Fuhlbrigge Anne L, Adams Robert J, Guilbert Theresa W, Grant Evie, Lozano Paula, Janson Susan L, Martinez Fernando, Weiss Kevin B, Weiss Scott T
Channing Laboratory, Department of Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston, Massachusetts 02115, USA.
Am J Respir Crit Care Med. 2002 Oct 15;166(8):1044-9. doi: 10.1164/rccm.2107057.
Asthma imposes a growing burden on society in terms of morbidity, quality of life, and healthcare costs. Although federally sponsored national surveys provide estimates of asthma prevalence, these surveys are not designed to characterize the burden of asthma by self-reported disease activity. We sought to characterize asthma burden in the United States. This study was based on a cross-sectional random-digit-dial household telephone survey designed to identify adult patients and parents of children with current asthma. Global asthma burden was comprised of three components: short-term symptom burden (4-week recall), long-term symptom burden (past year), and functional impact (activity limitation). Using this construct, only 10.7% of individuals were classified as having a global asthma burden consistent with mild intermittent disease, and 77.3% had moderate to severe persistent disease. These results suggest that a majority of the United States population with asthma experiences persistent rather than intermittent asthma burden. In addition, the discordance in type and distribution of asthma symptoms reported by individual subjects suggests that the exact estimate of the burden of asthma is related to how the National Asthma Education and Prevention Program classification is operationalized. Inquiry into recent day or nighttime symptoms alone underestimates the burden of asthma and may lead to inadequate treatment of asthma based on national guideline recommendations.
哮喘在发病率、生活质量和医疗费用方面给社会带来了日益沉重的负担。尽管联邦政府资助的全国性调查提供了哮喘患病率的估计数据，但这些调查并非旨在通过自我报告的疾病活动来描述哮喘的负担情况。我们试图描述美国哮喘的负担情况。这项研究基于一项横断面随机数字拨号家庭电话调查，旨在识别患有当前哮喘的成年患者和儿童的父母。全球哮喘负担由三个部分组成：短期症状负担（4周回顾）、长期症状负担（过去一年）和功能影响（活动受限）。使用这一结构，只有10.7%的个体被归类为具有与轻度间歇性疾病相符的全球哮喘负担，而77.3%的个体患有中度至重度持续性疾病。这些结果表明，美国大多数哮喘患者经历的是持续性而非间歇性哮喘负担。此外，个体受试者报告的哮喘症状类型和分布不一致表明，哮喘负担的确切估计与国家哮喘教育和预防计划分类的实施方式有关。仅询问近期白天或夜间症状会低估哮喘负担，并可能导致基于国家指南建议的哮喘治疗不足。
