[波兰罗兹省普通人群中哮喘的诊断不足与治疗不足]
[The underdiagnosis and undertreatment of asthma in general population of the Lodz Province (Poland)].
作者信息
Kupryś-Lipińska Izabela, Elgalal Anna, Kuna Piotr
出版信息
Pneumonol Alergol Pol. 2010;78(1):21-7.
INTRODUCTION
Hundreds of studies investigating the epidemiology of asthma in various populations have been conducted in the past 30 years, yielding a large body of interesting data, including data on prevalence and risk factors. Less information is, however, available on the accurate diagnosis of asthma and its correct treatment. Epidemiological studies of the prevalence of asthma in the general population was conducted between 1998 and 2000 in the Lodz Province in Poland. The present analysis is an evaluation of the detectability and treatment of this disease.
MATERIAL AND METHODS
The study group consisted of 1522 randomly selected residents of the Lodz Province aged 3 to 80 years. The demographics and medical history were collected using standardised questionnaires. All the respondents underwent skin prick tests and screening spirometry. Additional diagnostic tests were performed in doubtful cases.
RESULTS
Complete data collected from 1340 subjects (1057 adults and 283 children) were included in the analysis. The prevalence of asthma was calculated at 7.3% in adults and 8.5% in children. The accurate diagnosis of asthma had not been made in 71% of symptomatic children and 49% of the adults. Forty-eight percent of adult asthmatics had not used any antiasthmatic medication in the previous 12 months. Subjects suffering from asthma had most commonly used the following drugs in the previous 12 months: beta(2)-agonists (46.8%), anticholinergics (13%), inhalation glucocorticoids (36.4%), oral glucocorticoids (16.9%), parenteral glucocorticoids (3.9%), xanthine derivatives (33.8%) and cromones (11.7%).
CONCLUSIONS
The results of this study reveal shortcomings in the healthcare system which require appropriate actions aimed at early diagnosis and improvement of allergy treatment before the patient's health deteriorates irreversibly.
引言
在过去30年里,已经开展了数百项针对不同人群哮喘流行病学的研究,产生了大量有趣的数据,包括患病率和风险因素的数据。然而,关于哮喘的准确诊断及其正确治疗的信息较少。1998年至2000年期间,在波兰罗兹省对普通人群哮喘患病率进行了流行病学研究。本分析是对该疾病的可检测性和治疗情况的评估。
材料与方法
研究组由1522名随机选取的罗兹省3至80岁居民组成。使用标准化问卷收集人口统计学和病史信息。所有受访者均接受皮肤点刺试验和筛查肺功能测定。对可疑病例进行额外的诊断测试。
结果
分析纳入了从1340名受试者(1057名成年人和283名儿童)收集的完整数据。计算得出成年人哮喘患病率为7.3%,儿童为8.5%。71%有症状的儿童和49%的成年人未得到哮喘的准确诊断。48%的成年哮喘患者在过去12个月内未使用任何抗哮喘药物。哮喘患者在过去12个月内最常使用的药物如下:β2受体激动剂(46.8%)、抗胆碱能药物(13%)、吸入性糖皮质激素(36.4%)、口服糖皮质激素(16.9%)、胃肠外糖皮质激素(3.9%)、黄嘌呤衍生物(33.8%)和色酮类药物(11.7%)。
结论
本研究结果揭示了医疗保健系统中的不足之处,需要采取适当行动,旨在早期诊断并在患者健康不可逆转地恶化之前改善过敏治疗。