalence. Because these results substantially change our understanding of asthma prevalence in rural areas, further investigation is needed to determine geographic-related risk factors     

High risk of adult-onset asthma and work-related wheeze in farmers despite low prevalence of asthma in young farmers.

OBJECTIVE: To investigate risk factors for asthma in farmers. METHODS: A questionnaire was sent to all farms (n = 2499) and to 2900 controls aged 19-65 years from the general population in the county of Uppsala. Sixty per cent of the farms (1514 men and 248 women) and 64% of the controls (900 men, 943 women) responded. RESULTS: Only 13% of the male farmers had heredity for allergy compared to 24% of the controls, and fewer farmers were smokers. After adjusting for confounders, male farmers had a significantly lower prevalence of doctor-diagnosed asthma and nocturnal breathlessness than the controls (OR 0.75, 95%CI 0.57-0.98 and OR 0.61, 95%CI 0.44-0.84), but a significantly higher prevalence of work-related wheeze (OR 1.74, 95%CI 1.30-2.35). The risk for asthma increased with age in the farmers. Of male farmers with asthma, 70% had developed asthma after the age of 21, in contrast with only 30% of the asthmatic controls. The young female farmers had a high prevalence of asthma. CONCLUSION: Male farmers have an increased risk of work-related wheeze and adult-onset asthma increasing with age despite a lower prevalence of asthma during childhood and young age than in the general population.