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[一项关于中国城市地区哮喘患者疾病认知与控制之间关联的多中心研究]

[A multi-center study for the association between the perception and control of disease among asthmatic patients in Chinese urban areas].

作者信息

Nong Y, Lin J T, Wang W Q, Zhou X, Wang C Z, Huang M, Cai S X, Chen P, Lin Q C, Zhou J Y, Gu Y H, Yuan Y D, Sun D J, Yang X H, Yang L, Huo J M, Chen Z C, Jiang P, Zhang J, Ye X W, Liu H G, Tang H P, Liu R Y, Liu C T, Zhang W, Hu C P, Chen Y Q, Liu X J, Dai L M, Zhou W, Huang Y J, Xu J Y

机构信息

Department of Respiratory and Critical Care Medicine, China-Japan Friendship Hospital, Beijing 100029, China.

出版信息

Zhonghua Yi Xue Za Zhi. 2017 May 16;97(18):1425-1429. doi: 10.3760/cma.j.issn.0376-2491.2017.18.015.

Abstract

To investigate the current perception of disease among asthmatic patients in Chinese urban areas, and to address its association with asthma control. This was a nationwide, multi-center, cross-sectional study covering 30 third-level, grade A hospitals in 30 provinces, municipalities and autonomous regions (not including Tibet) across Chinese mainland. The survey was carried out from October 2015 to May 2016. Asthmatic outpatients were selected to receive face-to-face questionnaire survey on asthma control including Asthma Control Test (ACT) score, classification of asthma control level[according to the Global Initiative for Asthma (GINA) 2015 classification system, as assessed by the physician completing the survey], perception of asthma (including question 1: nature of asthma as a disease; question 2: selection of first-line therapeutic agents to be regularly used daily for asthma; question 3: appropriate timing of the use of short-acting aerosols of β(2) receptor agonists; and question 4: therapeutic goals for asthma). A total of 3 875 asthmatic outpatients were included; among them, 69.0% (2 660/3 857) were aware that asthma is "an airway inflammatory disorder resulting from the combined effects of heredity and environment" ; 60.2% (2 321/3 857) considered "inhaled glucocorticoids or their compound preparations" to be the first-line therapeutic agents to be regularly used daily for patients with persistent chronic asthma; 85.7% (3 277/3 823) considered it appropriate to use short-acting aerosols of β(2) receptor agonists "as needed in the event of disease aggravation or acute exacerbation" ; and 75.4% (2 761/3 661) were aware that asthma "can be adequately or completely controlled in the long term" . The ACT score[20 (16, 23) vs 19 (16, 22) points; =-3.928, <0.001]and asthma control rate (29.92% vs 25.31%; χ(2)=8.616, =0.003) were significantly higher, and the rate of uncontrolled asthma (19.92% vs 23.48%; χ(2)=6.267, =0.012) was significantly lower among the 2 660 (69.0%) patients correctly answering question 1 than among the 1 197 (31.0%) patients giving incorrect answer. The ACT score[21 (17, 23) vs 19 (15, 22) points; =-9.190, <0.001] and asthma control rate (32.66% vs 22.20%; χ(2)=49.614, <0.001) were significantly higher, and the rate of uncontrolled asthma (18.40% vs 25.00%; χ(2)=24.267, <0.001) was significantly lower among the 2 321 (60.2%) patient correctly answering question 2 than among the 1 536 (39.8%) patients giving incorrect answer. Compared to previous surveys, there has been improved perception of disease among asthmatic patients in Chinese urban areas. Correct perception of disease is favorable for improving asthma control level.

摘要

为调查中国城市地区哮喘患者对疾病的当前认知情况,并探讨其与哮喘控制的关联。这是一项全国性、多中心的横断面研究,涵盖中国大陆30个省、直辖市和自治区(不包括西藏)的30家三级甲等医院。调查于2015年10月至2016年5月进行。选取哮喘门诊患者进行关于哮喘控制的面对面问卷调查,包括哮喘控制测试(ACT)评分、哮喘控制水平分类[根据全球哮喘防治创议(GINA)2015分类系统,由完成调查的医生评估]、对哮喘的认知(包括问题1:哮喘作为一种疾病的本质;问题2:日常常规使用的一线治疗药物选择;问题3:β₂受体激动剂短效气雾剂的恰当使用时机;问题4:哮喘的治疗目标)。共纳入3875例哮喘门诊患者;其中,69.0%(2660/3857)知晓哮喘是“一种由遗传和环境共同作用导致的气道炎症性疾病”;60.2%(2321/3857)认为“吸入性糖皮质激素或其复方制剂”是持续性慢性哮喘患者日常常规使用的一线治疗药物;85.7%(3277/3823)认为在“病情加重或急性发作时按需”使用β₂受体激动剂短效气雾剂是恰当的;75.4%(2761/3661)知晓哮喘“长期可得到充分或完全控制”。在正确回答问题1的2660例(69.0%)患者中,ACT评分[20(16,23)分对19(16,22)分;z=-3.928,P<0.001]和哮喘控制率(29.92%对25.31%;χ²=8.616,P=0.003)显著更高,未控制哮喘率(19.92%对23.48%;χ²=6.267,P=0.012)显著更低。在正确回答问题2的2321例(60.2%)患者中,ACT评分[21(17,23)分对19(15,22)分;z=-9.190,P<0.001]和哮喘控制率(32.66%对22.20%;χ²=49.614,P<0.001)显著更高,未控制哮喘率(18.40%对25.00%;χ²=24.267,P<0.001)显著更低。与既往调查相比,中国城市地区哮喘患者对疾病的认知有所改善。正确的疾病认知有利于提高哮喘控制水平。

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