Department of Public Health and Clinical Medicine, Occupational and Environmental Medicine, Umeå University, Umeå, Sweden.
Pediatr Allergy Immunol. 2010 Aug;21(5):859-66. doi: 10.1111/j.1399-3038.2010.01055.x. Epub 2010 Apr 15.
Several studies have reported diverging trends in the prevalence of asthma and wheeze. The aim of this study was to investigate the clinical expression of childhood asthma in 1996 and 2006 by studying asthma morbidity, treatment, and environmental exposures in school children with physician-diagnosed asthma and wheeze, respectively. All children enrolled in first or second grade (7-8 yr-old) in three municipalities in northern Sweden were invited to a questionnaire study in 1996 and 2006, respectively. In 1996, 3430 (97%) participated; and in 2006, 2585 (96%) participated. The same parental completed questionnaire, including the ISAAC questions, was used in both surveys. Physician-diagnosed asthma was reported at 5.7% in 1996 and 7.4% in 2006. A significantly greater proportion of children with asthma were using inhaled corticosteroids (ICS) in 2006, 67% vs. 55% in 1996. This increase was parallel to a major decrease in severe asthma symptoms such as disturbed sleep because of wheeze (49% vs. 38%) and troublesome asthma (21% vs. 11%). The prevalence of current wheeze among the asthmatics decreased significantly; however, this was seen only among children not using ICS. Parental smoking decreased significantly as did the proportion living in damp buildings. In conclusion, although asthma remains a major public health issue in school age children, children with asthma had less respiratory symptoms and a better asthma control in 2006 compared to 1996. This parallels with an increase in treatment with ICS, more beneficial environmental conditions, and an increased diagnostic intensity resulting in a larger proportion of children with mild symptoms being diagnosed as having asthma.
一些研究报告称，哮喘和喘息的患病率呈下降趋势。本研究旨在通过研究分别诊断为哮喘和喘息的学龄儿童的哮喘发病率、治疗方法和环境暴露情况，探讨儿童哮喘在 1996 年和 2006 年的临床表现。瑞典北部三个城市的所有一年级或二年级（7-8 岁）儿童均被邀请参加 1996 年和 2006 年的问卷调查研究。1996 年，3430 名（97%）儿童参加了研究；2006 年，2585 名（96%）儿童参加了研究。两个调查都使用了相同的父母完成的问卷，包括 ISAAC 问卷。1996 年和 2006 年，报告的哮喘发病率分别为 5.7%和 7.4%。2006 年，使用吸入性皮质类固醇（ICS）的哮喘儿童比例显著增加，67%比 1996 年的 55%。这种增加与严重哮喘症状（如因喘息而睡眠紊乱（49%比 38%）和哮喘麻烦（21%比 11%）的显著减少平行。目前哮喘儿童喘息的患病率显著下降，但这仅见于未使用 ICS 的儿童。父母吸烟显著减少，居住在潮湿房屋中的比例也有所下降。总之，尽管哮喘仍是学龄儿童的一个主要公共卫生问题，但与 1996 年相比，2006 年哮喘儿童的呼吸道症状较少，哮喘控制较好。这与 ICS 治疗的增加、更有利的环境条件以及诊断强度的增加平行，导致更多症状较轻的儿童被诊断为哮喘。
