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哮喘儿童的哮喘患病率及药物处方情况。

Asthma prevalence and drug prescription in asthmatic children.

作者信息

Barbato A, Panizzolo C, Biserna L, Cantarutti L, Giaquinto C, Frati F, Marcucci F, Monciotti C, Testi R, di Blasi P, Sturkenboom M C J M

机构信息

Dept of Pediatrics, University of Padova, Italy.

出版信息

Eur Ann Allergy Clin Immunol. 2003 Feb;35(2):47-51.

Abstract

A cross-sectional study was conducted on among 28,856 children aged from birth to 14 years to determine the prevalence of asthma and assess its treatment in a sample of asthmatic children. Children diagnosed with asthma were identified by a sensitive algorithm applied to the information stored in the computerized medical records between 1997 and 1998. Pediatricians then reviewed and validated the diagnosis. Specific information was obtained, after age stratification under 5 yrs and over 6 ys, from the medical records and by interview regarding their personal details and treatment of asthmatic patients. In all, 1,263 cases of asthma were identified (64% males) with a prevalence of 6.3% among males and 4% among females in under 5 year-olds, and 3.9% for males and 2.1% for females in over 6 year-olds. The prevalence of asthma diagnosed directly by the pediatrician was consequently higher among under 5 year-olds, in both genders, than among the older children. Contrary to the international guidelines, pediatricians prescribed more oral corticosteroids and nebulized short-acting beta-2 agonists for children under 5 ys olds than for over 6 year-olds (13.3% Vs 4.8% and 25% Vs 10.9%, respectively, p < 0.001). For the > or = 6 year-olds, the most commonly prescribed treatments were oral antihistamines (13.9% Vs 12.6%), inhaled corticosteroids via metered-dose inhaler (30.8% Vs 28.7%) and sodium cromoglycate (12.1% Vs 4.8%, p < 0.001).

摘要

对28856名年龄从出生到14岁的儿童进行了一项横断面研究,以确定哮喘的患病率,并评估哮喘儿童样本的治疗情况。通过应用一种敏感算法,对1997年至1998年存储在计算机化医疗记录中的信息进行分析,从而识别出被诊断为哮喘的儿童。然后,儿科医生对诊断进行了复查和验证。在按年龄分层为5岁以下和6岁以上后,从医疗记录中并通过访谈获取了有关哮喘患者个人详细信息和治疗情况的具体信息。总共识别出1263例哮喘病例(64%为男性),5岁以下男性患病率为6.3%,女性为4%;6岁以上男性患病率为3.9%,女性为2.1%。因此,儿科医生直接诊断出的哮喘患病率在5岁以下儿童中,无论男女,均高于年龄较大的儿童。与国际指南相反,儿科医生给5岁以下儿童开的口服皮质类固醇和雾化吸入短效β-2激动剂比6岁以上儿童更多(分别为13.3%对4.8%和25%对10.9%,p<0.001)。对于6岁及以上儿童,最常用的治疗方法是口服抗组胺药(13.9%对12.6%)、通过定量吸入器吸入皮质类固醇(30.8%对28.7%)和色甘酸钠(12.1%对4.8%,p<0.001)。

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