Peat J K, Haby M, Spijker J, Berry G, Woolcock A J
Department of Medicine, University of Sydney, New South Wales, Australia.
BMJ. 1992 Nov 28;305(6865):1326-9. doi: 10.1136/bmj.305.6865.1326.
To estimate whether the prevalence of asthma in adults increased over a nine year interval.
Serial cross sectional studies of the population with a protocol that included both subjective and objective measurements.
Busselton, Western Australia.
A random sample of 553 subjects aged 18-55 years in 1981, and of 1028 subjects aged 18-55 years in 1990.
Respiratory symptoms measured by self administered questionnaire, bronchial responsiveness measured by bronchial challenge with histamine, and allergy measured by skin prick tests.
Symptoms with increased prevalence were those with significant association with allergy in this population. Recent wheeze increased from 17.5% to 28.8% (p < 0.001) and diagnosed asthma increased from 9.0% to 16.3% (p < 0.001). The increase was greatest in subjects less than 30 years old. The prevalence of shortness of breath coming on at rest and of hay fever also increased significantly, but the prevalence of shortness of breath on exertion, chronic cough, bronchial hyperresponsiveness, current asthma (defined as recent wheeze plus bronchial hyperresponsiveness), and allergy did not increase. The severity of bronchial responsiveness did not change significantly in any symptom group.
Young adults showed a significant increase in reporting of symptoms related to allergy but not in the prevalence of current asthma. The increase in symptoms may be due to increased awareness of asthma in this community, to changed treatment patterns, or to increased exposures to allergens.
评估成年人群中哮喘患病率在九年期间是否有所上升。
采用系列横断面研究,方案包括主观和客观测量。
西澳大利亚州的巴瑟尔顿。
1981年随机抽取553名年龄在18至55岁之间的受试者,1990年随机抽取1028名年龄在18至55岁之间的受试者。
通过自我填写问卷测量呼吸症状,通过组胺支气管激发试验测量支气管反应性,通过皮肤点刺试验测量过敏情况。
患病率上升的症状是与该人群过敏显著相关的症状。近期喘息患病率从17.5%升至28.8%(p<0.001),确诊哮喘患病率从9.0%升至16.3%(p<0.001)。年龄小于30岁的受试者中增幅最大。静息时气短和花粉症的患病率也显著上升,但运动时气短、慢性咳嗽、支气管高反应性、现患哮喘(定义为近期喘息加支气管高反应性)和过敏的患病率未增加。任何症状组中支气管反应性的严重程度均无显著变化。
年轻成年人中与过敏相关症状的报告显著增加,但现患哮喘的患病率未增加。症状增加可能是由于该社区对哮喘的认识提高、治疗模式改变或接触过敏原增加所致。