Ställberg Björn, Lisspers Karin, Hasselgren Mikael, Johansson Gunnar, Svärdsudd Kurt
Department of Public Health and Caring Sciences, Family Medicine and Clinical Epidemiology, Uppsala University, Uppsala, Sweden.
Respir Med. 2007 Oct;101(10):2076-83. doi: 10.1016/j.rmed.2007.05.016. Epub 2007 Jul 12.
The severity of asthma varies in patients in primary care. The aim of this study was to identify factors related to asthma severity in a primary care setting.
In this cross-sectional asthma study a random sample of 1477 patients, aged 15-45 years, from 42 primary health care centres received two questionnaires: one disease oriented and one quality of life oriented, MiniAQLQ. A classification of the asthma severity similar to the GINA guidelines was made with the information obtained from the questionnaire. The classification was based on current treatment, use of rescue medication, night symptoms, emergency consultations and use of oral steroids for treatment of exacerbations.
Thirty-five per cent of the women and 24% of the men were classified as having severe asthma. Women used more inhaled corticosteroids, more often took long acting beta-2 agonists or a leukotrien antagonist in addition to corticosteroids, experienced more frequent night awakenings and were more often smokers than men. In a multivariable analysis, female sex increased the odds of having severe asthma by 60% as compared with male sex, age by 3% per year, not having the asthma prescription filled owing to cost by 59%, daily smoking by 66% and pollen allergy by 85%.
Female sex, age, pollen and pet allergy, not having the asthma prescription filled owing to cost, and daily smoking were all independently associated with asthma severity.
在初级保健中，哮喘患者的病情严重程度各不相同。本研究的目的是确定在初级保健环境中与哮喘严重程度相关的因素。
在这项横断面哮喘研究中，从42个初级保健中心随机抽取了1477名年龄在15至45岁之间的患者，他们收到了两份问卷：一份是面向疾病的，一份是面向生活质量的，即MiniAQLQ。根据从问卷中获得的信息，进行了与全球哮喘防治创议（GINA）指南类似的哮喘严重程度分类。该分类基于当前治疗、急救药物的使用、夜间症状、急诊就诊以及使用口服类固醇治疗急性加重情况。
35%的女性和24%的男性被归类为患有重度哮喘。女性比男性更多地使用吸入性皮质类固醇，除皮质类固醇外更常使用长效β2激动剂或白三烯拮抗剂，夜间醒来更频繁，而且吸烟者也更多。在多变量分析中，与男性相比，女性患重度哮喘的几率增加了60%，年龄每增加一岁几率增加3%，因费用问题未填写哮喘处方的几率增加59%，每日吸烟的几率增加66%，花粉过敏的几率增加85%。
女性、年龄、花粉和宠物过敏、因费用问题未填写哮喘处方以及每日吸烟均与哮喘严重程度独立相关。
