McWhorter W P, Polis M A, Kaslow R A
Division of Hematology-Oncology, University of Utah School of Medicine, Salt Lake City 84132.
Am Rev Respir Dis. 1989 Mar;139(3):721-4. doi: 10.1164/ajrccm/139.3.721.
Adult asthma has been the subject of relatively few epidemiologic studies; separation from chronic obstructive pulmonary disease (COPD) has been difficult. Utilizing a cohort of 14,404 subjects, 25 to 74 yr of age, from the First National Health and Nutrition Survey (NHANESI, 1971-75) traced by the NHANESI Epidemiologic Followup Survey (1982-84), we investigated prevalence, incidence, predictors, and consequences of adult asthma. Cases were based on subject reports of active doctor-diagnosed asthma (without COPD). Differentiation of asthma from COPD was partially successful, as suggested by correlations with smoking status and pulmonary symptoms, but was imperfect, as suggested by subsequent hospital experience. Followup interview underestimated interim hospital diagnosis of asthma by 28%. Prevalence of active asthma at NHANESI among U.S. adults was estimated at 2.6%, and followup incidence of new-onset asthma at 2.1/1,000/yr. Low income was the strongest independent predictor of asthma; the higher rates seen in blacks were largely explained by their lower income. Males and females had equal prevalence rates, but females had higher incidence rates. Asthma prevalence and incidence were independent of age and cigarette smoking. Asthmatics were often hospitalized with various lung conditions in the followup period, but unlike those with COPD, did not have a significantly increased risk of death.
成人哮喘一直是相对较少的流行病学研究的主题；将其与慢性阻塞性肺疾病（COPD）区分开来一直很困难。利用来自第一次全国健康和营养调查（NHANESI，1971 - 1975年）的14404名年龄在25至74岁的受试者队列，并由NHANESI流行病学随访调查（1982 - 1984年）进行追踪，我们调查了成人哮喘的患病率、发病率、预测因素及后果。病例基于受试者关于医生确诊的活动性哮喘（无COPD）的报告。从吸烟状况和肺部症状的相关性来看，哮喘与COPD的区分部分成功，但从随后的住院经历来看并不完美。随访访谈低估了哮喘的中期医院诊断率28%。在美国成年人中，NHANESI时活动性哮喘的患病率估计为2.6%，新发性哮喘的随访发病率为2.1/1000/年。低收入是哮喘最强的独立预测因素；黑人中较高的发病率在很大程度上是由他们较低的收入所解释的。男性和女性的患病率相等，但女性的发病率较高。哮喘的患病率和发病率与年龄及吸烟无关。在随访期间，哮喘患者常因各种肺部疾病住院，但与COPD患者不同的是，其死亡风险并未显著增加。
