Hu Zhizhen, Xuan Jianwei, Zhao Haijin, Dong Hangming, Yu Changhui, Cai Shaoxi, Gao Yue, Li Liran, Hu Xiaohan
Department of Respiratory and Critical Care Medicine, Chronic Airways Diseases Laboratory, Nanfang Hospital, Southern Medical University, Guangzhou, China.
Health Economic Research Institute, Sun Yat-sen University, Guangzhou, China.
Ann Transl Med. 2022 Jan;10(2):75. doi: 10.21037/atm-21-6470.
There are no large sample, epidemiological data describing initial asthma severity and change. We used a large health care database to examine asthma severity at initial diagnosis, and the changes in severity over the first year of management.
The clinical data of patients diagnosed with asthma for the first time were collated from the SuValue electronic medical database. The following inclusion criteria were applied: (I) patients who were 14 years or older at the time of first diagnosis; (II) initial diagnosis occurred between Jan 2001 and Mar 2019; (III) patients were followed up for at least 12 months; (IV) patients had follow-up visits every 3 months. Disease severity at diagnosis and at each follow-up visit, medications prescribed were collated and analyzed.
A total of 7,654 adult patients with newly diagnosed asthma from tertiary hospitals (26.38%) and secondary hospitals (73.62%), who were followed up for at least 12 months, were included in this retrospective analysis. Approximately 54% of patients were females and the largest age group was over 60 years old (37.66%). Nearly 16% of patients were moderate to severe asthma initially. The proportions of patients with moderate and severe asthma decreased during the first 6 months, and remained stable thereafter. At the end of the 1-year follow-up period, 2.7% of patients had severe asthma. Patients with mild asthma tended to continue to have mild asthma in the following 3 months (>76.19%). However, of the patients with mild or moderate asthma at 3 months, 92.85% and 75.1%, respectively, experienced maintenance and reduction in severity and had mild asthma by 12 months. 1.26% and 3.15% of patients with mild or moderate asthma, respectively, progressed to severe asthma by 12 months.
Patients with mild asthma did not progress but rather, remained stable with mild asthma over the year. A proportion of patients diagnosed with moderate and severe asthma remained stable over a 1-year period. Further studies should be conducted to examine the clinical features of newly diagnosed patients with severe asthma without reduction in severity in order to facilitate intensive treatment and reduce the disease burden for these patients.
目前尚无描述哮喘初始严重程度及变化的大样本流行病学数据。我们利用一个大型医疗保健数据库来研究哮喘初诊时的严重程度以及管理第一年中严重程度的变化。
从苏值电子医疗数据库中整理首次诊断为哮喘的患者的临床数据。应用以下纳入标准：（I）首次诊断时年龄在14岁及以上的患者；（II）初始诊断发生在2001年1月至2019年3月之间；（III）患者随访至少12个月；（IV）患者每3个月进行一次随访。整理并分析诊断时及每次随访时的疾病严重程度、所开药物。
本回顾性分析纳入了7654例来自三级医院（26.38%）和二级医院（73.62%）的新诊断哮喘成年患者，这些患者至少随访了12个月。约54%的患者为女性，最大年龄组为60岁以上（37.66%）。近16%的患者初诊时为中度至重度哮喘。中度和重度哮喘患者的比例在最初6个月内下降，此后保持稳定。在1年随访期结束时，2.7%的患者患有重度哮喘。轻度哮喘患者在接下来的3个月内倾向于继续患有轻度哮喘（>76.19%）。然而，在3个月时患有轻度或中度哮喘的患者中，分别有92.85%和75.1%的患者病情维持稳定或减轻，到12个月时患有轻度哮喘。轻度或中度哮喘患者分别有1.26%和3.15%在12个月时进展为重度哮喘。
轻度哮喘患者在一年中病情未进展，而是保持轻度哮喘且病情稳定。一部分诊断为中度和重度哮喘的患者在1年期间病情保持稳定。应进一步开展研究，以检查新诊断的重度哮喘患者病情未减轻的临床特征，以便进行强化治疗并减轻这些患者的疾病负担。
