Jarvis Debbie, Newson Roger, Janson Christer, Corsico Angelo, Heinrich Joachim, Anto Josep M, Abramson Michael J, Kirsten Anne-Marie, Zock Jan Paul, Bono Roberto, Demoly Pascal, Leynaert Bénédicte, Raherison Chantal, Pin Isabelle, Gislason Thorarinn, Jogi Rain, Schlunssen Vivi, Svanes Cecilie, Watkins John, Weyler Joost, Pereira-Vega Antonio, Urrutia Isabel, Gullón Jose A, Forsberg Bertil, Probst-Hensch Nicole, Boezen H Marike, Martinez-Moratalla Rovira Jesús, Accordini Simone, de Marco Roberto, Burney Peter
Population Health and Occupational Disease, National Heart and Lung Institute, Imperial College, London, UK.
MRC-PHE Centre for Environment and Health, Imperial College London, London, UK.
Thorax. 2018 Jan;73(1):37-48. doi: 10.1136/thoraxjnl-2016-209596. Epub 2017 Oct 3.
Change in the prevalence of asthma-like symptoms in populations of ageing adults is likely to be influenced by smoking, asthma treatment and atopy.
The European Community Respiratory Health Survey collected information on prevalent asthma-like symptoms from representative samples of adults aged 20-44 years (29 centres in 13 European countries and Australia) at baseline and 10 and 20 years later (n=7844). Net changes in symptom prevalence were determined using generalised estimating equations (accounting for non-response through inverse probability weighting), followed by meta-analysis of centre level estimates.
Over 20 years the prevalence of 'wheeze' and 'wheeze in the absence of a cold' decreased (-2.4%, 95% CI -3.5 to -1.3%; -1.5%, 95% CI -2.4 to -0.6%, respectively) but the prevalence of asthma attacks, use of asthma medication and hay fever/nasal allergies increased (0.6%, 95% CI 0.1 to 1.11; 3.6%, 95% CI 3.0 to 4.2; 2.7%, 95% CI 1.7 to 3.7). Changes were similar in the first 10 years compared with the second 10 years, except for hay fever/nasal allergies (increase seen in the first 10 years only). Decreases in these wheeze-related symptoms were largely seen in the group who gave up smoking, and were seen in those who reported hay fever/nasal allergies at baseline.
European adults born between 1946 and 1970 have, over the last 20 years, experienced less wheeze, although they were more likely to report asthma attacks, use of asthma medication and hay fever. Decrease in wheeze is largely attributable to smoking cessation, rather than improved treatment of asthma. It may also be influenced by reductions in atopy with ageing.
老年人群中哮喘样症状患病率的变化可能受到吸烟、哮喘治疗和特应性的影响。
欧洲共同体呼吸健康调查从20 - 44岁成年人的代表性样本（来自13个欧洲国家和澳大利亚的29个中心）中收集了关于哮喘样症状患病率的信息，基线时以及10年和20年后（n = 7844）。使用广义估计方程（通过逆概率加权处理无应答情况）确定症状患病率的净变化，随后对中心层面的估计值进行荟萃分析。
在20年期间，“喘息”和“无感冒时喘息”的患病率下降（分别为 - 2.4%，95%置信区间 - 3.5%至 - 1.3%； - 1.5%，95%置信区间 - 2.4%至 - 0.6%），但哮喘发作、使用哮喘药物以及花粉症/鼻过敏的患病率增加（0.6%，95%置信区间0.1%至1.11%；3.6%，95%置信区间3.0%至4.2%；2.7%，95%置信区间1.7%至3.7%）。与第二个10年相比，第一个10年的变化相似，但花粉症/鼻过敏情况除外（仅在第一个10年出现增加）。这些与喘息相关症状的下降主要出现在戒烟人群中，并且在基线时报告有花粉症/鼻过敏的人群中也有出现。
在过去20年中，出生于1946年至1970年之间的欧洲成年人喘息情况有所减少，尽管他们更有可能报告哮喘发作、使用哮喘药物和花粉症。喘息的减少主要归因于戒烟，而非哮喘治疗的改善。这也可能受到随着年龄增长特应性降低的影响。
