Wang W Y, Lin J T, Zhou X, Chen P, Wan H Y, Yin K S, Ma L J, Wu C G, Li J, Liu C T, Xie H, Tang W, Huang M, Chen Y, Liu Y H, Song L Q, Chen X L, Liu G L, Zhang Y M, Li W, Sun L C
Department of Pulmonary and Critical Care Medicine, China-Japan Friendship Hospital, Beijing 100029, China.
Department of Respiratory Diseases, Shanghai General Hospital of Shanghai Jiaotong University, Shanghai 201315, China.
Zhonghua Yi Xue Za Zhi. 2020 May 12;100(18):1426-1431. doi: 10.3760/cma.j.cn112137-20191117-02498.
To investigate the prevalence of asthma among the elderly people in China and to analyze the clinical features, self-management and cognitive level of elderly asthma patients. According to the multi-stage random cluster sampling methods, a total of 164 215 subjects were visited by a questionnaire in the last epidemiology survey from eight provinces (Beijing, Shanghai, Guangdong, Liaoning, Henan, Shanxi, Jiangsu, Sichuan provinces) and seven regions (north, northeast, southern china, east, south, southwest and northwest) in China from February 2010 to August 2012. 2 034 were diagnosed as asthma. The elderly patients aged ≥65 years were selected from the 2 034 asthma patients. The clinical characteristics, comorbidities, the status of asthma control and self-management and insights of the disease in elderly asthma patients were analyzed. Among the 2 034 asthma patients, 584 (28.7%) were elderly asthmatics aged ≥65 years old and 1 450 (71.3%) were<65 years old. In the elderly asthma group, Early-onset asthma accounted for 439 (75.2%) and 145 (24.8%) were late-onset. The common clinical manifestations of elderly asthma patients were: chest distress 395 (67.6%), wheezing 304 (52.1%), cough 298 (51.0%). Common comorbidities of elderly asthmatics were: chronic obstructive pulmonary disease 144 (24.7%), allergic rhinitis 122(20.9%), gastroesopheal reflux disease (GERD) 114(19.5%), allergic conjunctivitis 86 (14.7%), eczema 82 (14.0%), chronic bronchitis 76 (13.0%). The Asthma Control Test (ACT) scores of elderly asthmatics and non-elderly asthmatics were (18.5±3.2) and (21.7±3.4) respectively. There was a significant difference between the two groups (0.042). Of the elderly asthmatics, only 13 (2.2%) patients monitored daily using a peak flow meter. 93 (15.9%) patients aware that asthma was characterized by chronic airway inflammation. 64 (11.0%) asthmatics understood that the treatment goal. The clinical manifestations of elderly asthmatics are atypical, especially paroxysmal wheezing. Asthma in elderly people causes more comorbidities and mortality. The self-management and cognitive level of patients with asthma needs to be improved.
调查我国老年人哮喘的患病率,并分析老年哮喘患者的临床特征、自我管理情况及认知水平。按照多阶段随机整群抽样方法,在2010年2月至2012年8月对来自中国八个省份(北京、上海、广东、辽宁、河南、山西、江苏、四川)和七个地区(华北、东北、华南、华东、中南、西南、西北)的164215名受试者进行了末次流行病学调查问卷调查。共确诊2034例哮喘患者。从这2034例哮喘患者中选取年龄≥65岁的老年患者,分析老年哮喘患者的临床特征、合并症、哮喘控制状况、自我管理情况及对疾病的认知情况。在2034例哮喘患者中,584例(28.7%)为年龄≥65岁的老年哮喘患者,1450例(71.3%)年龄<65岁。在老年哮喘组中,早发型哮喘占439例(75.2%),晚发型145例(24.8%)。老年哮喘患者的常见临床表现为:胸闷395例(67.6%)、喘息304例(52.1%)、咳嗽298例(51.0%)。老年哮喘患者的常见合并症为:慢性阻塞性肺疾病144例(24.7%)、过敏性鼻炎122例(20.9%)、胃食管反流病(GERD)114例(19.5%)、过敏性结膜炎86例(14.7%)、湿疹82例(14.0%)、慢性支气管炎76例(13.0%)。老年哮喘患者和非老年哮喘患者的哮喘控制测试(ACT)得分分别为(18.5±3.2)和(21.7±3.4)。两组间差异有统计学意义(P = 0.042)。在老年哮喘患者中,仅13例(2.2%)患者每日使用峰流速仪进行监测。93例(15.9%)患者知晓哮喘以慢性气道炎症为特征。64例(11.0%)哮喘患者了解治疗目标。老年哮喘患者的临床表现不典型,尤其是阵发性喘息。老年人哮喘导致更多的合并症和死亡。哮喘患者的自我管理和认知水平有待提高。