Nordlund Björn, Melén Erik, Schultz Erica S, Grönlund Hans, Hedlin Gunilla, Kull Inger
Astrid Lindgren Children's Hospital, Karolinska University Hospital, Stockholm, Sweden; Department of Women's and Children's Health, Karolinska Institutet, Stockholm, Sweden.
Institute of Environmental Medicine, Karolinska Institutet, Stockholm, Sweden; Centre for Allergy Research, Karolinska Institutet, Stockholm, Sweden; Sachs' Children's Hospital, Södersjukhuset, Stockholm, Sweden.
Respir Med. 2014 Aug;108(8):1234-7. doi: 10.1016/j.rmed.2014.05.015. Epub 2014 Jun 4.
The World Health Organization (WHO) recently proposed a new definition of severe asthma to facilitate standardized characterization of patients, and enable more accurate estimations of the prevalence of severe asthma. The aim of this study was to estimate the prevalence of severe asthma according to the WHO definition in children aged 12 years, in Stockholm, Sweden.
The birth cohort BAMSE enrolled 4089 children during 1994-96. Parental questionnaires provided information on asthma-related symptoms, diagnosis and medication from 3015 enrolled children at the age of 12 years. Severe asthma was defined as the presence of asthma, as well as continuous treatment with inhaled corticosteroids and long-acting beta-2 agonists, based on information from the Swedish prescribed drug register demonstrating prescriptions of at least 800 μg budesonide daily (or equivalent).
The prevalence of asthma was 11% among 12-year-olds (n = 329). Based on information from the Swedish prescribed drug register, seven children with asthma fulfilled the definition of severe asthma. The estimated prevalence corresponds to 0.23% (95% CI, 0.06-0.4) of the population, or 2.1% (95% CI, 0.5-3.7) of children with asthma. Based on assessed markers of asthma control, 3/7 with severe asthma were considered to have controlled asthma and 4/7 had partly or uncontrolled asthma.
Severe asthma appears rare both among 12-year-old schoolchildren with asthma and in the general population. Combining self-reported information from a population-based birth cohort with data from a drug register seems trustworthy in estimating severe asthma as defined by the WHO.
世界卫生组织（WHO）最近提出了重度哮喘的新定义，以促进对患者进行标准化特征描述，并更准确地估计重度哮喘的患病率。本研究的目的是根据WHO的定义，估计瑞典斯德哥尔摩12岁儿童中重度哮喘的患病率。
BAMSE出生队列在1994 - 1996年期间纳入了4089名儿童。父母问卷调查提供了3015名12岁已登记儿童与哮喘相关的症状、诊断和用药信息。根据瑞典处方药登记册显示的每日至少800μg布地奈德（或等效药物）的处方信息，重度哮喘被定义为患有哮喘，并持续接受吸入性糖皮质激素和长效β-2激动剂治疗。
12岁儿童中哮喘患病率为11%（n = 329）。根据瑞典处方药登记册的信息，7名哮喘儿童符合重度哮喘的定义。估计患病率相当于该人群的0.23%（95%CI，0.06 - 0.4），或哮喘儿童的2.1%（95%CI，0.5 - 3.7）。根据评估的哮喘控制指标，7名重度哮喘患者中有3名被认为哮喘得到控制，4名哮喘部分控制或未得到控制。
重度哮喘在12岁患哮喘的学龄儿童和普通人群中似乎都很罕见。将基于人群的出生队列中的自我报告信息与药物登记数据相结合，在估计WHO定义的重度哮喘方面似乎是可靠的。
