Urrutia Isabel, Aguirre Urko, Sunyer Jordi, Plana Estel, Muniozguren Nerea, Martínez-Moratalla Jesús, Payo Félix, Maldonado José Antonio, Anto Josep Maria
Servicio de Neumología, Hospital de Galdakao, Bizkaia, España.
Arch Bronconeumol. 2007 Aug;43(8):425-30. doi: 10.1016/s1579-2129(07)60098-6.
The rise in the prevalence of asthma in the second half of the 20th century has not been evenly distributed according to recent surveys. We assessed changes in the prevalence of asthma after a period of 9 to 10 years in a cohort of young adults in the Spanish arm of the European Community Respiratory Health Survey (ECRHS).
The ECRHS-II is a multicenter cohort study taking place in 27 centers around Europe, with Spanish centers located in Albacete, Barcelona, Galdakao, Huelva, and Oviedo. The ECRHS questionnaire was administered to individuals who had participated in the first phase of the survey; spirometry and methacholine challenge tests were also performed according to the published protocol.
Among new smokers, the prevalence of wheezing in the last 12 months increased from 10% to 33%, while the frequency of phlegm production rose from 8% to 22% (P< .05). In ex-smokers, the prevalences of wheezing and phlegm production decreased from 21% to 12% and from 15% to 8%, respectively (P< .05). Symptom prevalences remained similar for never smokers, although the frequency of diagnosed asthma rose from 4% to 7% (P< .05). After adjusting for smoking, age, sex, and center, we found no significant differences in the frequency of symptoms or asthma, even when the phrase bronchial hyperreactivity was included in the definition. However, the rate of reported asthma rose annually by 0.34% (95% confidence interval [CI], 0.20%-0.48%), while diagnosed asthma rose by 0.26% (95% CI, 0.13%-0.39%) and treated asthma by 0.16% (95% CI, 0.07%-0.25%).
Increased prevalence rates of asthma diagnosis and treatment have been detected, but the rates of reported symptoms have remained similar, consistent with the assumption that more persons are being classified as asthmatics.
根据近期调查，20世纪下半叶哮喘患病率的上升分布并不均匀。我们评估了欧洲共同体呼吸健康调查（ECRHS）西班牙队列中一组年轻成年人在9至10年期间哮喘患病率的变化。
ECRHS-II是一项多中心队列研究，在欧洲各地的27个中心开展，西班牙的中心位于阿尔瓦塞特、巴塞罗那、加尔达考、韦尔瓦和奥维耶多。对参与调查第一阶段的个体进行ECRHS问卷调查；还根据已发表的方案进行了肺活量测定和乙酰甲胆碱激发试验。
在新吸烟者中，过去12个月内喘息的患病率从10%升至33%，而咳痰频率从8%升至22%（P<0.05）。在戒烟者中，喘息和咳痰的患病率分别从21%降至12%和从15%降至8%（P<0.05）。从不吸烟者的症状患病率保持相似，尽管确诊哮喘的频率从4%升至7%（P<0.05）。在对吸烟、年龄、性别和中心进行调整后，我们发现症状或哮喘的频率没有显著差异，即使在定义中纳入支气管高反应性这一表述也是如此。然而，报告的哮喘发病率每年上升0.34%（95%置信区间[CI]，0.20%-0.48%），确诊哮喘上升0.26%（95%CI，0.13%-0.39%），接受治疗的哮喘上升0.16%（95%CI，0.07%-0.25%）。
已检测到哮喘诊断和治疗的患病率增加，但报告的症状发生率保持相似，这与更多人被归类为哮喘患者的假设一致。
