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[参与初级卫生保健的哮喘儿童和青少年的临床演变及营养状况]

[Clinical evolution and nutritional status in asthmatic children and adolescents enrolled in Primary Health Care].

作者信息

Morishita Rosinha Yoko Matsubayaci, Strufaldi Maria Wany Louzada, Puccini Rosana Fiorini

机构信息

Departamento de Pediatria, Escola Paulista de Medicina, Universidade Federal de São Paulo (Unifesp), São Paulo, SP, Brasil.

Departamento de Pediatria, Escola Paulista de Medicina, Universidade Federal de São Paulo (Unifesp), São Paulo, SP, Brasil.

出版信息

Rev Paul Pediatr. 2015 Dec;33(4):387-93. doi: 10.1016/j.rpped.2015.02.005. Epub 2015 Aug 10.

Abstract

OBJECTIVE

: To evaluate the clinical evolution and the association between nutritional status and severity of asthma in children and adolescents enrolled in Primary Health Care.

METHODS

: A retrospective cohort study of 219 asthmatic patients (3-17 years old) enrolled in Primary Care Services (PCSs) in Embu das Artes (SP), from 2007 to 2011. Secondary data: gender, age, diagnosis of asthma severity, other atopic diseases, family history of atopy, and body mass index. To evaluate the clinical outcome of asthma, data were collected on number of asthma exacerbations, number of emergency room consultations and doses of inhaled corticosteroids at follow-up visits in the 6th and 12th months. The statistical analysis included chi-square and Kappa agreement index, with 5% set as the significance level.

RESULTS

: 50.5% of patients started wheezing before the age of 2 years, 99.5% had allergic rhinitis and 65.2% had a positive family history of atopy. Regarding severity, intermittent asthma was more frequent (51.6%) and, in relation to nutritional status, 65.8% of patients had normal weight. There was no association between nutritional status and asthma severity (=0.409). After 1 year of follow-up, 25.2% of patients showed reduction in exacerbations and emergency room consultations, and 16.2% reduced the amount of inhaled corticosteroids.

CONCLUSIONS

: The monitoring of asthmatic patients in Primary Care Services showed improvement in clinical outcome, with a decreased number of exacerbations, emergency room consultations and doses of inhaled corticosteroids. No association between nutritional status and asthma severity was observed in this study.

摘要

目的

评估纳入初级卫生保健的儿童和青少年哮喘患者的临床演变情况以及营养状况与哮喘严重程度之间的关联。

方法

对2007年至2011年在巴西圣保罗州恩布达斯阿尔蒂斯市初级保健服务机构登记的219例哮喘患者(3至17岁)进行回顾性队列研究。二手数据包括:性别、年龄、哮喘严重程度诊断、其他特应性疾病、特应性家族史和体重指数。为评估哮喘的临床结局,收集了第6个月和第12个月随访时哮喘发作次数、急诊就诊次数以及吸入性糖皮质激素剂量的数据。统计分析包括卡方检验和Kappa一致性指数,显著性水平设定为5%。

结果

50.5%的患者在2岁前开始出现喘息,99.5%患有过敏性鼻炎,65.2%有特应性家族史阳性。关于严重程度,间歇性哮喘更为常见(51.6%),就营养状况而言,65.8%的患者体重正常。营养状况与哮喘严重程度之间无关联(P = 0.409)。随访1年后,25.2%的患者哮喘发作次数和急诊就诊次数减少,16.2%的患者吸入性糖皮质激素用量减少。

结论

初级保健服务机构对哮喘患者的监测显示临床结局有所改善,哮喘发作次数、急诊就诊次数和吸入性糖皮质激素剂量均减少。本研究未观察到营养状况与哮喘严重程度之间存在关联。

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