Hyrkäs Henna, Ikäheimo Tiina M, Jaakkola Jouni J K, Jaakkola Maritta S
Center for Environmental and Respiratory Health Research, University of Oulu, P.O. Box 5000, FI-90014 Oulu, Finland; Medical Research Center, University of Oulu and Oulu University Hospital, Finland.
Respir Med. 2016 Apr;113:1-7. doi: 10.1016/j.rmed.2016.02.005. Epub 2016 Feb 23.
In the northern hemisphere people are exposed recurrently to cold air and asthmatics experience more respiratory symptoms. We hypothesized that subjects with poor asthma control are more prone to experience cold weather-related respiratory symptoms than those with good asthma control.
A population-based cross-sectional study of 1995 adult asthmatics (response rate 40.4%) living in the Northern Finland was conducted using a questionnaire where cold weather-related respiratory symptoms as well as questions related to asthma control were inquired. The Asthma Control Test (ACT) was defined based on five questions (disadvantage and occurrence of asthma symptoms, waking up because of asthma symptoms, use of rescue medication and self-assessment of asthma control during the past 4 weeks), and was divided into quartiles.
Cold weather-related respiratory symptoms were more frequent among asthmatics with poorly controlled asthma (ACT Q1 vs. ACT Q4); adjusted prevalence ratio (PR) for shortness of breath (men 1.47, 95% confidence interval 1.22-1.77; women 1.18, 1.07-1.30), cough (men 1.10, 0.91-1.34; women 1.18, 1.08-1.30), wheezing (men 1.91, 1.31-2.78; women 1.48, 1.17-1.87), phlegm production (men 1.51, 1.06-2.14; women 1.62, 1.27-2.08) and chest pain (men 4.47, 1.89-10.56; women 2.60, 1.64-4.12). The relations between asthma control and symptom occurrence seemed stronger among smokers than never smokers and subjects with body mass index (BMI) below and above 25-30.
Our study provides new evidence that subjects whose asthma is poorly controlled are more prone to experience cold weather-related respiratory symptoms and even a slight worsening of asthma control increases symptom prevalences.
在北半球，人们反复暴露于冷空气之中，哮喘患者会出现更多呼吸道症状。我们推测，哮喘控制不佳的患者比哮喘控制良好的患者更容易出现与寒冷天气相关的呼吸道症状。
采用问卷调查的方式，对居住在芬兰北部的1995名成年哮喘患者（应答率40.4%）进行了一项基于人群的横断面研究，问卷中询问了与寒冷天气相关的呼吸道症状以及与哮喘控制相关的问题。哮喘控制测试（ACT）基于五个问题（哮喘症状的不利影响和发生情况、因哮喘症状醒来、使用急救药物以及过去4周内对哮喘控制的自我评估）进行定义，并分为四分位数。
哮喘控制不佳的患者（ACT Q1与ACT Q4）出现与寒冷天气相关的呼吸道症状更为频繁；呼吸急促的调整患病率比值（PR）（男性1.47，95%置信区间1.22 - 1.77；女性1.18，1.07 - 1.30）、咳嗽（男性1.10，0.91 - 1.34；女性1.18，1.08 - 1.30）、喘息（男性1.91，1.31 - 2.78；女性1.48，1.17 - 1.87）、咳痰（男性1.51，1.06 - 2.14；女性1.62，1.27 - 2.08）和胸痛（男性4.47，1.89 -
10.56；女性2.60，1.64 - 4.12）。在吸烟者中，哮喘控制与症状发生之间的关系似乎比从不吸烟者更强，且在体重指数（BMI）低于和高于25 - 30的人群中也是如此。
我们的研究提供了新的证据，表明哮喘控制不佳的患者更容易出现与寒冷天气相关的呼吸道症状，即使哮喘控制稍有恶化也会增加症状患病率。
