Bonner Sebastian, Matte Thomas, Rubin Mitchell, Fagan Joanne K, Ahern Jennifer, Evans David
Center for Urban Epidemiologic Studies, The New York Academy of Medicine, New York, NY 10029-5293
J Asthma. 2006 Jan-Feb;43(1):31-5. doi: 10.1080/02770900500446989.
Although studies have documented underuse of controller medications and overuse of short-acting inhaled ss(2)-agonist among children with persistent asthma in disadvantaged communities, the persistence of oral ss(2)-agonist use in pediatric practice has not been studied since inhaled short-acting ss(2)-agonists became widespread. We describe medications used to treat asthma among children 3 to 5 years of age at 10 Head Start and other subsidized preschool centers in East and Central Harlem, New York City. We interviewed 149 parents/guardians of children who were identified as having probable asthma based on physician's diagnosis, persistent symptoms, hospitalization, and medication use. We classified 86 of the 149 children (58%) as having current persistent asthma. Only 15 of them (17%) were reported to have used controller medications at least 5 days/week in the last 4 weeks-only 2 of whom used inhaled corticosteroids. By contrast, 53 children (62%) used oral ss(2)-agonist in the last 4 weeks, often (72%) in conjunction with nebulized or inhaled short-acting ss(2)-agonist. Use of oral ss(2)-agonist was associated with more severe symptoms. This study documents the continued widespread use of oral ss(2)-agonist for treatment of children in a low-income community with high prevalence of asthma.
尽管有研究记录了在弱势社区中患有持续性哮喘的儿童中，控制药物使用不足以及短效吸入β₂-激动剂使用过度的情况，但自从吸入短效β₂-激动剂广泛应用以来，儿科实践中口服β₂-激动剂的持续使用情况尚未得到研究。我们描述了纽约市哈莱姆东区和中区10个“启智计划”及其他补贴性学前中心中3至5岁儿童用于治疗哮喘的药物。我们采访了149名儿童的家长/监护人，这些儿童根据医生诊断、持续症状、住院情况和用药情况被确定可能患有哮喘。我们将149名儿童中的86名（58%）归类为当前患有持续性哮喘。据报告，其中只有15名（17%）在过去4周中至少每周5天使用控制药物，其中只有2名使用吸入性糖皮质激素。相比之下，53名儿童（62%）在过去4周中使用了口服β₂-激动剂，通常（72%）与雾化或吸入短效β₂-激动剂联合使用。口服β₂-激动剂的使用与更严重的症状相关。这项研究记录了口服β₂-激动剂在哮喘患病率高的低收入社区中持续广泛用于治疗儿童的情况。
